Repeated Examination of a Patient: The Important Tool for Proper Diagnosis

                Dr. Dilip Kr. Goswami*, B.A.M.S, MD (Ayurveda), Ph.D

*Corresponding Author: Dr. Dilip Kr. Goswami, Associate Professor, Agada Tantra and Vidhi Ayurveda (Toxicology and Forensic Medicine) Govt. Ayurvedic College, Guwahati, Assam, India

Received Date: February 24, 2021

Publication Date: March 01, 2021

History taking and thorough examination are the two primary and important steps of patient examination. Until and unless a proper history is taken and a thorough examination is done reaching the diagnosis is impossible. History provides information about the onset and development of the disease which helps to frame an idea on the root cause and aggravating factors and probable organ /organs involved. A thorough examination helps in confirmation of the idea developed from the history. But merely speaking to take the history of the disease and examination of the patient cannot be considered to be sufficient to reach the proper and confirm the diagnosis.

In medical practice necessity of repeated conversation with the patient about the disease and repeated examination have a major role to diagnose the patient’s condition rightly. In this connection Charaka, the father of Indian Medicine in Charaka Samhita, Chikitsasthana, Chapter 30, Sloka 306 says that, if a physician examines the condition of the disease and also the patient then there is no chance of confusion in treatment.

Repeated history taking in the form of conversation with the patient can give the following benefits –

(1)The relation between the patient and the physician will become closer. The physician will be able to go closure to the patient and will get the scope to ask more questions about the suffering of the patient.

(2)The patient will gradually become easy with the doctor, will feel familiar to talk with him, and will try to express his feelings/ideas about his condition as much as he can. Language difference/problem, if any, will gradually reduce and both the doctor and the patient will ultimately understand each other even from the movements.

Repeated examination of the patient provides the following benefits –

(1)The patient’s cooperation increases. Uneasiness resulting in involuntary muscle rigidity, the feeling of shyness, etc. are reduced and the doctor gets the scope and facility to identify the organ/system involved in the disease process with the help of proper, thorough examination. Even the minute pathology can be identified with the help of repeated examination.

(2)As the doctor visits the patient repeatedly and regularly the doctor has to think about the patient’s condition deeply which results in entry into the inside of the patient’s body and mind. This can be considered as the key to a proper diagnosis that can only lead the doctor to success in treatment. Explaining the fact Bagbhata, the author of Ashtanga Sangraha, the book written with important, time tested and applicable knowledge of Charaka and Susruta Samhita, in Sutrasthana, Chapter 22,  Sloka  18, says that, the physician who does not enter into the inside of the patient with the strength of knowledge and experience cannot treat him successfully.  

It should be understood that repeated conversation and examination of the patient is far more beneficial for the doctor to reach the right diagnosis than the laboratory investigations. Laboratory investigations can help only when the physician already develops an idea about the patient and the disease. Otherwise, there may be a wrong concept and idea leading to failure in treatment.

Let the Doctors be Dedicated and Honest in History taking, Patient Examination, and Treatment. Society always expects Quality Service from Doctors.

Volume 2 Issue 3 March 2021

©All rights reserved by Dr. Dilip Kr. Goswami.