No doubt, the closer the remedy is to the
simillimum the deeper and more all-en-
Using Acute Intercurrent
ar Intermediate Remedies
in Chranic Diseases
Luc De Schepper, USA
Key
A61: Organon Aphorism by Hahnemann
Reference. This symbol represents the
paragraph from Hahnemann's Organon,
specifically the Aphorism number from
where the reference originated.
CO:Chronic Diseases by Hahnemann Refer-
ence. This symbol represents the thought
taken from Hahnemann's Chronic Diseases
book.
Using Acute Intercurrent
Remedies
Modern homeopaths no longer understand
how to use an acute intercurrent remedy.
These remedies have been called every-
thing from drainage remedies and tandem
remedies to support and lesional remedies.
Toa many so-called masters, who claim to
be constitutional prescribers (homeopaths
who say they do chronic "layer" prescrib-
ing), totally forbid the use of acute inter-
current remedies and misinform others by
saying that the use of acute remedies dur-
ing the administration of a chronic remedy
is suppressive. These individuaIs always try
to find one remedy that goes throughout
the chronic case history, no matter what
the patient's present acute disease state
may be. They use this "constitutional" rem-
edy for everything, no matter what disease
state arises! This limited view is toa ex-
treme for the general practitioner of ho-
meopathic healing.
Why does this very rare/y work? We only
have to refer to Aphorisms 36-40
Organon on similar and dissimilar diseases.
In Aphorism 38, Hahnemann tells us that
the stronger and dissimilar acute disease
will postpone ar suspend the old chronic
22 L. De Schepper. Using Remedies in Chronic
compassing its action will be on the Vital
Force (VF). This is a very subtle aspect of
the single remedy and minimal dose and
is a wonder to perceive. The goal is always
to use the minimum number of remedies,
the smallest amount of medicine, and the
fewest repetitions. Since the simillimum
addresses the soil on which acute and
chronic diseases grow, it can sometimes
cure both acute and chronic manifestations
as well as acting as a prophylactic. Espe-
cially with the use of Hahnemann's medic-
inal solutions (5th and 6th Edition of the
and weaker disease. Thus, administering Organon), we often find that the adjust-
the constitutionaljchronic remedy during ment of the succussion ar size of the dose
emergencies such as dangerous pathologi- will keep the remedy working.
cal crises, severe traumas, overexposure,
serious injuries, and virulent acute rni- The skilful use of intercurrents is an essen-
asms, is a serious mistake as it runs the risk tial method in classical homeopathy, an as-
of disrupting the natural symptom pattern pect of complete case management. Acute
and causing unproductive aggravations as intercurrent remedies are used during
well as accessory symptoms of the chronic temporary disruptions of the chronic treat-
remedy! ment. For example, "taking cold in the
stomach by eating fruit, [cured) by smell-
During an acute crisis the remedy of choice ing of Arsenicum" (Hahnemann, 1997,
is the acute intercurrent! This acute illness p.131). These remedies are chosen because
shows a different clinical picture from the of the exciting cause and the active acute
chronic natural disease. How could a dis- symptoms so that they do not disrupt the
similar remedy correct this situation? That deeper layer associated with a different
would fly in the face of our most sacred fundamental cause and with the constitu-
principie: Like cures like. A homeopath tion. These intercurrents mainly act super-
must have the tools to prevent and cure ficially so that they will not interfere with
dangerous epidemic diseases, treat emer- the complementary constitutional treat-
gencies, crises, and acute virulent miasms. ment. They are specialised specifics, which
The acute remedy must be chosen accord- deal with the disruption of the chronic
ing to the causal ar exciting factor and its treatment by occasional exciting causes
active symptoms (von Boenninghausen that would delay the cure.
[VB) method), not according to the chronic
case history! The desired middle path is Because of the continued suppression of
the class of homeopaths who find a bal- miasmatic chronic diseases in modern
ance between those who treat in layers countries, we must know when to use
and those who use the grand constitutional acute intercurrents. If you read the old
remedy for everything. Turning this sub- masters (see von Boenninghausen's Lesser
ject into absolutes will only help create op- Writings), you will see that they dealt with
posing extremist views. horrendous acute situations which are still
Modern homeopaths no longer understand how to use an acute intercur-
rent remedy. Many homeopaths always try to find one "constitutional"
remedy that goes throughout the chronic case history, and apply this one
remedy no matter what disease state arises. This article explains why this
strategy rarely works. The author discusses when and where to use acute
intercurrent remedies and how they are essential for the chronic treatment.
of the
Knowledge of Hahnemann's teachings is in these matters the only guide!
