There are a number of parameters to define prior to comprehending the issues presented in casetaking. Hopefully the notes below will be of some benefit.
What is a Diagnosis?
In orthodox medicine, it is implied that detection of the site and nature of the lesion, with reference to a defined anatomical region, ie location, (internal organs, external organs, tissue, blood etc) , that this is the sole purpose of the investigation to name the disease or disorder. From here on in, an existing treatment regime will be allocated dependent on the name.
In doing so, the orthodox Diagnostic definition leans heavily on predetermined criteria which in itself is subject to negative critical evaluation.
First: it is assumed that the only reality is the Organism itself, and thus all phenomena are functions or effects of altered structures of the body. Further, it is assumed that 3 causal factors are involved in making changes to the organism, bacteria/virus, pathological events and functional events.
Secondly: there is a mechanical viewpoint towards the organism/body/structure that allows for the repair of any structure, organ, lesion by localised treatment, independent of any other system or part of the body. This is the current prevailing view and the reason why specialists exist and confine their area of expertise to one location or system, independent of the rest of the organism.
To a homoeopath, the above criteria for treatment is of little use, save for knowledge of the disease process, rather than the name of the disease. Given that a homoeopath views the organism as an interdependent living singular entity, intertwined with each system, and reliant on the whole, it does not help too much in forming a diagnosis for the real illness the patient is suffering, albeit not one that has a clinical name or observed pathology.
So what is the basis for a homoeopathic investigation to make a diagnosis?
Primarily, it is an evaluation of symptoms present in this individual Organism, that reflect the internal disorder, and express the nature of the disease. This is the MOST important part of casetaking and the sole pointer towards a remedial treatment plan that will cure the patient. The nature of the diagnosis method is purely clinical. Evaluation of the symptoms that are present in the disease state, will lead to a match with a medicine that has been clinically tested and found to produce similar symptoms. Is a pathological diagnosis in homoeopathy necessary? Yes it is.
A pathological investigation is necessary to discover as much information as possible regarding what is actually occurring within the body. What processes are happening, what organs are involved and what damage has ensued. This information will inform as to supportive treatments, ie diet, surgery or replacement. It is the homoeopaths knowledge of single medicine action on particular organs or disease states, that may aid in the selection of remedies where interaction between the patient and physician is not available or if individualising pertinent symptoms cannot be elicited during case taking.
Homoeopathic evaluation, will where required, look at an aetological connection. Combined with clinical observations, the precipitating factor or type of onset will have relation or indicate a certain medicine for curative action. Hahnemann instructed that this information, where of observable clinical usefulness, be included in the Materia Medica. There is no time limit placed on the causation of the illness, observing the singular fact that causation may be responsible for the onset, although perhaps not of the presenting symptoms noted. The factor may be in the distant past, of genetic inheritance, infection, environmental, psychological, mechanical, occupational etc etc.
There is also attention paid to the constitution of the patient. People are individuals and as such will respond uniquely to a medicine that matches the symptoms presented. Homeopathic schools today, do not teach the correct understanding of constitution, and try and push medicine pictures of what a “typical” XXX “personality is like. Medicines do not have personalities. They have symptoms produced by ingesting the substance and reacting to the drug. When a symptom is produced, it will have a state of dis-ease to the economy, an altered dis-ordered exhibition of temporary derangement which will wear off in time. A drug can produce a “state” of being which is different from the patients normal constitution, or is similar to a patients constitution whilst ill.
It is worth noting that the miasmatic theory of diseases, which is really a study in disease types, the origins, the enhanced infecting agent of various types, be it of recent or generations of familial strains, this peculiar and unique form of diagnosis and acceptance that chronic disorders or disease may be the inceptor for a present illness, although not apparently related to it in terms of modern medicine acknowledgement of such.