We all work hard to understand our patient and determine his simillimum, yet our cases often get spoiled due to mismanagement or poor follow up. We are thankful to Master, Dr. M. L. Sehgal for guiding us on this issue. There are various ways to select a medicine, but somehow we feel that, while following a case, we all have to follow an identical pattern. Here are some pointers for doing a good follow up as per the guidelines of Revolutionized Homoeopathy:
Since the basis of prescribing according to Revolutionized Homoeopathy is the mental state, the first thing we note in the follow up is the change in the mental state of the patient. If a patient’s mental state before prescribing was anxiety that his problem could lead to cancer, then after the remedy we should ask if he is still worried about getting this disease, and then ask about changes in other mental or physical symptoms. We also have to understand if the rubrics on which we have selected the medicine still exist or not. If the mental state is same as it was during the first case taking, then we can think of changing the potency.
Master, Dr. M. L. Sehgal had taught us that, in the majority of failures of cases, a physician changes the medicine and seldom thinks of changing the potency. So he has asked us to exhaust all the available potencies before discarding the medicine.
If a patient says there is some change in the mental state, then we have to look for changes that occurred in the other symptoms that were presented at the first consultation. We must analyze his physical wellbeing, such as fatigue, prostration, or tiredness feeling in the bones and muscles.
General condition of the patient:
In every case, irrespective of the nature of the sickness, it is important to note if there is any effect on the overall energy level of the mind and body.
Energy level of mind:
To assess if the sickness has affected the mind we have to ask the patient if he has felt some changes in his mental faculties after becoming sick. Some patients can clearly describe the changes and some are not fully prepared to answer such questions, or are not aware if there has been a change in their mental faculties. It could be a cause of worry for a patient and he wishes that with the improvement in his physical problem, he would gets back the ability of his mind to perform normally.
Those who can clearly describe their state may say that, before the sickness, the level of concentration, grasping power, or memorizing things was good but that level has gone down. The patient may say, “Earlier, it was easier for me to do mental work for a long time without getting exhausted, but now I get easily tired or feel exhausted and I’m not able to continue to work mentally after a short period.”
From the above example, we see that after the medicine, this level of energy at the mental level should start becoming normal with the improvement in health. Sometimes a patient tells you that the energy level of his mind has improved dramatically, whereas there is a little change at the physical level.
To access the level of energy at the physical level:
We may ask a patient how much energy he feels in the body after becoming sick. In more than 95% of cases patients can easily tell how much their energy has been reduced at the physical level due to which, they are not able to perform their day to day work. After the medicine, we must ask the patient if he feels some change in energy level. It has been seen that even if the medicine has failed to show any significant change in the sickness, still the patient feels a change in his energy level.
Change in the Mood/temperament
When asked about the changes in mood because of the sickness, 70% of patients are not able to recognize the change. They may simply say, “There is nothing wrong with my mood.” Mood/temperament means, calmness, mildness, depression, frustration, contentedness, discontent, destructiveness, anger, irritability, positive or negative attitude.
Next is Recurrence of complaints:
- Intensity of the complaint.
- Time taken for the recovery.
iii. If the remedy given is a Simillimum, then the cure takes place mainly in two ways:
First Action & Second Action:
First action: Immediate relief in physical as well as mental suffering, which means a feeling of total well being.
Second action: Expulsion of the toxin from the body.
In both the actions, the feeling of well-being should remain there.
Other vital points to take care of are:
- Keep your eyes on the intensity, duration and frequency of expulsion (discharges) taking place during the second action.
- The next point is to keep track if the expulsion is taking place in the right direction (Hering’s law of cure).
- Is everything going according to the tenets of homeopathy, ie, the case is moving towards recovery.
- If the patient starts feeling restless immediately after the expulsion and asks you for some immediate help, then there is a need to stop the action of the wrong medicine or potency by changing the medicine or potency.
- Discharges have to take place from the five natural outlets: nose, mouth, anus, urethra and skin. Toxins are expelled as per the location of the diseases. These are signals of a curative process. Each phase will be lesser in intensity, duration and frequency than the previous one.