KEVWORDS Chronic diseases, Acutes, lntercurrent remedies, lnter-
mediate remedies
Diseases - Homceopathic Links Spring 2005. Vai. 18: 22 -28 © Sonntag Verlag in MVS Medizinverlage Stuttgart Stuttgart GmbH & Co. KG
present today. Nothing has really changed,
except that we have some new acute dis-
eases: SARS(Severe Acute Respiratory Syn-
drome), West Nile virus, the Four Corners
disease (hantavirus), etc.
The reason some homeopaths speak about
disrupting their chronic cases with acute
remedies is that they do not know the
strategy behind using acute intercurrents.
As mentioned above, ifyou use the exciting
cause and active symptoms of the acute
syndrome as a basis for selecting a remedy
(VB method), then the intercurrent will not
disturb the chronic conditian. But if, during
an acute attack, the homeopath continues
to administer a deeper-acting chronic rem-
edy, which envelopes the previous deeper
and often different fundamental causes,
this may disrupt the natural symptom
layers. Simply put, one-dimensional con-
stitutional prescribers are afraid oftreating
acute diseases because they do not know
how to do it.
Hahnemann and
Acute Intercurrents
What does Hahnemann have to say about
acute intercurrents? He introduced the
idea in 1828 by presenting the following
examples in Chronic Diseases:
CO: Among the mishaps which disturb the
treatment only in a temporary way, I enu-
merate: overloading the stomach (this
may be remedied by hunger ... ; disarder
af the stamach from fat meat, especially
from eating park (to be cured by fasting
and Pu/satil/a); a disarder af the stamach
which causes rising from the stamach after
eating and especially nausea and inclina-
tian to vomit (by highly patentised Anti-
monium audum); taking cold in the stam-
ach by eating fruit (by smelling af Arseni-
cum); traubles from spirituous liquors
(Nux vomica); ... when vexatian is jained
with fright, by Acanite; but if sadness is
caused by fright give 19natia seed; ... un-
happy lave with jealausy (Hyascyamus); ...
burning afthe skin by Arsenicum; ... horne-
sickness with redness of cheeks by Capsi-
cum, etc. (1997, pp.131 -132).
After talking abaut this first class of acute
illnesses, Hahnemann tells us not to con-
tinue the chronic antipsaric treatment in
cases af epidemic diseases ar intermediary
diseases, 50 as nat to mix the symptams af
the acute crisis with thase af the chranic
l. De Schepper. Using Remedies in Chronic Diseases - Homceopathic
disease. If ane needs to administer a first
aid, crisis ar genus epidemicus remedy, the
constitutional chronic remedy shauld be
withheld until after the crisis subsides.
CO: But during the treatment af chronic
diseases by antipsaric remedies we aften
need the ather nan-antipsaric stare of
medicines in cases where epidemic dis-
eases ar intermediate diseases (morbi in-
tercurrentes) arising usually from metearic
and telluric causes attack aur chronic pa-
tients, and 50 nat anly tempararily disturb
the treatment, but even interrupt it for a
langer time. Here the ather hameapathic
remedies will have to be used, wherefare I
shall nat enter upan this here, except to say
that the antipsaric treatment will have for
the time to be tatal/y discontinued, 50 lang
as the treatment of the epidemic disease
which has also seized aur (chronic) patient
may last, even if a few weeks in the warst
cases may thus be last. But here alsa, if the
disease is nat toa severe, the abave men-
tianed methad of applying the medicine
by smelling a moistened pellet (alfactory
methad) is aften sufficient to help, and the
cure of the acute disease may thus be ex-
traardinarily shartened (1997, p.132). (Au-
thor's emphasis and words added.)
