Blog - Shilpa Bhouraskar

Acute Remedies and Chronic Remedies

Student Query

I was reading an email from one of my students where she asked me a question. She was working on her presentation on Hahnemann Chronic Miasms and wanted to know if certain remedies were acute or chronic. She referred to Hahnemann's "Acute" and "Chronic miasmatic disease classification where he mentioned a few "acute " remedies such as Coff., Bry., Ign., Ip., Cham., Acon., Arn., Rhus-t., Ant-c., etc.

So her questions were -
Do we really have acute and chronic remedies in Homoeopathy?

Can certain remedies only work in acute situations and have no effect on deeper chronic miasmatic conditions?

It was hard to just reply in a few words so I decided to create this post and provide my thoughts in detail based on my experience and research because for me Homoeopathy is a medicine of Experience.

And I did not want my students to believe things just because I said so or even Hahnemann said so...

So let's look at what experience and research shows.

The evidence through Proving

The first evidence can be found when we study provings.

When we conduct provings of unknown substances, it is seen that no proving can never bring out the same symptoms in every prover. While some general symptoms are similar, each individual prover will bring into play his own peculiarities. For the same substance one prover will bring the emotional symptoms more clearly while another would bring the chest symptoms more strongly and a third the rectal symptoms.

The proving team then put it together as if one man had proved that medicine.
So the picture of a remedy depends on how extensive the proving was irrespective of the substance proved.
Ideally every remedy needs to be proved on hundreds and hundreds of people across all demographics, at different times and places. This could possibly allow a full expression of the whole nature of the remedy. And how it affects the entire person and manifests through every organ of the body.

But unfortunately, most of our provings are patchy so the scope of application of majority of our remedies is restricted to acute therapeutic or specific action.

Interestingly when some of these remedies are reproved or enriched through clinical use the potential of their scope expands that confirms that the real depth of many remedies is still unexplored.

The evidence through Clinical Cases

Next we study our clinical cases and look at what our experience shows us.

Over the years through thousands of cases across different cultures and background, my personal experience tells me the same story which I am sure many of you would agree.

Many of these "acute remedies" have unfolded the entire chronic condition for so many of my patients.

Eg I remember a young Man his 20's and who had asthma since he was a little child. Interestingly the remedy based on his chronic and acute manifestation was the same. It was Rhus toxicodendron. This remedy not just helped during the acute episode but even shifted the chronic tendency to get these episodes.

He has been well since I last saw him more than 10 years ago. But there is an interesting reason why I remember this case. He mentioned that he had forgotten the taste of ice-cream. He avoided it ever since he was a little child because that triggered the asthma. And within three months as the frequency and intensity of the asthmatic attacks subsided, he could start eating ice-cream again.

On the other hand I have seen so called "chronic remedies" like Sulphur clearing acute diarrhoea in hundreds of little infants at a primary health clinic in India within a few doses.
It was a genus epidemics at that time in that little town where I had my set my rural clinic.

And this is not just my experience. We have seen most of the experienced homoeopaths including Hahnemann, Boenninghausen, Kent and others talk about using an acute intercurrent when the acute picture is not covered by the chronic baseline remedy.

So if the same remedy does not cover both the "acute" and a "chronic"phase, then separate remedies are used to match different phases that complement each other.

Eg Kent gives an example. Belladona can cover the symptoms of an acute headache because it matches the acute state of the patient's exacerbation. And then a complementary remedy such as Calc Carb that matches the deeper chronic state inbetween the episodes can complete the work or take it from there.

However there are many cases that show that Belladona has a chronic phase. Eg I remember one of my teachers who had resolved a case of Hypertension completely using Belladona. Here it worked as a deep acting Chronic remedy!

Stages and Remedy Picture

So the purpose of today's blog is to re-enforce the concept that no remedy can be just acute or chronic.

It would be limiting the potential of our remedies if we use them as one or the other.

In fact when I developed the Stages Concept a few years back to find the best approach for my patients. I realised that I could use the same template to understand the remedy in its entire disease expression, from local to general, in acute and chronic manifestations.

It not only helped me identify the gaps in the remedy picture due to patchy proving but even fill those gaps through a variety of creative tools and resources in homoeopathy today.

If you need more information on the Stages Template and how you can use it to simplify your homoeopathic practice, kindly download my ebook - When your favourite Approach Does Not Work. The first book is free and you can download it from the left side of this blog page

In the meantime I just received an email from an extremely relieved mother this morning. And I thought I should share her child's case today.

Although the case is still work in progress I want to share it because it clarifies and reinforces the concept of acute and chronic remedies for me all over again.

And more importantly taught me some unknown facts about a remedy that I thought I knew "well"

Our patients are after all our best teachers.

