5/14/2017 DynamicMedicineAcuteandchronicprescribing:What'sthedifference?

|NationalCenterforHomeopathy

DynamicMedicineAcuteandchronicprescribing:What's
thedifference?
homeopathycenter.org /homeopathytoday/dynamicmedicineacuteandchronicprescribingwhats
difference

Whetherapatient'scaseisacuteorchronicisadistinctionthatisoftenmadebyhomeopaths.Acute
conditionsareselflimiting,usuallyspanningdaysorweeks,andendingwitheitherrecoveryordeathwhereas,
untreatedchronicconditionstendtobecomeworseandworseastimegoesby,withoutrecovery,causing
discomfort,pain,incapacity,orevendeath.

Acuteorchronicillness?
Colds,influenza,cystitis(bladderinfection),pneumonia,andotitismedia(middleearinfection)aretypicalacute
conditions.Bacterialinfectionsaremostoftenacute.Someviralconditionsareacute,suchaschickenpoxor
measles,whileviralillnessessuchasherpesorAIDSarechronic.Fungalinfectionsmayalsobeacuteorchronic.
Injuriesandfirstaidconditionsareacute,thoughtheirresultsmaybecomechronicordisablingiftheyarenot
treatedimmediatelyandeffectively.
Illnessessuchasdiabetes,arthritis,autoimmunediseases,eczema,allergies,endocrinedysfunction,asthma,
heartdisease,andcanceraremostoftenconsideredchronicconditions.Thewordchronicitselfdenoteslengthof
timeasafactorintheillness(fromGreek,"chronos"=time).Chronicdiseasestendtobelongtermwhileacute
diseasestendtohaveamorerapidcourse.Chronicconditions,thoughlongterm,mayhaveaninitialacute
phase,orothertimeswhentheillnessbecomessharplyworseforalimitedperiod.Theseexacerbationsmay,at
times,beconfusedwithacuteillness.
Isitnecessarytodeterminewhetheraconditionisacuteorchronicbeforemakingaprescription?Some
homeopathswouldsayyes,someno.
Letusexaminethedistinctionsandwhytheyaremade.Mosthomeopathsbeginwithanextensiveinitialcase
takinginwhichthegoalistofindthepatient'schronic/constitutionalremedy,basedonthetotalityofsymptoms.If
thepatienthasaminorillnesssuchasacoldoraskininfection,itwillbenotedduringthecasetaking,butunless
thesymptomsareverylonglastingorrecurrent,theywillnotbegivenmuchweightinthefinalanalysis.Whenthe
constitutionalmedicineisprescribed,itisexpectedtorelievethechronicsymptomsovertime,whilemakingthe
personmoreresistanttocontractingacuteillnesses.

Managingacuteproblemsduringconstitutionalcare
Whenacuteillnessdoesariseduringsuccessfulconstitutionaltreatment(i.e.,whentheconstitutionalmedicineis
working),whatshouldthehomeopathdo?Thereareseveralpossibleresponses.Iftheacuteillnessislife
threatening,actionmustbetaken,eitherhomeopathicorbyothermeans,suchasconventionaldrugsorsurgery.
Homeopathiccarecanbeofbenefitinlifethreateningillnessesifthesymptomsareveryclearandtheresultsof
theprescriptionareseenimmediately,orverysoonaftertakingtheremedy.Iftheillnessisselflimitingandnot
toosevere(suchasasorethroat,mildcold,orflu),naturalsupportivecaresuchasdietarychanges,fluids,
hydrotherapy,physicaltherapy,andherbssuchasEchinaceamaybeusedeffectively.Overthecounter
allopathicmedicinessuchasnonsteroidalantiinflammatories,decongestantsandaspirinmaybeusedifnatural
methodsdonotprovidesufficientrelief.Whentheacutesymptomsarewelldefinedandclearlymatchaparticular
homeopathicmedicine,onemaybeprescribed,resultinginpartialorcompleterecovery,oftenrapidly.
Infrequently,suchaprescriptionwillinterferewiththeactionoftheconstitutionalremedy.Itisimportanttonotjust
randomlytakeremedyafterremedywithoutresults,becauseyourchancesofcausingproblemsincrease.Choose
yourremediescarefully.Ourbook,HomeopathicSelfCare,TheQuickandEasyGuidefortheWholeFamily,for
instance,canbeveryusefulinlearninghowtochoosearemedythatwillworkquicklyandeffectively.

