Minutus

Hello Everyone,

I would agree that in many cases the acute remedy and the chronic
remedy is the same. A person who has chronic Pulsatilla symptoms will often
develop the acute Pulsatilla symptoms. For example, they may be treated for
a host of chronic symptoms like weeping, etc., and then show up in a crisis
with an acute painful earache with a bland discharge, etc. I see this all
the time. Many times the patient comes in an acute crisis and the remedy
that ameliorates the acute becomes the chronic remedy. This is also very
common. it is a good sign that you have a deep remedy. This, however, is
not ALWAYS the case under every time and circumstances. It is the
exceptions that are the MOST important because this is where there is a
danger lurks hidden to those who are not looking.

There are times in which the acute crisis is so severe that it will
change symptom pattern and repress the chronic state. At this time, a
series of new symptoms will develop NOT found under the chronic remedy in
the materia medica. For example, the Puls. case develops seizures not found
under Puls that are found under its acute complement Hellaborus. This is an
important differential diagnosis that affects the case management. To think
only in terms of the "one remedy for all situations" in a dogmatic way is
not the best or most flexible method because it is too rigid. It is always
best to follow the symptoms and circumstances as the mistuned vital force
is the best guide. Case management always takes INDIVIDUALIZATION! This is
not zig-zag prescribing, which is using partial simillimums. This is being
an unprejudiced observer and following the direction the vital force moves
by the symptoms and circumstances. This is flexibility, openness responding
to the causes, symptoms, times and circumstances.

I would not give Arnica to a chronic patient on a chronic remedy for a
bruise! It would, however, consider using Arnica if they got into a car
accident and were seriously hurt with a concussion and broken bones. This
is going the cause, symptoms, time and circumstances, which is Hahnemann's
method. Have I seen anyone raise the basic ideas of the one remedy an be
used over very long period of time for many conditions? Yes, I have but one
should not turn this into a one sided therapeutic dogma for everyone and
all situations at all times. I have observed the same remedy cure acute and
chronic conditions for decades but it is NOT an absolute with no
exceptions. I have seen some who are now professing the one remedy for all
conditions model who do not really manage their cases all that well. Why?
Because they are always trying to do the same thing to everyone rather than
looking at each situation and patient individually.

Some now say they don't even believe in acute and chronic diseases.
They do not that best job in emergencies, virulent acute miasms, serious
acute disorders and acute-like acerbations of chronic pathology that change
the symptom pattern to a new state not found under previous chronic remedy.
I have also heard of some very strong aggravations of acute and chronic
crisis states through this method. I have had to sort some of these
mistakes in my practice. Why does this happen? This happens because they
gave the chronic remedy (the one so-called constitutional remedy for all
situations) when they were faced with a true acute disorder or a true
pathological crisis of a chronic condition that changed the state of the VF
and repressed the chronic symptoms.

I would like to say something about the second condition mentioned
above, that is, a pathological crisis of a serious chronic disorder. This
is when a there is serious tissue, organ or systems failure that produces a
crisis. At this time, giving the one constitutional remedy for all
situations dogmatically can be dangerous to the patient! As Kent said,
"Don't give them that constitutional remedy they needed 20 years ago". Why?
The answer is there is too much pathology at the moment. and the reaction
may injure the patient. This is also true in acquired chronic miasms like
active TB in advanced stages, etc. Kent warmed about this also.

When I studied TB treatment there was a one sided constitutionalist at
the hospital who ignored the above warnings. He decided to give Lycopodium
as the one grand constitutional remedy for all situations and ignored the
idea of treating serious organic pathology in layers. The patient
hemorrhaged and died due to the aggravation caused the giving too deep
acting chronic remedy at the wrong time. He should have treated the
symptoms of the advanced TB first not the entire constitutional picture of
the patient. Maybe 20 years ago this remedy would have been wonderful and
prevented him from getting TB. Now it was far too late!!! One must
individualize their approach on a case by case basis by the nature and
stage of the disease symptoms and the state of health of the patient and
the VF. This is a lesson I will never forget!

If you follow the causes, symptoms, time and circumstances and confirm
them in the materia medica you will never make such mistakes. Why? Because
the VF will show one by the nature of the illness and the accompanying
circumstances exactly what the patient needs. I have many, many cases where
one remedy covers the acute and chronic states of the patient. I would say
this is true with a *majority of my cases* BUT one must know when this is
NOT true. One should not think that just finding that one remedy for all
conditions replaces awareness of causes, symptoms, nature and stage of the
disease and the attendant circumstances affecting the patient. A simple
mono-case manage strategy is just not flexible enough to treat serious
acute diseases and virulent acute miasms or a dangerous crisis of an
organic pathological complaints. There is no one way that is suitable for
all patients at all times under all circumstances. I am sorry, but treating
the ill is just not that simple!

