Acute V. Chronic

[Phosphor]

(1)> Acute diseases are by nature short in duration and self limiting.

(2)> However, many chronic diseases have an acute aetiology. (Never been
since

(3)> So a gastric set of symptoms from badly cooked food - where there is
no

I think these views are an absolutely correct interpretation of Hn, but i
believe there are problems with them nevertheless, at least in the
application.

The problem with (1) is that after a week or so we may have a case of either
an acute or chronic disease (2), and there does not seem to be any way to be
sure until you have succseffully treated the case - ie in retrospect. So
there is a risk of giving an acute where a chronic is actually reqired. and
suppressing the case, according to Kentian doctrine.

Remember Kent we know that the first manifestation of a chronic case renders
the case chronic, even if the symptom fits into an acute case. But
depending on how wide you cast your symptom net, it is quite likely to come
up with credible candidates both for an acute and a chronic remedy - two
'cores.'

The issue with (3) is whether a remedy via aetiology becomes superseded over
a period of time. I'm inclined to think that aetiology is less relevant as
time proceeds, as the case is likely to evolve in some direction. Again, if
this is conceivable then at some point the competing 'cores' of the case -
aetiology and symptom picture - will co-exist will equal strength.

A futher issue is whether ther dichotomy of acute and chronic is really
valid. i think it is overly simplistic. A chronic disease is not simply one
that is not acute, but by Hn a manifestaion of a miasm. However, its seems
common sense that some states of illness are neither acute nor chronic
acording to the strict definitions. Acute gastritis can turn into a
lingering digestive weakness with loose stools, poor assimilation, fullness
after eating small amounts etc. This can go on ad nauseum [literally]
without recovery [hence not acute] but there is no reason to assume
automatically that it is dues to the emergence of a chronic miasm. it can
be due to erosion of gastric mucosa, loss of intestinal flora.

Andrew

[Soroush Ebrahimi]

Dear Andrew

I'd like you to show me a chronic case of one week old where your pt has
gastric problems and has NEVER had any gastric sx before.

I believe the acute origin of a chronic occurs when the acute is treated in
a suppressive manner.
I do not believe that if you treat a flu homeopathically it will develop in
to a chronic. However in the middle of a chronic treatment the pt may give
you acute sxs and you have to decide on the basis of safety and comfort of
the pt whether to interfere or not. (and is it a return of old sx??) This
acute is a true reflection of the miasms whether active or latent. An acute
in the middle of chronic treatment is your best guide to the Similimum.

I remember when were sitting our final exams, the case that we had to solve
was reflecting some of the problems that you refer to. However, the guys who
passed were the ones who knew their acutes and chronics!

If you have patient who has given birth and is now losing blood, you MUST
treat as an acute.
If you have a patient who at 1-2 a.m. has suddenly started to vomit
violently and cannot get off the toilet seat, you HAVE to treat it as an
acute.

If you have a child - 4th week in to a whooping cough case, it is still an
acute.
Ditto typhoid.

However, if you have a patient who has had various problems and it is now
discovered that they have high BP, then this is not an acute (discovery has
nothing to do with the definition of acute/chronic) but a chronic.

So your case taking will guide you whether your case is acute and chronic.

Confuse yourself about it and you have confused the case.

Regards and good healing
Soroush

[Phosphor]

the hydra-headed beast of a miasm grows another head, this time , for the
first time, gastric symptoms.
in

yes, but not only. A slight indisposition may arouse the tinder.

in

No, but if its chronic to begin with, the acute will only temporarily
ameliorate. Symptoms can be essentially identical, yet one case is acute
and the other chronic - eg Bell And Calc in middle ear infection.

You forgot to address some other problems i raised.

Andrew

[Soroush Ebrahimi]

Dear Andrew,

As Ahmed correctly directed, there is a great need to study Kent Phil
Lecture XXVI.
"This illustrates the doctrine of not prescribing for an acute and chronic
trouble together. p175" Or as the gardeners say, you need to know your
onions!

I thought I had responded to the pertinent points - if there are any that
you feel need further attention, kindly raise them again - point by point
and I'll do my best.

Rgds
Soroush

[Phosphor]

if there are any that

yes, the points are as follows...

1. how can we evaluate competing claims presented by analysis by aetiology
versus analysis by characteristic pathological symptoms versus analysis by
peculiar distinguishing symptoms

2. how can we be sure the presentation of an apparent acute is not the
beginnings of a chronic - miasmatic - uprising

3. how do we evaluate whether the lingering case of an slow-recovering acute
is or is not due to a decline in vital energy of the patient and can be
suitably treated by constituitional remedy rather than seeking another acute
option.

4. how would you categorise a lingering sequalae to gastritis
[malassimilation, decline in intestinal flora, bloating etc] which does not
seem to meet Hn's criteria for either acute or chronic -ie miasmatic -
state. woudl you categorise it as either acute or chronic? if so , which
one? if not, how would you categorise it?
thanks!
Andrew

[Joy Lucas]

on 4/10/01 5:10 pm, Phosphor at phosphor@hotkey.net.au wrote:

I hope that it is ok for others to pass on their thoughts re the ongoing
comments about acute and chronic cases. I would like to add the following:-

1. how can we evaluate competing claims presented by analysis by aetiology

Surely accurate case taking resolves all these evaluations - you will know
if there is a definate aetiology, if you know the course by which a disease
will go you will know how to distinguish the common pathological Sx from any
others, and if you are lucky enough to have peculiar Sx they alone can lead
you to the correct Rx - which is all that you need.

2. how can we be sure the presentation of an apparent acute is not the

Does this really matter, you take the case, you prescribe if necessary and
then you wait and see. Obvious acutes will be just that.

3. how do we evaluate whether the lingering case of an slow-recovering
acute
Acutes are nearly always self limiting. Lingering generally means that the
right Rx and/or potency has not been given, or if the patient is still
suffering re-take the case and prescribe accordingly.

4. how would you categorise a lingering sequalae to gastritis

Again does this theorising really matter - you have in front of you a sick
person - take or it would seem in this instance re-take the case.

Sometimes our instincts are much more useful than theory. Experience often
tells us that.

Thank you for reading, regards Joy Lucas