Repeattheconstitutionalremedy
Someprescribers,suchasMassimoMangialavoriofItalyandRajanSankaranofIndia,prefertorepeatthe
constitutionalremedyforallacuteproblems,expectingittoworkforacuteproblemstooiftheoriginal
constitutionalprescriptionwascorrect.Mangialavorievengoessofarastosaythattheconstitutionalprescription
isincorrectifitdoesnotworkineveryacuteillness.Wehavefoundthisprincipletobetrueinsomecases,butnot
all.JudythhasapatientwhohasbeenconsistentlyhelpedbyTheridionforchronicPMS,irritablebowel
5/14/2017 DynamicMedicineAcuteandchronicprescribing:What'sthedifference?|NationalCenterforHomeopathy

syndrome,andjointpainoverthepastsixyears.Theridionhasworkedbeautifullyoverthisentiretimeforevery
acuteillness(therehavebeenfew),whetherTheridionmatchesthespecificsymptomsornot.Bobhasamother
andsonwhobothrespondwelltoPhosphorusforallchronicandacuteproblems.Manypatientsdoseemtobe
strengthenedbyadoseoftheirconstitutionalremedyatthetimeofanacuteillness,andtheyrecovermore
quickly.Somedonot.

Anacuteprescription
Forthosepatientswhodonotrespondquicklytoadoseoftheirconstitutionalremedy,anacuteprescriptionis
oftenneededtoaidrecovery.Oneruleofthumbweuseistoassesswhethertheacutesymptomsaretrulyan
independentacuteillness(suchasaninfection)or,rather,asharpworseningofthechronicstate(suchasan
asthmaattackinsomeonewithchronicasthmaorprofuse,bloodydiarrheaorarecurrenceofthementaland
emotionalsymptomsinsomeonewithcolitis).Inacuteillnessesthatappeartohavenothingtodowiththechronic
state,acuteremediesmaybeofmoreservice,especiallywhentimeisoftheessence.Ifthereisnoneedfor
especiallyspeedyresults,however,adoseoftheconstitutionalremedycanbetriedtoseeifanyresponse
occurs.Ifnothinghaschangedintwelvetotwentyfourhours,anacuteremedymaybeprescribed.Conversely,
someacuteexacerbationsofachronicillness,suchasanasthmaattack,maynotrespondtotheconstitutional
remedy,butwillrespondtotheremedythatmatchesthespecificsymptomsoftheattack.Forexample,apatient
receivingTuberculinumconstitutionallymightrespondtoNatrumsulphuricum,Arsenicum,orMedorrhinumduring
theattackofasthma,ifthesymptomsagree.
Duringacutehomeopathicprescribing,differentmedicinesmayneedtobeprescribedasthesymptoms
change,particularlyinillnesseswithwelldefinedstagesasapartoftheircourse.Forexample,inacaseofthe
commoncold,Alliumcepa,Arsenicum,orAconitemaybeprescribedforadrippynoseandsorethroat,butifthe
coldmovestothechest,producingasignificantcough,Drosera,Rumex,orSpongiamightbemoreeffective,
prescribedbasedontheparticularsymptomsandmodalitiesofthecough.
Insomeacutecases,onemedicinemaybesufficienttoniptheillnessinthebudorcauseacomplete
recovery.OnegoodexampleistheroutineuseofOscillococcinumforbeginninginfluenza,Ferrum
phosphoricumatthefirstsignoffever,orAconitewhenthesymptomscomeonsuddenlyafterexposuretocoldor
wind.Whenthesinglemedicinecoversthesymptomsoftheillnesscompletely,theacuteillnesscanrapidly
resolvewithoutanyfurtherstages.Chamomilla,Pulsatilla,orMercuriuscanshowthiskindofresponseinacase
ofotitismedia.CantharisorSarsaparillamayprovidestartlingreliefoftheburninganddiscomfortofacutecystitis.
Thedefiniteanddramaticactionofhomeopathicmedicinesinfirstaidprescribinghasconvincedmanyskepticsof
therealityofhomeopathictreatment.TheuseofArnicaintraumaticinjuries,Cantharisinburns,Hypericumin
nerveinjuries,andApisinstingsandallergicreactionshasshownthepowerofthewellchosenacute
homeopathicremedyinanemergency.Infirstaid,theconstitutionalhomeopathicremedyisusuallyignored,in
pursuitofquickanddramaticresults.