The same idea - nat taking inta account the
active miasmatic state in acute events - is
reflected in the Organon:
A221: lf, hawever, insanityor mania (pre-
cipitated by fright, vexatian, alcahal, etc.)
suddenly bursts farth as an acute disease
from the patient's usually calm conditian,
althaugh it almast always arises fram in-
ternal psora (like a flame flaring up from
it), at this initial, acute stage it shauld im-
mediately be treated, not with antipsaric
remedies, but with medicines such as
Aconite, Bel/adonna, Stramonium, Hyoscya-
mus, Mercury, etc., chasen from the other
group af proved remedies and given in
highly patentised subtle hameopathic
doses, sa as to avercame it to the paint
where the psara returns for the time being
to its farmer, almast latent canditian, in
which the patient appears to be well.
In such acute flare-ups, Hahnemann tells
us to use thase very specific acute rem-
edies withaut taking inta account the dom-
inant miasmatic state as we would for
chronic cases. This is ane of the few excep-
tians - tagether with the ane-sided dis-
eases, which can be regarded as severe
acute situatians suspending the chranic
miasmatic natural illness - in which we
Links Spring 2005, Vol.18: 22-28 10 Sonntag Verlag in MVS Medizinverloge Stuttgart Stuttgart GmbH & Co. KG
use the VB method. With this methad yau
select the remedy according to madalities,
locatian, sensation and cancomitant symp-
tams. The VF needs an intercurrent remedy
in high patency and subtle ar minute dose,
to subdue a threatening acute flare-up.
Kent and Acute
Intercurrents
Kent cantinued this discussian in his Lec-
tures an Hameapathic Philosaphy in Lec-
ture XXVItitled, The Examination of the Pa-
tient.
Kent: It is impartant to avaid getting con-
fused by two disease images that may exist
in the body at the same time (that does not
mean both are equal/y active). A chronic pa-
tient, for instance, may be suffering from
an acute disease and the physician an
being called may think that it is necessary
to take the tatality of the symptoms; but if
he should do that in an acute disease, mix-
ing bath chronic and acute symptams to-
gether, he will became canfused and will
not find the right remedy. Fhe twa things
must be separated. The group of symptams
that constitutes the image and appearance
af the acute miasm must naw be pre-
scribed for. The chronic symptoms will
nat, of course, be present when the acute
miasm is running, because the latter sup-
presses ar suspends the chronic symptams.
... This illustrates the dactrine af nat pre-
scribing for an acute and chronic trouble
tagether. ... The acute disease is never
camplicated with the chronic; the acute
suppresses the chronic and they never be-
come complex .... Prescribe first for the
acute attack, and the symptams that be-
long to it. It is well, however, for the physi-
cian to knaw ali the symptams that the pa-
tient has af a chronic character, that he may
knaw what to expect, that he may loak at
the clase of the acute attack for the coming
aut af the ald manifestatians af psora,
althaugh aften an entirely new group of
syrnptoms will appear (Kent, 1979,
pp.174-176). (Author's note added.)
As yau can see, here Kent follaws Hahne-
mann and lays to rest thase "madern
myths" of nat treating acutes while you
are treating a chronic disarder. He speaks
here af true virulent acute miasms, nat
sparadic befallments ar non-threatening
exacerbatians af chronic miasms. After the
acute crisis is aver, the hameopath can re-
sume the chronic treatment.
23

von Boenninghausen
and Acute Intercurrents
Von Boenninghausen was another homeo-
path who talked about acute intercurrents
in the first published homeopathic reper-
tory (1832), A Systematic Alphabetical Rep-
ertory of Homeopathic Remedies. Within a
sub-chapter titled Interruption of the Anti-
psoric Cure is the section Intercurrent Rem-
edies in Chronic Disease. This section in-
cludes a list of acute intercurrents and
their symptoms in crisis during chronic
treatments. These therapeutic hints are
characteristic keynotes of the acute inter-
current remedies and the homeopath must
refer to the materia medica for confirma-
tion and differential diagnosis with other
remedies. Some examples include:
Stomach, overloading of (main rubric)
with sub-rubrics:
• Deranged with gastric fever, chills and
coldness with eructations, Bty.
- And inclination to it, Ant. crud.
- By fatty foods, Puls.
