Ask more precise questions only after the patient has freely given his account.
Only after the patient has finished freely relating the pertinent information upon simply being invited to do so, and upon being prompted [with general questions], thereby providing a fairly complete image of the disease, is it allowable and indeed necessary for the physician to ask more precise and specific questions if he feels he has not yet been fully informed. 144
The patient’s own account of his sensibilities is usually the most reliable.
Of the accounts received from the patient and from others, most belief is to be attributed to the patient’s own account with respect to his sensibilities (except in feigned diseases).
144 For example: 1. How frequent are his bowel movements? What is the exact quality of the stools? Was the whitish bowel movement, mucous or fecal matter? Were there any pains upon defecation, or not? Exactly what kind of pains and where? 2. What did the patient vomit? 3. Is the vile taste in the mouth putrid, bitter, sour, or something else? Does it come before, during or after eating or drinking? At what time of the day is it the worst? What is the taste of any eructations? 4. Does the urine become cloudy on standing or is it cloudy immediately upon being passed? What is its color when it is first passed? What color is the sediment? 5. How does the patient gesticulate and express himself in his sleep? Does he whimper, groan, talk or cry out in his sleep? Does he get frightened during sleep? Does he snore on breathing in or breathing out? Does he lie only on his back, or on his side; which side? Does he cover up snugly, or can he not stand being covered? Does he wake easily, or does he sleep too soundly? How does he feel immediately after waking? 6. How often does this or that ailment occur? 7. What occasions the ailment? Does it come on while sitting, lying, standing, or with movement? Only on an empty stomach, or at least early in the morning? Only in the evening, or after a meal, or when does it usually occur? 8. When did the chill come? Was it only a chilly sensation or was the patient cold at the same time? In what parts? Or was the patient hot to the touch during the chilly sensation? Was it merely a sensation of cold without shivering? Was he hot without being flushed in the face? What parts were hot to the touch? Or did he complain about heat without being hot to the touch? How long did the chill last; how long the heat? When did the thirst come? With the chill? With the heat? Before or after the heat or the chill? How strong was the thirst and for what? When did the sweat come? At the beginning or at the end of the heat? Or how many hours after the heat? While asleep or while awake? How strong was the sweat? Was it hot or cold? On which parts? What was the odor? What ailments did the patient complain of before or with the chill? With the heat? After the heat? With or after the sweat? 9. With respect to the female gender, how are the menses or other discharges? etc.