The anamnesis (from ancient Greek ἀνά aná , German 'auf' and μνήμη mnémē , German 'memory, memory' ) or previous history is the professional inquiry of potentially medically relevant information by specialist staff (e.g. a doctor ). Either the patient answers ( personal history ) or a third person ( external history ) answers . The goal is usually to record the medical history of a patient in the context of a current illness.
The anamnesis is the essential basis for making a diagnosis and is of great importance in all medical disciplines. It can include questions such as: B. according to previous illnesses and allergies , family illnesses, occupation, medication intake, risk factors, sexual behavior, travel behavior and subjective complaints.
The term “anamnesis” does not appear in the Corpus Hippocraticum . The Hippocratic doctor does not question the patient systematically, but only sporadically; the medical history is not used for diagnosis, but for prognosis . The first work, which deals exclusively with the questioning of the sick, comes from Rufus of Ephesus .
In the Middle Ages , the anamnesis played no role as a means of making a diagnosis or prognosis. Only Rhazes used the term again like Rufus. He complains that doctors use knowledge that they have acquired from third parties about the patient in order to astonish him with supposed medical knowledge. Only Montanus calls, the doctor must "[...] with the patients themselves talk" to learn everything, "which for the detection of the disease is important." This is the first time that the anamnesis is linked to the diagnosis.
In the 17th and 18th centuries, the collection of the disease and medical history became a fixed and required part of the diagnosis. Girolamo Cappivaccio and Possevinus write the first monographs with which the anamnesis becomes a targeted anamnesis.
In his medical histories, Herman Boerhaave puts the chronologically ordered biographical anamnesis before the examination findings . For Georg Ernst Stahl and his followers, the anamnesis is a kind of confession , since “people will eventually get sick for their sins”. In the late Baroque era, the anamnesis is assigned to pathology . It does not matter whether the history is identified through questions or anamnestic signs and symptoms . In Diderot's Encyclopédie , the anamnestic signs belong to semiotics , on a par with the diagnostic and prognostic signs. German treatises on the practice of the “health exam” from the Age of Enlightenment combine the patient's medical history, cathartic self-presentation and the patient's current status.
Forms of anamnesis
The content of an anamnesis corresponds to the momentary memory and the survey is always situation-dependent. However, the basic process is often the same: You are asked about current and past physical complaints, previous treatments and medication taken. Information about physical stress during work or leisure time, eating habits or stays abroad should also provide information on the causes of health disorders. Further parts of the anamnesis are questions about the psychological state and social position of the patient. Depending on the content of the survey, one differentiates between the following forms:
- Psychosocial anamnesis,
- Family history,
- social anamnesis (also social anamnesis),
- sexual history (also sexual history),
- Addiction history,
- biographical anamnesis, general anamnesis,
- Medication history,
- physical history,
- vegetative anamnesis,
- Nutritional history.
Furthermore, one can differentiate according to who the information comes from and speak accordingly of personal or third-party anamnesis.
Personal and external anamnesis
The personal history is the result of questioning the patient. The biographical anamnesis also includes the entire life story of the patient. A careful survey takes into account biological , psychological and social - i. H. biopsychosocial aspects. The information obtained in this way often allows conclusions to be drawn about risk factors and causal relationships.
The external anamnesis arises from the questioning of people from the patient's environment. It can bring important additional information to light, since outsiders notice things that the patient himself cannot or does not want to perceive. It is often the only means of obtaining information about the medical history of people who cannot communicate adequately. The external anamnesis is also important with regard to information that the patient cannot provide himself, for example because it only occurs during sleep.
Family and social history
Questions are asked about family status, profession and religious affiliation, among other things. The family history is part of the personal or third-party history. Information about a patient's relatives can provide clues about hereditary diseases and susceptibility to certain diseases. This applies, for example, to the increased occurrence of tumors , allergies , infectious diseases , cardiovascular diseases or mental disorders .
With the social history , the social position of the patient should be recorded.
Medical history in the ambulance service
In the ambulance service, a comprehensive anamnesis is part of the work on the patient. There are various schemes that are common in the preclinical area:
The schemes play different levels of relevance. The SAMPLER scheme, for example, is a supplement to the ABCDE scheme. The OPQRST scheme is based on the SAMPLER scheme.
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