Detailed Introduction

Abstract

The systematic history covers the following five question areas, each consisting of five individual questions:

• 1. Current complaints Case history

• 2. Previous course Case history

• 3. Social history Personal history

• 4. Health history Personal history

• 5. Family history Personal history

Rather than begin with the family history, it is more pertinent to have the patient first describe the complaints that prompted him to seek medical attention (pain, dysfunction, morphologic abnormality). The patient should be allowed to speak as freely as possible. The nature of the description often provides clues to the patient’s personality. Seriously ill patients tend to give more objective reports, whereas a tendency to offer vague or multiple complaints often signifies a neurotic component. Depressives tend to give scant information. The examiner should interrupt the spontaneous narrative with questions only in order to:

• 1. Clarify unclear statements

• 2. Elicit further information where needed

• 3. Prompt a hesitant patient to continue talking

The patient should also be asked what he believes the cause of his pain to be.