What should be observed by the Physician himself on a patient?

In homeopathic case‐taking data come from three sources—what the patient tells you, what attendants report, and what you yourself observe. The last category (“objective phenomena”) is strictly limited to anything the physician can perceive directly with the five senses. Key items include:

1. General constitution & appearance
• Body build (ectomorphic/mesomorphic/endomorphic), posture, gait and bearing
• Muscle tone (flaccid, tense) and involuntary movements (tremors, tics)
• Facial expressions (animated, dull, anxious) and eye contact (avoidant, staring)

2. Speech & behaviour
• Rate, volume, fluency, coherence of speech
• Gestures, automatisms, psychomotor agitation or retardation
• Level of interaction (maintains conversation vs. mute or monosyllabic)

3. Skin, nails & appendages
• Complexion (pallor, cyanosis, jaundice), turgor, moisture or dryness
• Rashes, eruptions, bruises or scars—exact location and character
• Nail texture (brittle, spoon‐shaped), hair loss or distribution

4. Eyes, mouth & orifices
• Conjunctival injection, pupil size and reaction to light
• Tongue coating, color, moisture and tremor
• Nasal or aural discharges—quantity, color, odor

5. Secretions & excretions
• Perspiration (odorous, profuse, scant), body odor
• Urine (color, turbidity), stool (consistency, odor), sputum, vaginal or urethral discharges

6. Vital signs & basic vitals
• Temperature (local or general—chill vs. flush), pulse (rate, rhythm, volume)
• Respiration (rate, depth, any noticeable effort)
• Blood pressure, if equipment is available

7. Appetite, thirst & digestion
• Actual behaviour at the interview: does the patient sip water, nibble a snack?
• Visible signs of anorexia or polyphagia (e.g. food wrappers, drink bottles)

8. Sleep & circadian features
• Demeanor on waking—alert or disoriented
• Signs of insomnia (dark circles, yawning) or hypersomnia (snores, drools)

Why this matters
• These are unfiltered “rubrics” of your case—no one else can reliably report them.
• They form the objective half of your totality and must precisely match the remedy’s provings.
• Subtle, characteristic observations (e.g. “patient rubs ear repeatedly” or “speaks with rising inflection”) often tip the balance when two remedies seem similar.

By systematically noting every perceptible sign—without interpretation or leading questions—you build the most accurate, full‐bodied symptom picture for selecting the true simillimum.