Watch this video to find more about the case and my learning…

I would love your frank feedback on this.
What does your experience say about Acute and Chronic remedies.

Discussion:

Please login or register to post your comment. Registration is free.

I have used aconite for chronic asthma before, with very good results . The mental picture should fit, patients falls over backwards trying to please the doctor .

Belladona is also a good chronic remedy for very many cases . I used it by doing a repertorization.
Using Ardavan's viral miasms indicate this for the rabies miasm . I have learned to recognise this and thus use Bell when it fits the patient.

Thanks Suriya. I have never heard of viral miasm or rabies miasm. How do you recognise them?

You may like to see these videos to understand about them. I have since been able to recognised several very common viral miasms, like the Epstein Barr Miasm, HSV miasm, HPV miasm, DHF miasm to solve cases
http://www.youtube.com/watch?v=Fzr1CJQ_Kws
ww.youtube.com/watch?v=O4JNs8cIi6c

Also a case I presented at the LIGA 2010 at Redondo Bay in California
http://medicalhomeopathinfo.ipage.com/2014/01/01/endometriosis-recognising-its-chronic-origin/

The explanation for the ASD case is here . THis is my video . That is my voice
http://www.youtube.com/watch?v=gkztY13vaTE

Hi Shilpa,

Your cases are always so enjoyable and this one another reminder to keep an open mind and repertorise carefully.

I have used so-called acute remedies as constitutional over the years but need to keep my mind open to this one again . One of the best cases I had was slowly curing a serious chronic fatigue syndrome with Arnica and it took me a while to realise it was Arnica. Also patients responding to Aconite as a constitutional .
Thanks so much

I am glad you enjoy the cases Sohani. It's amazing to hear that you used the potential of Arnica for chronic fatigue. It seems so right for that condition but we do not find it in the clinical rubric of Chronic Fatigue!!

We all have so many clinical gems in our practice to share and its time we start putting this together as a community..

There is a problem with terminology here. Ipecac is commonly used to treat acute ailments, but this does not make it an acute remedy - any more than Phos, Rhus tox or Gels can be called acute remedies. 'Acute remedies' are those which are miasmatically acute Eg. Arn, Bell, Acon, Stram, Lyssin, Hydrog. These remedies will be prescribed for acute and chronic diseases only when the pace, intensity and level of desperation are acute (Sudden, Panic, Danger, Alarm, Helpless, Instinctive, Alarm, Reflex, etc.)

Yes I agree there is a problem with terminology Peter.
So in my experience the best way to avoid confusion is to specify the term acute miasm and chronic miasm in what context ie Hahnemannian, Kentian or Sankaran's...

For example in this blog I have kept the focus on Hahnemann's definition of miasm and his classification of acute disease ( non miasmatic) and chronic diseases( miasmatic disease).
And then how his acute remedies can also be used in chronic diseases and vice versa.

But I understand where you come from because you are talking about Sankaran's acute miasm. Where the term miasm itself has a different definition i.e. a person reaction to a delusional situation.
And his acute miasm is a sub classification of a chronic miasm.
So by definition his acute miasmatic remedies such as Arnica, Belladona etc can be used in chronic diseases…

So lots of food for thought.

I have an elderly patient permanently on low Rhus Tox bd ~ it completely controls her arthritis and now she never comes to see me as for her it's enough ( of course Dr Joe would say and be right she's highly toxic but this is as far as she will go ! )

Hi Shilpa.
I recently prescribed Aconite 200C as it came up first in my repertorization. I've been working with this elderly woman for over a decade, with anticipatory anxiety as one of her main complaints.
A few weeks after taking the Aconite, she and her husband flew to Kingston, Ontario to visit their son and his family. This is evidence of a great healing response as she had cancelled a previous flight, then compensated by telling everyone that she doesn't like to venture far from home.
She has taken Aconite 30C in the past for acute panic attacks, but I've never considered it constitutionally before. However, I'll be certain to repeat the Aconite at her next follow-up.

That is an interesting clinical observation.
This compensation is so typical of the
200 potency.
I have see this in Divya's potency chart based on provings of different potencies.
So thanks for sharing Dianna.

I have used both Belladonna, Ign and Rhus Tox as chronic remedies. The Belladonna case is written up in Hpathy.com http://hpathy.com/clinical-cases/an-acute-earache/

Remedies can ast as acute or chronic depending on the situation. Everything is individualised in Homeopathy.

Thanks Rochelle
I will check this case out...

Thanks so much Shilpa - I love to follow your clear dissection of cases. This week I have read Massimo Mangialavori's case of Ipec in is book "Homeopathy for Anger and Mortification" - MM lists Ip as one of the 'angry / mortification' remedies - and perhaps this might explain some of the restlessness in some cases.

thanks Shilpa, I´m enjoyed this video.

Nice case, Shilpa. Thanks.