Aphorism 89

Explained of Aphorism 89

Need of asking special questions. 

When the patient has finished on his own accord his story of suffering and has answered to the questions of physician, but physician thinks that he had not made complete picture of disease then he is at liberty to ask some special questions.

 Physician has to rely on patient for description of his sensation of suffering unless it is a case of malingering. Even feigned diseases can be diagnosed by close observation.

 In footnote Dr. Hahnemann gives example of special questions, avoiding its frame to be suggestive in itself, like - 

•How often are his bowels moved? What is the exact character of the stool? Did the whitish evacuation consist of mucus or faeces? Had he or had he not pains during the evacuation? What was their exact character, and where were they seated? 

•What did the patient vomit? Is the bad taste in the mouth putrid, or bitter, or sour, or what? Before or after eating, or during the repast? At what period of the day was it worst? What is the taste of what is eructated

• Does the urine only become turbid on standing, or is it turbid when first discharged? What is its color when first emitted? Of what color is the sediment?

• How does he behave during sleep? Does he whine, moan, talk or cry out in his sleep? Does he start during sleep? Does he snore during inspiration, or during expiration? Does he lie only on his back, or on which side? Does he cover himself well up, or can he not bear the clothes on him? Does he easily awake, or does he sleep too soundly?

• How often does this or that symptom occur? What is the cause that produces it each time it occurs? Does it come on whilst sitting, lying, standing, or when in motion? Only when fasting, or in the morning, or only in the evening, or only after a meal, or when does it usually appear?

• When did the rigor come on? Was it merely a chilly sensation, or was he actually cold at the same time? If so, in what parts? Or while feeling chilly, was he actually warm to touch? Was it merely a sensation of cold, without shivering? Was he hot without redness of the face? What parts of him were hot to touch? Or did he complain of heat without being hot to touch? How long did the chilliness last? How long was the hot stage? 

• When did the thirst come on during the cold stage? During the heat? Or previous to it? Or subsequent to it? How great was the thirst, and what was the beverage desired?

• When did the sweat come on - at the beginning or the end of the heat? Or, how many hours after the heat? When asleep or when awake? How great was the sweat? Was it warm or cold? On what parts? How did it smell? What does he complain of before or during the cold stage? What during the hot stage? What after it? What during or after the sweating stage? 

•In women, note the character of menstruation and other discharges, etc.