INDIVIDUALIZATION by the cause, symptoms, nature and stage of the
disease state, the accompanying circumstances is superior to any one
method. One must also use the materia medica to confirm the presiding
symptoms and study the nature of the remedy to see if it suitable for the
present condition. Why? Because it covers EVERY possibility in a
scientific, consistently repeatable and safe manner.

Sincerely, David Little
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000

Well stated David !
If there is only one cure all for a case, then the
whole idea of relationship of remedies and the
enormous amount of labour gone into this area will be
useless.

Hahnemann, Boger,Roberts, were all for the "acute
first then chronic " method. But here also there are
exceptions. As Boger stated ' It gives little credit
if a person who always had homeopathic treatment
develop tuberculosis or cancer'. This is a problem in
zig zagging when we will be lost in a maze of related
remedies without knowing the prime one.

Then there is another class of cases which do not
resolve with a constitutional. They sometimes yield to
a smart act by the practitioner when he senses that
the man's father had gonorrhea !

We do not have clear demarcations on this subject yet.
A man of Grauvogl's stature has remarked " If we are
to treat by symptomatology alone , i.e, if we treat
only according to the similars in a given case we will
end up the way allopathy has ended." so much for
routinism. Is that why Hahnemann called it an art?
Sigh ! when am I going to catch up ?

Regards
venkat
--- David Little wrote:
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At 08:52 PM 1/8/2005, you wrote:
Dear Venket et al,

It is my humble opinion that one must treat every patient and
situation individually as there is no one method that suits every patient
under every circumstances all the time. The idea that there is one
constitutional remedy for every person that will do everything at all
times, under every condition, and all circumstances is going to far. Yes,
when one has a deep acting simillimum one should be able to use it over a
longer period of time in every higher potencies without any major changes
in the symptoms. This is always a good sign!

When one is giving partial simillimums there are usually frequent
changes in symptoms and relapse in which the same remedy become less and
less effective. Some people imagine they are treating layers with new
remedies but over the long run the patient slowly circles downward. Yes,
there are layers. Yes, sometimes on needs to use more than one remedy but
that is no excuse for giving too many superficial remedies. The more
remedies one has to use - the further from the essential cores of the case
at hand. I can always tell how well I have understood a case by how many
remedies I have use over the years. More remedies means less understanding
and less remedies means more understanding Nevertheless, to turn the
so-called grand constitutional remedy into a new therapeutic dogma is
counterproductive to a well balance case management strategy.

Using as few remedies as possible is part of principles of minimal dose
and minimal intervention and is important BUT to think that every patient
has one grand remedy that will do all things and at all times under every
circumstance and forever is going far too far. One must patient attention
to the nature and stage of the diseases as well as the condition of the
vital force and vitality. To project a monolithic case manage strategy on
every patient regardless of the time and circumstances is not being an
unprejudiced observer.
Causa and chronic miasms are primary facts that complement the signs and
symptoms. One must think in terms of the significant points of the case
history, Causa, miasms, symptoms and the concomitant circumstances.
Hahnemann never said "just take the presiding symptoms". He clearly
says that one must record all the significant points in the whole history,
the exciting and fundamental cause, the miasms and the attendant
circumstances that relate to the condition of the physical body and
constitution, the character, occupation, habit and lifestyle, domestic and
social relationships, the affects of aging and sexuality, etc. (aph. 5). On
this basis, he goes on to discourse on the collection of the objective
signs, coincidental befallments and subjective symptoms of the body and
soul (aph 6). All this phenomena is included in aphorism 5 and 6, which are
the first instructions on taking a case in the Organon.

Then in aphorism 7 he speaks of being directed by the "symptoms alone"
but he also says "with regard for any contingent miasms and with attention
to the attendant circumstances (aph 5)." He repeats the theme of *cause,
miasms, symptoms and concomitant circumstances* in aphorism 18 and 24 an in
other places. In every major aphorism dealing with the importance of the
totality of the symptoms in case taking he also notes the importance of the
miasms and accompanying circumstances as stated in aphorism 5. The folks
that say "only treat the symptoms" always take this statement out of
context and always leave out the cause, the miasms and concomitant
circumstances affecting the patient. Simply put - Hahnemann NEVER said
treat the symptoms alone!!! In aphorism 7, 18,, 24 etc. He clearly speaks
in terms cause, miasms, symptoms and circumstances. My advice is for
everyone to go read aphorism 5, 6, 7, 18 and 24 right now so they
understand the bigger picture.

Sincerely, David Litlle
---------------
"It is the life-force which cures diseases because a dead man needs no more
medicines."

Samuel Hahnemann

Visit our website on Hahnemannian Homoeopathy and Cyberspace Homoeopathic
Academy at
http://www.simillimum.com
David Little © 2000