Changesinthemental/emotionalstate
Inacuteprescribing,itisoftenveryhelpfultoassesswhethertherehavebeenanychangesinthementalor
emotionalstateofthepatient.Thisassessmentmayalsohelptodistinguishwhetherthepatient'sstateisthe
sameastheconstitutionalstateornot.Ifitisthesame,andthephysicalparticularandgeneralsymptomsalsofall
withinthescopeoftheconstitutionalremedy,thatremedycanbegivenwithconfidence.Ifthemental/emotional
stateisthesame,butthephysicalsymptomsareradicallydifferent,thenanacuteremedymaybeneeded.Ifthe
physicalsymptomsarethesame,butthemental/emotionalstateisradicallydifferent,eitheranewconstitutional
remedyoranewacuteremedymayberequired.Sometimesastrong,clearacutestatemaycallforaremedy
thatwasnotconsideredduringtheinitialcasetaking,butthathasastrongimpactonthechronicsymptomsas
wellastheacuteillness.Inthisway,anacutestatecanbethedoorwaytoabetterconstitutionalprescription.
Whensucharemedyworks,oftenfutureacuteillnessesmaybecuredbyitaswell.
Whenyoudoprescribe,whetherforanacuteorchroniccondition,itisimportanttohaveyourintentionfirmly
inmind.Whatistobecured,andwhatdoestheremedyyouhavechosenreallyaddress?Doyouexpectthe
medicinetocurethechickenpoxorthepatient'schroniceczema?Doyouwanttoaddressanymentaland
emotionalaspectsinthecase,eitherchronicallyoracutely,anddoesyourchosenremedymatchthesewell?
Haveyoutakenintoaccountthestrange,rare,andpeculiarsymptomsoftheacutecaseandwhethertheseare
alsocoveredbytheconstitutionalremedyoraretotallynew?Answeringquestionssuchasthesecanhelpyou
focusonwhatyouexpectfromthemedicineascomparedwiththeresultsthatoccurafteritisgiven.Whenyou
giveamedicineforanacutecondition,knowwhatitisyouaretreating,thetimeframeinwhichyouexpectthe
5/14/2017 DynamicMedicineAcuteandchronicprescribing:What'sthedifference?|NationalCenterforHomeopathy

response,andwhatresponseyouexpect.Inthisway,youcanmakesenseofwhathappensfromgivingthe
remedyandmaketherightchoicesforresolvingtheacuteillnessquicklywhilepreservingandevenenhancing
theeffectsoftheconstitutionaltreatment.

Abouttheauthors:
JudythReichenbergUllmanandRobertUllmanarelicensednaturopathicphysiciansboardcertifiedin
homeopathicmedicine.Coauthorsofsevenbooks,theypracticeinEdmondsandLangley,Washington,where
theytreatpatientsinpersonandbytelephone.Theycanbereachedat(425)7745599.Theirwebsiteis
mailto:www.healthyhomeopathy.com.