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Detailed Chronic Case Taking Questionnaire

Dear Friends,

I am posting a detailed case taking questionnaire for the benefit of all the homeopaths as well as patients.


The Chronic Case Taking Questionnaire

How well or often do the following statements describe you as a person? Please answer these statements as they apply to you most of the time i.e. over a period of several years.

Responses: never=not at all, rarely=hardly at all,
occasionally=to some extent, often=very much so,

(1) I get anxious before an important event.
(2) I have a strong craving for sweet things.
(3) My memory is not very good
(4) I often have a fear of going out, or of walking over bridges, of heights or of closed
places like elevators (lifts).
(5) I often find myself walking fast, even when there is no reason to hurry.
(6) Sometimes I have strong impulses to do strange or dangerous things but I do not
act on them.
(7) I feel more comfortable in cold, fresh air.
(8) I have bloating or diarrhea.
(9) I worry about my own health or about the well-being of my family.
(10) I am fussy about cleanliness.
(11) When I feel anxious I pace about the room, especially at night, sometimes to the
point of exhaustion.
(12) I am a terrible worrier about small things.
(13) I generally do not have much appetite, but I like to sip warm drinks frequently.
(14) I often cannot sleep at night, or I wake up with anxiety.
(15) I am worse when it is cold and better when it is hot.
(16) I have dry, flaky skin.
(17) I have suffered from depression my whole life.
(18) I have considered suicide.
(19) I feel I have to do something important with my life.
(20) Failure is my worst fear.
(21) Music is soothing to me.
(22) Generally I feel better in the summer.
(23) My aches and pains feel better at night.
(24) I crave open air.
(25) I worry about what other people think of me.
(26) I enjoy eating eggs, especially soft boiled.
(27) I work slowly, but I am reliable.
(28) I feel as if I am cracking up and won't be able to cope.
(29) I often wear socks at night because my feet are cold in bed.
(30) As a child, I had a larger than average head.
(31) I tend to put on weight easily.
(32) I am troubled by nightmares.
(33) I sleep with my knees tucked up to my chest.
(34) I have lots of moles and birth marks.
(35) I enjoy travelling.
(36) I enjoy eating chocolate.
(37) I am a perfectionist.
(38) I love a good thunderstorm.
(39) There has been a lot of cancer in my family.
(40) I put other's needs in front of my own.
(41) Injustice makes me angry.
(42) My voice is hoarser.
(43) I am sensitive to changes in the weather.
(44) I am sensitive to the suffering of others.
(45) I sometimes stammer, mispronounce words, or have to repeat a question before
answering it.
(46) I have suffered long lasting stress in my personal life.
(47) I might lose a little urine now and then, especially during coughing or sneezing.
(48) I have had warts near the tip of my fingers or on my face.
(49) I have been hurt deeply in love.
(50) I often find myself sighing.
(51) I get a lump in my throat.
(52) I hate to be consoled when I'm sad.
(53) My muscles twitch.
(54) My physical condition can change very rapidly and unpredictably.
(55) Emotional shock has caused many of my problems.
(56) I am very sensitive to pain, smells or sound.
(57) I am very talkative and tend to wander from one topic to another during a
(58) I am a jealous or envious person.
(59) I am suspicious of other people's motives.
(60) People describe me as an intense person.
(61) I can't stand to be overheated.
(62) I feel bad after waking up, either from a short or long sleep.
(63) I blush easily.
(64) I hate clothes that are too tight around my neck or chest.
(65) I don't like to speak in public, or to take on new responsibilities, but I do fine once
I get started.
(66) I am reserved or aloof, and feel more comfortable keeping people at a distance.
(67) I have poor self-confidence.
(68) I prefer small groups of close friends rather than large social gatherings.
(69) I have a low energy period from 4 pm to about 8 pm in the evening.
(70) I may get sentimental and weep when someone thanks me or expresses
(71) I dislike being alone in the house, yet I dislike staying in the same room with
(72) I frequently suffer from gas or some other kind of digestive complaints.
(73) I like to be near the ocean.
(74) My performance is erratic; sometimes very
good, sometimes bad.
(75) I have had infections or discharges from my genital organs.
(76) I am afraid of closed narrow places, such as elevators.
(77) I remember having sexual feelings a child.
