.  Past  History —Review   past   illnesses, surgical  procedures  and  dates  thereof,  and  all major  injuries. .  Family  History—Obtain  the  health  status of blood relatives, including their age if living and the  cause  of  death  if  deceased. .  Social  History—The  patient’s  personal habits, sex life, emotional adjustments, and work and  recreational  habits  are  of  importance. l  Marital  History—Health  of  spouse,  sex- ual  adjustment,  number  of  children  and  their health, and the emotional status of the marriage. NOTE:  Depending  upon  the  circumstances  and the   type   of   the   patient’s   complaint,   not   all questions are pertinent and should not be asked of  the  patient  in  every  case, .  Occupational  History—Where  the  patient works, what he or she does, who he or she works for,  how  long  in  that  position,  health  hazards in   that   area,   and   recent   changes   in   position or  authority  may  be  important  points  to explore. .   Include   past   environmental   conditions (i.e.,   foreign   countries   visited,   areas   of   the country  visited). A   comprehensive   account   of   complaints referable to each body system in logical sequence from  head  to  toe  should  be  made  a  part  of  the history.  This  review  provides  a  thorough evaluation of the past and present status of each body system. It also permits the grouping of like symptoms  and  provides  a  double  check  to prevent  omissions  of  significant  data  concerning the  present  illness  or  injury.  The  following  is merely a suggested guideline to follow and should not  be  interpreted  as  a  hard  and  fast  rule  of thumb. Again, each case is unique and should not be  stereotyped. .  Body  Weight—Determine  the  average, maximum, and least weight for the individual, and check  for  loss  or  gain  in  weight  and  the  time interval  between  such  loss  or  gain. .  Skin,  Hair,  and  Nails—Check  the  texture for   dryness,   sweating,   discolorations,   itching, changes  in  temperature,  dermatological  conditions and  therapeutic  efforts  to  control  them,  and baldness  and  itching  of  the  scalp. .  Head—Determine  if  there  are  headaches, their  frequency,  duration,  and  what  time  of  day they occur; be alert for and determine the presence or  absence  of  vertigo,  lightheadedness,  fainting, and  any  signs  of  trauma. .  Eyes—Ask  about  disturbances  in  vision, lacrimation,   itching,   photophobia,   and   pain. l  Ears-Determine  the  degree  of  deafness  (if suspected), pain, discharge, vertigo, and tinnitus. .   Nose—Note   any   discharges   or   obstruc- tions.  Ask  the  patient  if  he  or  she  is  subject  to frequent colds or allergies and if there has been any  change  in  the  sense  of  smell. .  Mouth  and  Throat—Ask  about  pain  and history   of   bleeding   gums,   sore   throats,   voice changes,  and  dysphagia  (difficulty  in  swallowing), and look for indications of dental hygiene habits. l   Neck—Determine   if   there   are   stiffness, swelling, pain and associated symptoms of lymph node  enlargement,  and  limitation  of  motion. .   Respiratory   System—Check   for   com- plaints   of   dyspnea,   orthopnea,   edema,   cough (productive  or  nonproductive,  and  if  productive, odor  and  color  as  well  as  amount  of  sputum), pain,  wheezing,  palpitation,  syncope,  cyanosis, hypertension,  hoarseness,  and  stridor  (harsh  or high-pitched  respirations). l   Cardiovascular   System—Ask   about exertional   dyspnea,   paroxysmal   nocturnal dyspnea,  chest  pain,  angina,  myocardial  infarc- tion,   claudication,   orthopnea,   varicosities, phlebitis   and   circulatory   problems   in   the extremities,  particularly  with  exposure  to  cold (Raeynaud’s),  heart  murmurs,  etc. .   Gastrointestinal   System—Ask   about changes  in  appetite,  complaints  of  dysphagia, pyrosis,  indigestion,  nausea,  vomiting,  blood  in stool   or   vomitus,   flatulence,   jaundice,   pain, changes  in  bowel  habits,  constipation,  diarrhea, and   hemorrhoids. l  Genitourinary  System—Ask  about  fre- quency  of  urination,  including  urgency,  hesita- tion, pain, blood, absence or diminishing amount, pus,  color,  and  dribbling  or  incontinence;  and check  for  past  or  present  evidence  of  sexually transmitted  diseases  (STD). 2-3