Before examination, it is most important to ask some genuine questions from the sick person as he/she interacts with a person from whom he/she wants to take some help regarding sickness. Pay more attention on patient’s sign and symptoms (sign is what you observe in the patient and symptom is what patient tells you). It is also important to listen patient’s experience regarding the sickness from which he/she is suffering from. It will be more helpful to diagnose. See carefully the sign of a child or a person who is unable to speak.


There are some basic things which must be followed when a sick person has been examined/ questioned.

  • He/she (sick person) should in comfortable position.
  • Maintain privacy while questioning. Use door curtain or screen etc for this purpose.
  • Keep all records of a sick person as it helps in his/her further treatment.
  • Always focus on his/her problems and ask the question in orderly manner.
  • If a patient has severe bleeding, unconsciousness, convulsions or shock, treat him/her first. After treatment, go for taking history.
  • Examine the patient where adequate light and ventilation available. If a patient cannot remember the exact date of occurring the sickness, he/she should be remembered few important events or festivals so that he/she can remember the period from when the sickness started.
  • While examining children and infants, all clothes must be removed.


                    Also try to take other information besides history or complaint of illness as the other information may contribute to the development of his/her present illness.



    General Information:    It is more informative about sick person and provides an idea about illn

    A database should be prepared containing sick person’s name, age, sex, marital status, address, date, single, widow, occupation, religion etc. If a sick person is a child, write down such information from his/her parents or the person who has brought.There are certain factors which may develop or influence the illness like:

    • in certain age and sex.
    • in certain religious practices.
    • in certain occupation
    • On the basis of questions and examinations, the illness can easily be determined.


    Main Problems:              

    Main problems are those difficulties which a sick person is facing in his/her day to day life. The difficulties /problems may be more than one.

    Try to find out most serious difficulty and will be considered as main problem. Write the fact exactly wherever patient has told. The fact not to be manipulated by own ideas.

     If a patient is suffering from cough, cold, headache etc for about 15 days or more but suddenly fresh blood coming out with cough is really a serious problem than normal cough and headache.


    History of present illness:

     The patient to be asked that when and how that disease started. Try to know the back history as much as he/she can tell. Ask when he/she felt such sign and symptom first time. Continue the quarries as and when patient finishes his/her experiences.

     If patient has a complaint of pain, then ask about:

  • Site of pain. Keep his/her finger to locate exact area/ place of pain. Whether the pain is spreading, if yes, which side?
  • How is the pain type? Whether it is dull or sharp, burning, heavy, cramping etc.
  • Frequency and duration of pain.
  • Severity of pain. Does it wake him/her up?
  • Position in which the pain started. Sitting, standing, rest, walking, running, working or after taking food.
  • Position which make the condition better? Whether while taking rest or lying one side or any  other means to reduce the pain.
  • The things which make condition worse like pain is much while walking, eating, working etc.
  • What effort has been done by him/her to reduce the pain? Whether taken any medicine or   any other help taken from somebody to reduce pain.
  • Any different signs he/she noticed? Like weight loss, burning/ pain sensation while passing    urine, loss of appetite or changes in bowel habits or change in sleeping pattern etc.


    If a person suffering from breathing problem:

     Ask there is any pain in chest? While coughing the chest pain become worse? Does there any improvement while lying one side, if yes, then it is starting stage of pneumonia.

      if chest pain starts during running , walking, jumping, doing exercise or climbing up stairs and vanished on taking rest for a few minutes means heart disease may developing.

    If a person is suffering from cough:-

    Ask whether he/she get disturbed in sleeping. Color of mucus is white or mixed with blood or yellowish color.

     Excessive smoking leads to cough in morning.

     Sputum mixed with blood, weight loss, evening fever, loss of appetite and person is a chain smoker and attained age above 40 years, there may be Tuberculosis or lungs cancer.


    If any discharge or fluid coming out from ear or wound, then ask or see:

    • Quantity of discharge an
    • Color and smell of fluid

    If there is any lump

     Know about:

    • When the lump was noticed?
    • Size of lump when it was noticed first time and compare with size of today.
    • Any special thing noticed about the lump.

    Past history of illness:

    It is very important aspect to ask about any past illness. It will help to diagnose the disease easily as it may be in continuation of past illness. For that ask the following:

    • What was the disease in the past? When had it occur? Whether the same problem was there before?
    • Has the patient approached any doctor or traditional healers? What he/she had diagnosed?
    • Did patient have any serious injury in the past?


    Present status of the health:

     Ask about any allergy or reaction of drug, food, fluid, dust or suffering from Asthma (Breathing difficulty). If yes,

    When and how does trouble arise? Also try to find out when he/she used to take drink (alcohol) or smokes (cigarettes, bidi, hukka etc). If drinks alcohol then from how long time and how much quantity, like ½ or ¼ glass.


    Ailment in family:   Some diseases are genetic. These diseases come from father, forefather and even from mother’s family. The diseases may be Asthma, Diabetes, Hyper Tension, Tuberculosis, Cancer, Leprosy, Epilepsy and contagious diseases. Ask what was the reason of death of forefathers? Is there any family member suffering from any of above disease.

    For examination of pregnant woman: Ask-

    • Has she any history of blood stain discharge from genitals, bleeding during pregnancy before delivery starts, abortion etc.
    • Whether she has ever had any cesarean for delivery.
    • Has she ever had blood test during pregnancy which said mismatching with baby? (ABO – Rh incompatibility)
    • Has she any history of twin pregnancy or wrong position of baby before delivery?
    • Has she any history of prolapsed uterus or retroverted uterus?
    • Has she lost any baby during pregnancy?
    • Has she any ectopic pregnancy in the past or any miscarriage?
    • When is baby due, to take birth according to last menstrual period.

    Examining General Condition of a sick person:

                    For examining a sick person, use sensory organ such as ear, nose, hand and brain. See carefully to the patient before touching. Observe how much he/she is sick or weak. Pay attention to his/her movements, breathings mental status. Also look for any sign of dehydration.

                    Observe the sick person’s nourishment status whether well-nourished or poor nourished. Whether he/she has lost weight. If a person is losing weight gradually over a long period of time, he/she may have any chronic disease.

          When a person is sick, his/her colour of skin and eyes become pale. Also palm of hands, sole of feet, the finger nails or inside of lips and eye lids become yellowish in colour.

    • Yellow colour of nails and eye lids is a sign of “Anemia”.
    • Shining of skin becomes lighter in case of Tuberculosis and Kwashiorkor.
    • In starvation skin colour becomes dark.
    • If lips and finger nails become bluish in colour, it indicates any respiratory disease or heart problem. Blue gray colour of an unconscious child is a sign of cerebral malaria.
    • Yellowish colour of skin, nails, eyes may indicates disease of liver (Jaundice/Hepatitis) or Amoebic abscess or problem in gall bladder.
    • Neonates are more vulnerable from this disease.
    • Cool, moist skin with grayish white coloring often means a person is in shock.

    Also record vital signs of a sick person. Such as:

  • Temprature
  • Pulse
  • Respiration
  • Blood Pressure.


                                                                                                                                                                     By  Arun Kr Tripathi