(78) I tend to be lively at night, but I have a hard time getting going
in the morning.
(79) I crave oranges, or sour fruit, or like to chew on ice.
(80) I often have hot feet and like to stick them out from under the bed covers.
(81) I find it hard to cry in public even after very sad news.
(82) People talk to me about their problems, but I don't like others to console me or
make a fuss about me.
(83) I am very sensitive to being hurt or humiliated.
(84) I think about past disappointments, or hold grudges for a long time.
(85) I feel worse in the sun or when the weather warms up in summer.
(86) I get cold sores on my lips.
(87) I suffer from insomnia as a result of grief or insults.
(88) I often have a strong desire for salty things.
(89) I get irritated if I can't get things done right.
(90) I am bothered by sloppiness or inefficiency.
(91) I am an ambitious and competitive person.
(92) I have a bad temper but may feel sorry about it afterwards.
(93) I am irritated by loud noise.
(94) I feel worse in the morning.
(95) I often wake early, and have trouble falling asleep again.
(96) I tend to overindulge in food, drink, or sex.
(97) I am outgoing, and make contact easily, and have lots of friends.
(98) I am very sensitive to other people and also easily influenced by them
(99) I am fearful of the dark, or of thunderstorms, or of deep water.
(100) I readily understand other people's feelings.
(101) I like cold, juicy and refreshing things, like iced water or ice-cream.
(102) I tend to get nosebleeds or bruise easily, or have bleeding gums.
(103) I function on high energy yet I burn out easily, feeling fatigued afterwards.
(104) I get tired quickly and feel better after a short sleep.
(105) I long for affection and like to be hugged or held.
(106) My moods and inclinations change quickly.
(107) I have difficulty making decisions.
(108) When I have a problem, I feel better if I can talk to someone about it.
(109) I dislike the fat on meat, or other fatty, greasy things.
(110) I have pain or discomfort that changes locations frequently.
(111) I have nasal congestion (catarrh) which is worse in a hot room.
(112) I am sensitive to the cold, but I dislike hot, stuffy rooms, and often need
fresh air when others are comfortable.
(113) At times I lose affection for my family and friends.
(114) I have very little interest in sex.
(115) I say nasty things to my family and then feel guilty for doing so.
(116) I do not like to be cold.
(117) When I am depressed, I prefer to be left alone.
(118) I feel better after dancing, intense exercise, or listening to lively music.
(119) I feel nauseated from the smell of cooking, or lose my appetite completely.
(120) I have suffered from sluggish digestion or chronic constipation.
(121) I am afraid of sharp objects.
(122) I have low self-confidence, give in easily, and lack courage when it comes to standing up for myself, or to speaking in public.
(123) I have difficulty making up my mind, because I get caught up in the details, rather
than seeing the big picture.
(124) I feel tired or rundown, but still push myself to finish things.
(125) I tend to develop scar tissue after injuries or surgery.
(126) My hands are cold and sweaty.
(127) My nails break easily and/or my hair is fine in texture.
(128) I get infections easily.
(129) I hold in my anger or sometimes don't even realize I'm angry until
several days later.
(130) I get angry about mistreatment of me by other people.
(131) I have had styes in my eves.
(132) I tend to fantacise or dwell on sexual matters.
(133) I sometimes masturbate to fall asleep at night.
(134) I tend to itch all over my body.
(135) My bladder gives me problems.
(136) I feel sleepy during the day and sleepless at night.
(137) I am intelligent and imaginative, and I can turn useless things into something
(138) I tend to be messy or untidy.
(139) I have strong opinions and enjoy discussion and debate with others.
(140) I am outgoing and sociable.
(141) I like to eat spicy, rich food.
(142) I don't like to stand for long periods, and I prefer to slouch in the nearest
chair or couch.
(143) I often feel too hot; even in winter, or I have dry burning skin.
(144) I feel thirsty.
(145) I feel fragile like I am made of glass.
(146) I feel phoney or artificial or as if I am hiding something - people wouldn't like me if they knew what I am like.
(147) I am secretive.
(148) I hate onions or onions really upset my system.
(149) I have warts or I used to have many warts.
(150) Some of my health problems started after vaccinations.
(151) My perspiration is sweet smelling or offensive.
(152) I have dreams of falling.

