How should a patient be examined?

Here’s a concise, systematic approach to examining any patient—whether it’s for a routine check‐up or diagnostic workup:

1. Preparation & Rapport
– Wash hands, don gloves as needed.
– Introduce yourself, confirm patient identity (name, DOB).
– Explain the purpose and sequence of the exam; obtain consent.
– Ensure privacy and adequate lighting; have patient in a gown if required.

2. General Inspection & Vital Signs
– Observe overall appearance: posture, gait, level of distress, nutrition, hygiene.
– Record temperature, pulse, respiratory rate and blood pressure; note SpO₂ if relevant.
– Check height, weight and calculate BMI.

3. Head‐to‐Toe Physical Exam
A. Head & Neck
– Inspect scalp, hair, facial symmetry; palpate lymph nodes, thyroid.
– Examine eyes (PERRL, fundi), ears, nose, throat and oral mucosa.
B. Chest & Lungs
– Observe respiratory pattern; percuss and auscultate all lung fields bilaterally.
C. Cardiovascular
– Inspect precordium; palpate PMI, pulses (radial, femoral, dorsalis pedis).
– Auscultate heart in all four areas (aortic, pulmonic, tricuspid, mitral), noting rate, rhythm and any murmurs.
D. Abdomen
– Inspect for distension, scars; auscultate bowel sounds in all quadrants.
– Percuss for tympany vs. dullness; palpate lightly then deeply for tenderness or masses.
E. Extremities & Peripheral Vascular
– Check joint range of motion, muscle bulk and tone.
– Assess edema, skin changes, capillary refill and peripheral pulses.
F. Neurological Screen
– Assess mental status, cranial nerves, motor strength, sensation, reflexes, gait and coordination.
G. Skin
– Inspect entire skin surface for rashes, lesions, color changes and turgor.

4. Focused Systems or Special Tests
– Tailor additional maneuvers to presenting complaints (e.g., CVA tenderness, meningeal signs, joint special tests, pelvic exam).

5. Documentation & Next Steps
– Record all findings immediately—normal and abnormal.
– Summarize impressions, recommend further investigation (labs, imaging) or referrals.
– Discuss findings and plan with the patient, answering any questions.

By following this head-to-toe, reproducible sequence you’ll ensure no key system is missed—and you’ll build trust by communicating clearly at each step.

IN HOMOEOPATHY
Below is the classic structure for a homeopathic patient examination—rooted in Organon principles and lectures by Stuart Close and J.T. Kent.

1. Establish the Purpose
“The purpose of a homeopathic examination is to elicit every symptom—mental, emotional and physical—in the patient’s own language so these can be compared with the materia medica for remedy selection.”

2. Open‐Ended Case‐Taking
• Invite the patient (and family if needed) to narrate complaints without interruption, using their exact words for key phrases.
• Exhort slow, thorough description to capture nuances of sensation, location, intensity and concomitants.
• Note modalities—what makes symptoms better or worse (e.g., heat, cold, motion, time of day).

3. Systematic Symptom Classification
Divide your notes into columns or headings, for rapid visual scanning:
• Date/Prescription (to track progress)
• Emphatic headings (mental, general, local)
• Detailed symptom entries (verbatim when possible)

4. Mental & Emotional Sphere
• Mood (anxious, irritable, apathetic, fearful)
• Thought processes (obsessions, clarity, memory lapses)
• Desires/aversions (food, thirst, temperature, company vs. solitude)

5. Physical Generals
• Thermals (hot vs. chilly), thirst (quantity, frequency, temperature of fluids), sweat (profuse vs. scanty).
• Stools, urine, sleep patterns and dreams.
• Energy levels, posture, gait.

6. Local/Objective Signs
• Inspection: skin, tongue, eyes, nails, gait.
• Palpation/percussion as needed (abdomen, lymph nodes).
• Vital signs: pulse quality, blood pressure, respiration.

7. Concomitants & Peculiarities
• Any symptom that accompanies the chief complaint but seems unrelated (e.g., a headache whenever the back pain flares).
• Strange, rare, peculiar symptoms carry the greatest weight in remedy selection.

8. Miasmatic & Constitutional Assessment
• Identify dominant miasm (psoric, sycotic, syphilitic) based on history of recurrent patterns and depth of disease.
• Note constitutional type—tall vs. short, lean vs. stout, swift vs. slow metabolism.

9. Repertorization & Remedy Confirmation
• After full symptom capture, select rubrics in a repertory, giving priority to totality of picture and highest‐grade peculiarities.
• Cross-check final remedy choice in the materia medica for confirming key keynote symptoms.

10. Record‐Keeping & Follow-Up
• Keep prescription dates and potencies clearly logged.
• Re-examine every 2–4 weeks: note changes in symptom intensity, disappearance of key rubrics, emergence of new modalities.
• Adjust potency or change remedy based on evolving totality.

By meticulously documenting subjective and objective data in the patient’s own words, then classifying and repertorizing, a homeopath arrives at the single most similar remedy for lasting cure.