Prescribing in Acute Diseases

Hahnemann classified diseases into acute and chronic along with their various sub-groups (Aphorism No. 72-82)

Acute diseases are rapid, morbid processes of the abnormally deranged vital force, which have a tendency to finish their course more or less quickly, but always in a moderate time, resulting in recovery in the course of time or in death, if the vital force is overwhelmed.

These may affect the individual or groups of persons in a sporadic manner.

These are transient explosions of latent psora, which spontaneously return to its dormant state if the acute diseases are not of too violent character and are soon quelled.

These diseases may supervene in the course of time of the chronic disease due to adverse factors.

The Prescribing Totality which consists of the chief complaint(s) and the concomitants governs the choice of the remedy in the acute diseases.

In acute diseases, the constitutional symptoms of the patient are thrown into the background, and the vital force under the impact of the environmental force brings the acute symptomatology to the forefront.

This could be deciphered relatively easily as compared to the chronic diseases.

In a case of chronic disease, when an acute condition develops, do not be afraid to prescribe the remedy, as long as the picture is quite clear.

Giving an acute remedy in a chronic condition without a clear picture is very dangerous as patient will not improve and may rather deteriorate. (Ref: Talks on Classical Homoeopathy by G. Vithoulkhas)

After the acute symptomatology is treated adequately by the indicated acute remedy, they disappear, and the chronic constitutional symptoms previously submerged, now reappear at the end of the acute disease.

This is the best time to give the indicated constitutional remedy, which will prevent relapses.

In infants and children, in comatose as well in persons with communication blocks or in the insane, the objective data assumes the greatest importance for prescribing.

The value of concomitants in acute prescribing has to be borne in mind, especially the mental concomitants in the physical diseases, and the physical concomitants in mental diseases.

ACUTE EXACERBATIONS OF CHRONIC DISEASES

There are two approaches to the acute attacks of chronic diseases:

• Acute prescription based on the presenting totality

• Constitutional prescribing as in chronic diseases.

Acute prescription based on the presenting totality:

This is required in chronic diseases of relapsing nature or periodicity, interspersed with acute attacks.

They are totally or partially asymptomatic during the intervals.

e.g. Epilepsy Bronchial asthma Intermittent fevers Migraines

The acute episode requires acute prescribing based on the presenting totality.

Constitutional drug has to be administered after the acute phase is over.

Constitutional prescribing as in chronic diseases.

At times, in acute diseases, the vital force is so overwhelmed by the morbific agent, that it is not able to throw up the acute response, but has to call upon the “generals” in self-defense.

The constitutional symptoms, instead of receding into the background become prominent

This calls for the deep-acting constitutional remedy indicated for the case

e.g. Phos & Sulph in pneumonia, Lyc in MeningoEncephalitis, Diabetic acidosis

If the right constitutional remedy is not given in time, the case is likely to turn fatal

Constitutional remedy, if given in the Prodromal phase of an acute disease, also acts as an “abortive”

This is helpful when • the Totality which emerges is of the constitutional remedy and no other remedy,

UNUSUAL PRESCRIPTIONS

On rare occasions in acute diseases, in the absence of clear-cut pointers to the remedy, recourse has to be taken to the following categories of remedies on the basis of the available data in the case:

Nosodes: Staphylococcinum in Myocardial infarction Bacillus No.7 in Cardiac arrest

Streptococcus hemolyticus in acute endocarditis Paratyphoidinum B in acute gastro-enteritis Secale cor in acute hemorrhages

Organ Remedies: Carduus marianus for liver Crategus for heart

Pathological Prescribing: Hecla lava for tumors of the jaw. Citrus vulgaris in right facial palsy

Some practical hints in treating acute diseases during constitutional treatment:

1. If you feel after examining the patient and taking a detailed history of his complaints,

that the disease is not so serious, you can try household remedies. One can wait for 48 hours or so.

2. Many times it is not so easy to find an acute remedy on the first day. On the second day the picture of the remedy may be more clear.

Here again examine the patient thoroughly, theoretically and clinically. If the patient is improving on his own, wait and watch.

Do not take any measures to give a remedy, if the patient feel less ill than what he was on the first day.

But if the patient is getting more sick everyday, then one has to treat immediately.

Examination of different groups of acute cases seen in practice:

Observation 1: Patients who frequently had acute diseases before they were on Homoeopathic treatment

and in whom the frequency and degree of acute infections diminished after the treatment.

In such a case, the susceptibility of the patient is very good as their health has improved after the Homoeopathic treatment.

Observation 2: Patients who were never acutely ill before the Homoeopathic treatment

and who become frequently ill after the treatment, though their general energy has improved.

This is frequently observed in patients suffering from Cancer, Autoimmune disorders and Epilepsy.

Prior to Homoeopathic treatment, this group of patients were too weak to produce acute diseases.

Now if they feel generally better since the Homoeopathic treatment and if they get acute diseases afterwards,

their level of health has improved and the organism has become stronger.

e.g. 1. Patient with chronic Rheumatoid Arthritis, who was on Cortisone treatment for years, for the first time developed influenza after Homoeopathic treatment.

e.g. 2. In a case of Cancer of kidney, who never had any allergic rhinitis, suddenly developed multiple episodes.

Observation 3: Patients with recurrent acute infections such as tonsillitis, UTI, bronchitis, etc.

Here these acute infections are basically coming due to chronic disturbance in the defense and immune system.

Here one has to treat the chronic layer to stop recurrence of acute recurring illnesses.

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