QUESTIONS AND REFLECTIONS - BODY
Please read the following data given below and let me know what matches with your case. This data is not complete and is given as a guide to make you think of the possible conditions, factors, and complaints. During consultation mention all complaints from birth till date.
DETAILS REGARDING COMPLAINTS:
What are your complaints?
Since when are you suffering from your complaints?
If the symptom is pain, can you describe the pain according to:
Site of pain: Where is the pain?
At what time is it more or less, is it continuous?
How intense is the pain: severe, moderate, mild,
Is the pain crampy, burning, throbbing, etc. Describe its nature.
Is it radiating from one place to another? Is it at a fixed location? Is it shifting from location to location?
What are the most probable causes for your complaint? (Has it started after any particular incidence or exposure to a factor?)
Which factors increase or decrease the intensity of your sufferings?
Which are the other complaints you have along with the main complaint?
PAST HISTORY:
Blood pressure problems, either high or low.
Malaria, typhoid, jaundice, measles, chicken pox, mumps, tuberculosis.
Allergy: Food and environmental.
Cramps, Pains.
Acidity, Gas, Diarrhoea, Dysentery, Food poisoning.
Convulsions, Paralysis.
High uric acid: Gout.
Heart problems.
Fevers: Flu, Malaria, typhoid, hepatitis, etc.
Kidney stones, cysts, bleeding in urine. Urine infections.
Liver disease.
Medicinal reaction. Drug allergy.
Allergic rhinitis (colds), Bronchitis, Sinusitis, Tonsillitis, Whooping cough.
Syphillis, Gonorrhoea
Piles, fissure, fistula.
Blood transfusion.
Accidents, Injuries.
Operations, surgery.
Menstrual troubles in female.
Pregnancy troubles during and after.
Anything else?
FAMILY HISTORY OF:
Blood pressure problems, either high or low.
Diabetes, type I or II.
Heart: Heart attack, Heart failure.
Arthritis: Osteoarthritis, Rheumatoid, Gout: High uric acid, Back and neck problems.
Nutritional disorders: Rickets, Osteoporosis.
Blood: Anemia - Low hemoglobin, sickle cell, thalassemia. Bleeding tendency.
Respiratory: Sinusitis, Asthma, Bronchitis, Tuberculosis, COPD, Pneumonia.
Cancer.
Nervous System: Epilepsy, Meningitis, Paralysis, Parkinson, Alzheimer.
Psychiatric: Depression, Mania, etc.
Kidney: Stones, Renal failure. Cysts. Urine infections.
Liver: Hepatitis, Jaundice, Cirrhosis, Gallstones, Gallbladder surgery.
Skin: Warts, Corns, Eczema, Boils, Urticaria, Leprosy, Lichen Planus, Psoriasis, Cracks, etc.
Cholesterol problems.
Varicose veins, Piles, Fissure, Fistula.
Syphillis, Gonorrhoea, AIDS
Surgery.
Hospitalization.
Anything else?
PERSONAL HISTORY: -
FOOD AND DRINKS:
Please read the given list of food items and tell me whether you have a desire/craving or dislike/aversion or aggravation of symptoms or relief of symptoms by eating or drinking them.
Taste: Sweet, Sour, Spicy, Pungent, Salty, Bitter.
Fried food, Fruits, Vegetables, Lemons, Potatoes, Onions, Tomatoes, Cabbage, Beans, Peas, Vinegar, Salad, Raw Food, Nuts.
Soft Food, Solid Food, Dry Food, Liquid Food.
Hot Food, Hot Drink, Cold Food, Cold Drink.
Alcohol, Beer, Wine.
Chicken, Eggs, Fish, Meat, Pork.
Pickles, Jams, Sauces.
Colas, Ice-Cream, Tea, Coffee, Milk, Butter, Cheese, Buttermilk.
Bread, Cakes, Pastry.
Chocolate, Sugar, etc.
Addictions: Tobacco, Smoking, Alcohol, Gutkha, Pan Masala, etc.
Anything else.
GENERAL HISTORY:
Tendency of Bleeding easily.
Easy pus formation.
Do your wounds take a long time to heal? Do you have tendency for excess scar formation (keloid)?
Tendency to Cold-Coughs, Sorethroats, Diarrhoea, Hyperacidity, Headache, etc.
Are your complaints one-sided? Do they shift/alternate from one side to the other? In what manner?
FACTORS AFFECTING YOU:
While hungry, after eating, after overeating.
Belching, Passing gas, Vomiting, When constipated.
Before, During, After drinking
Before, During, After urine.
Before, During, After stool.
Before, During, After menses.
Before, During, After sleep, After afternoon nap, Loss of sleep, Yawning.
Lying, Lying on back, Lying on left or right side, Lying on abdomen, Lying with head low.
Bathing, Hot or Cold bath, Working in water, Getting feet wet,
Sweating,
Sun, Full moon, New moon, Moonlight,
Weather: Hot and Cold, Rainy, Thunderstorm, Cloudy.
Change of season, Open Air, Draft of air, Sea.
Fan, AC.
Covering during sleep: Thin bed-sheet, blanket, or shawl.
Riding in bus, car, aeroplane, boat.
Physical exertion, Mental exertion.
Sitting. Standing, Sitting erect, Walking, Stooping, Change of position, Running, Climbing stairs, Going downstairs. Raising the arms, Lowering arms. Stretching,
Morning, Afternoon, Evening, Night. Particular time aggravation.
Light, Music, Noise, Sudden noise.
Strong smell or odor. Dust, Smoke, Touch, Pressure, Massage, Tight clothes.
Looking up, Looking down, Looking from height, Looking at moving object, Movement of eyes, Opening or closing the eyes.
Coughing, Sneezing, Laughing, Talking, Listening to others talk, Reading, Writing, Combing hair, After haircut, Brushing teeth, Opening the mouth, Biting or chewing, Shaving, Blowing nose, Smoking.
Any other Symptoms you would like to mention?
