Family history in homoeopathic case taking: three generations, drawn properly

In homoeopathic case taking, a complaint grows in a constitution, and the constitution has a history older than the patient. Diabetes down the father’s side, asthma and eczema down the mother’s, a run of early strokes — that is the ground the present picture stands on. It shapes what you ask next and how you weigh what you hear.

Classical schools read that ground differently. Some read it miasmatically; others give it less weight. Either way the reading is the doctor’s, made in the consultation. A family history is background, not a forecast. It does not tell you what the patient will get, and no prescription rewrites what a family carries.

Three generations around the patient is the clinical standard, and it is enough.

• The patient’s generation: brothers and sisters, and the spouse — a shared household, if not shared blood.
• The generation above: father and mother, and the uncles and aunts on both sides — chacha and bua, mama and mausi.
• The generation above that: all four grandparents, dada and dadi, nana and nani.
• The generation below: sons and daughters.

Start with parents, siblings, spouse and children, then work outward. Ask about each side separately — “your father’s side first” — because patients merge the two if you let them, and the pattern you need usually sits on one side.

• The condition: in plain clinical terms, with the family’s own word beside it when the two differ.
• Onset age: diabetes at 38 is a different story from diabetes at 70. It is the detail most often left out.
• Living or deceased: and if deceased, roughly when, and at what age.
• Unknown names still count: a maternal grandfather nobody can name, who had “chest trouble” in his fifties, is still a relative with a history. Record him without the name.

Record what the case needs and stop there. A relative’s illness is sensitive personal data about someone who never sat in your chair. The clinic holds it in trust; keep only what has a clinical use.

• “Sugar” is not always diabetes: nor is “BP” always hypertension, or “weakness” anything at all. Ask what they took for it — tablets, insulin, nothing — and when it began.
• Some conditions don’t get named: tuberculosis, epilepsy, mental illness and cancer often arrive as “that illness” or a silence. Ask plainly, later in the visit, and note what is hearsay.
• One side is remembered better: usually the side the patient grew up with. The other comes back as “all fine, I think”, which is not the same as healthy. Mark it not known and ask again when a parent comes along.
• “None” and “not asked” look the same on paper: a blank line can mean either. A grandmother recorded at 90 with no conditions shows you asked.
• Half-siblings, step-relations and adoption: an adopted patient’s blood relatives may be unknown. Say so; don’t record the adoptive family as the biological one.

A square is male, a circle female, a diamond when sex is other or not stated. A filled shape means affected. A diagonal slash through a shape means deceased. An arrow points at the patient the drawing is about. A dashed outline with a “?” is a relative whose name is not known — present and counted. Generations are numbered I, II, III down the left, oldest at the top.

Why draw it at all? Because a sentence has to be rebuilt in your head every time you read it. “F: DM (45), HTN. PGM: DM. P. uncle: DM. M: thyroid. MGM: asthma.” is accurate, and it takes a minute to see what it says. Drawn, it takes a second: three filled shapes down the father’s side, and you know which side to ask more about.

On a paper case sheet, the family history is one cramped line from the first visit. By the tenth follow-up nobody reads it, and when a brother is diagnosed next year there is nowhere to put him. A history worth keeping is structured, dated and easy to add to.

That is what the Family tree in hpills is for. It opens from a button on the patient’s file and draws the standard pedigree as you go.

• Pick relations, don’t draw: “Add a relative” offers fifteen — parents, siblings, spouse, son and daughter, all four grandparents, uncles and aunts on each side. Pick “Paternal grandmother” and she lands in the right place; parents nobody has named yet are drawn as “name not known”.
• Unknowns don’t block anything: leave the name blank; year of death is optional.
• Conditions are one tap: sixteen chips, from Diabetes and Hypertension to Thyroid, Tuberculosis and Allergy / eczema, plus “Other condition…”, each with an optional onset age.
• Read it by condition: the Family history card lists what runs in the family, most-shared first. Tap Diabetes and everyone who has it lights up in the tree.
• Copy it into the file: “Add to patient’s family history” appends a dated summary to the Family history field in the patient’s info, never overwriting what you typed. It is a copy: after later edits, copy again for a new dated block.
• One family, one tree: when a relative is also your patient, link their file. Opened from the father’s file, the same tree calls your patient “Son”, and if that relative already has a tree, the two join instead of being drawn twice.

What it does not do: print or export the drawing, draw half-siblings, twins or adoption (those go in the relative’s note), or read anything into the pattern. No miasm, no risk score, no remedy. It records and summarises; the reading stays yours. The tree is on every plan, Free included, and the changelog has the release note.

If the family line on your case sheets has been one sentence nobody rereads, give one patient a proper tree and see what you notice at the next visit. Start today at ₹0 and judge from inside, request the live demo, or see the features in detail.