After having answered the above questions, you are requested to give a slightly detailed story of your life in a chronological order. Start with your earliest childhood and then proceed forward. Give all the incidents that have had a significant influence on you. Also describe how and what you felt when those incidents were happening. Also give a detailed history of the illnesses that you have had. Are any of your current symptoms related to any of your earlier illnesses – i.e. they started after that particular illness. Mention two or three happiest moments of your life and two or three saddest ones. What made you happy or sad in those situations?

Also mention the history of major illnesses in your parents, grandparents, their brothers and sisters, your close cousins and great grandparents. Illnesses like cancer, tuberculosis, psoriasis, asthma, eczema, gonorrhoea and other sexually transmitted diseases, rheumatism, heart ailments etc. should definitely be mentioned.
  rajivprasad on 2006-10-28
This is just a forum. Assume posts are not from medical professionals.
Gud thing Rajiv !!
PANKAJ VARMA last decade
Condition of tongue is missing.
Kuldeep last decade
Dear Kuldeep,

You may add the questions pertaining to the conditions of the tongue.With collaborative effort, this can become a standard questionnaire at this site if other homeopaths and the moderator agrees.

rajivprasad last decade
very good effort indeed.
dr.sajid mahmood
drsajid last decade
For complete case taking we need to follow Kent'What the Doctor needs to know in order to make a successful prescription.'

sajjadakram635 last decade
Dear Rajiv

I am not agains a quistionaire but the biggest drawback is that patient as well prescribers get lost in only and lonely questions.

So let's patient start a thread and ask him questions and then bring specific questions. The way computer programs work. You tell about throat, program asks, if the left side is affected or right.

Then if right, what makes it worse,,, and so questions progress.

If a patients starts with a questionaire, art of homeopathy is killed. Patient's opening sentences also presnt a unique picture if one has good observation.

Last year a patient came here with a strange name, I asked why she picked that name. Her answer resolved the case was resolved and thanks were transfered.
Kuldeep last decade
Dialogue with patient is necessary.

As it is ...we start with a handicap...don't get to see the person before us. The face has so many symptoms..which we don't get to see.

sunken eyes,
wrinkled forehead,
upper lip swollen,
sub-maxillary glands swollen
etc .etc. etc.

Best wishes
Pankaj Varma
PANKAJ VARMA last decade
With a fixed questionaire, case ends bluntly with a fixed conclusion.

I really believe software at this site is suprub. Patient must be directed to this software and a way must be designed so patient can paste the questions/answers by software on the post.
Kuldeep last decade
Of course when one meets a patient face to face there are umpteen advantages.The remedy itself might be revealed by his gestures, physical structure, body language, style of talking etc.The interactive style that Kuldeep mentioned is also much easier there.

So, a detailed questionnaire, if filled by the patient along with his life history, history of diseases in himself as well as in family, reveals almost everything that a skilled homeopath needs to know.Even the miasmatic and genetic taints that the person may be carrying.Moreover, further questions (now much fewer in number just to confirm the remedy choice) will then reveal the remedy.

Any way i intend to use it.Others are welcome with their own modifications to use it.

rajivprasad last decade
Dear Rajive

Treating by materia is an art, no book or system would, should or could bind it.

Of-course one systems suits to one may not suit to others. And questions are always needed and they can take the case either way.
Kuldeep last decade
I wanted to say, they can drive the case in either direction. Questions may make a boundry to a case or just bring things one could have easily missed by not asking those specific questions.

John Stanton (he stays a close personal friend) used to get lost in the questions he asked, questions brought more questions but patient stayed mortal and symptoms stayed changing...

One dose of only one medicine would not make a patient immortal. Symptoms are changing by each second so better to find a remedy for that second.
Kuldeep last decade
Dear Kuldeep,

Case taking is an art and so is homeopathy.What may be true for John Stanton may not be true for others.I treat people online via email for over 5 years and have always been using this type of questionnaires.They have served me well as i understand what to do with this data.Besides i am not suggesting anything unusual.All online professional homeopaths use questionnaires to get the starting data and then take it from there.I know people like Elaine Lewis, Dr. Leela, Gina Tyler and so many others use these questionnaires and have a success rate close to 100%.

Any way i respect your views.To each his own style of working.There is a place for all styles i guess.Your style makes you unique i guess.

rajivprasad last decade
Yes Sir, you nailed it right here. You know where the focus is on your questions. That's why it works for you.

If I have to ask, I may ask different questions.

We all are prisoners of our experiences.

By the way I hate this Cheif Executive name but time needs it. It is a nosode agains a virus that infects each and every post. Miraculasly this remedy is working.
Kuldeep last decade
Hi Rajiv

Go ahead, and do what you feel is best.

gavinimurthy last decade
Come on Rajiv, success rate close to 100%. There are arthritis, Cancer, leaperosy, HIV and ten thousand other diseases.

Or they can make a man immortal, eventually we die in old age with failing this or that organ.
Kuldeep last decade
Success rate close to 100% in curable cases.Not 100%, because even the best doctors botch up occasionally on curable cases.

rajivprasad last decade
Upped for a patient's benefit.
rajivprasad last decade
Hi Rajiv,
Would you like me to fill out the questionnaire and send to you via your e-mail?

griff last decade
Dear Griff,

I don't mind anyone contacting me via email but it is the forum's rule that anyone coming with their problem to this forum submit the case details at the forum itself.So, i request you to fill this form and post it on the thread that you started for your case.

rajivprasad last decade
Hello again Rajiv,

I don't know if you are saying that you want me to post my questionnaire answers in the forum. If so, please let me know how to do this. It just seems live a very large document. Or feel free to post it, if it is feasible for you.
Please advise. I would like everyone to benefit from my experience if possible.
griff last decade
Physician may use the questionnaire for noting down his observations for the the patient,thus converting the symptoms in to the corresopnding rubrics, but to ask the patient to fill up the questionnaire may or may not lead to accurate drug picture of the patient.The patient bias also may enter, because of the suggestive nature of the questionaire.

In my personal opinion the subjective & objective symptoms which are strongly marked in the patient carries significant value for the basis of prescription, rest got no value in prescribing the homeopathic medicines.

There is no doubt about this that many doctors are using the qnrs, still my discussions with Dr. Kanji Lal( Late), stops me personally to provide questionaire, to the patient for filling it up.He was deadly against it.

Even if I am asking the patient to mail his detailed history. Let the patient tell me what so ever he feels,& to analyse it furher ,it is my responsibilty to extract the symptoms.
sbahl last decade
Dear Dr.Bahl,

I completely agree with you specially when it is a physical case taking that is being taken.In such meetings it is best for a homeopath to listen attentively in an unbiased manner and then ask questions in the last part of the case taking to clarify the key symptoms.But in the case of online prescribing, the homeopath loses the opportunity to obsrve a number of key symptoms.Hence a detailed questionnaire becomes a good starting point for further questioning.Besides at the end of the questionnaire, i have asked the patient to give the story of his/her life in her own words.The two sets of information is then used to elicit more information through further interaction.

This method works quite well for me.It is also a case of experience with a particular method.With more and more practice, one becomes better and better at a given style.

Dr.Kanjilal was a great homeopath and hence he must have had reasons for opposing this.But any way.That is how life is.The bouquet needs different flowers to look beautiful.As long as we all remain 'flowers' (i.e. follow the tenets of homeopathy as laid down by Hahnemann and othe great masters), it is fine i suppose.

With warm regards,

rajivprasad last decade
Can you e-mail me. My id is in my profile.
Pankaj Varma
PANKAJ VARMA last decade
brought up.

gavinimurthy last decade
Sent up for Sekir.

rajivprasad last decade

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Information given in this forum is given by way of exchange of views only, and those views are not necessarily those of ABC Homeopathy. It is not to be treated as a medical diagnosis or prescription, and should not be used as a substitute for a consultation with a qualified homeopath or physician. It is possible that advice given here may be dangerous, and you should make your own checks that it is safe. If symptoms persist, seek professional medical attention. Bear in mind that even minor symptoms can be a sign of a more serious underlying condition, and a timely diagnosis by your doctor could save your life.