- Chilled as from fruit, Ars.
Among the remedies listed by the Baron
are non-miasmatic remedies like Aconite,
Antimonium crudum, Amica, Bryonia, Cha-
momilla, Coffea, Ignatia, Ipecacuanha, Rhus
tox., etc. These are used for acute emotional
crises, accidents, vomiting, diarrhoea,
weakness from loss offluids, and acute mi-
asms such as colds and fluo
Why would a deep-acting remedy such as
Arsenicum be found among these acute in-
tercurrents? It is in the acute list of Hahne-
rnann and von Boenninghausen for use in
an upset stomach - in other words an acute
local complaint. If Arsenicum had a deeper
relationship to the individual's case history
(anxiety, fear of death, fear of contamina-
tion, obsessive compulsive behaviour,
etc.), it should not be used during a serious
acute crisis as it might interrupt the
chronic treatment and delay the cure. An-
other more superficial simillimum must
be chosen at that point. Most intercurrents
are non-miasmatic remedies that have no
relationship to the deeper aspects of the
case. They are chosen according to the 10-
cation, sensation, modalities, and concom-
itants (a complete von Boenninghausen
case). These acute intercurrents act as
superficial remedies that suit the acute
layer of symptoms one wishes to remove,
but are not directed toward the underlying
miasm or constitution. This also means
24 L. De Schepper. Using Remedies in Chronic
that we should choose these intercurrents
only for serious acute events, only if the
crisis needs special attention, and not for
every trifling situation as often happens. A
homeopath should treat strong acute mi-
asms, painful exacerbations of chronic
states, and dangerous crises whenever nec-
essary, because it is preferable to adminis-
tering allopathic dissimilar drugs.
As an example, let me tell you about choos-
ing the right intercurrent for myselfwhen I
was plagued by an annoying, lingering
cough and while I was taking a chronic
constitutional remedy. After waiting for 14
days and finding that the cough was get-
ting worse, I decided to take an intercur-
rent. The rubrics included:
• Cough, dry
- Cough, with convulsions
- Cough, constriction in larynx
- Cough, irritation in larynx
- Larynx/trachea. irritation in throat -pit
- Chest, sensation as a band
- Chest, constriction
- Larynx, tickling, in throat-pit
- Irritability, wants to be left alone
- Very thirsty, usually thirstless
except with meals
Far stronger than the rest of the remedies
which appeared were Phosphorus (first),
and Cuprum (second). Because Phosphorus
is a deep-working anti-miasmatic remedy,
which would have interrupted my chronic
treatment, I decided on Bryonia 200 C, (the
acute of Phosphorus], split dose in bottle, 12
succussions, 1 tsp. PRN. After one dose my
cough was already much better, and it dis-
appeared completely the next day. Later,
chronic treatment was resumed.
I asked the following question: "What
changes are important in acute diseases?"
ALLthe symptoms that have changed since
the onset of the cough belong to the cough
- for example, being very thirsty now that
the cough started when usually I am not
thirsty. This becomes very important. It
would not be important if I were always
thirsty, even before the onset of this cough. -Iy recently lost, are to patient and relatives
Another very important facet of change in
acute diseases is the change in disposition
and mentaljernotional symptoms: the dis-
position during the acute disease as com-
pared to the usual disposition will be a key
factor. This absolutely must be investigated
and plays an important role in finding the
remedy. The more drastic this change is,
the more important it is. The "feeling of
Diseases - Homceopathic Links Spring 2005. Vol. 18: 22 -28
wanted to be left alone" is very unusual
for me, and Bryonia, the indicated remedy,
certainly has this symptom as well as the
great thirst. This resembles, of course, the
VB method, where von Boenninghausen
only takes into account the mental/erno-
tional symptoms as a tool to differentiate
between several remedies close to the case.
Hahnemann also stresses the importance
of emotional changes in acute diseases.
A213: Therefore one will neve r cure ac-
cording to nature-that is, homeopathi-
cally-unless one considers the mental
and emotional changes along with the oth-
er symptoms in all cases of disease, even
acute ones, and unless for treatment one
chooses from among the remedies a dis-
ease agent that can produce an emotional
or mental state of its own similar to that of
the disease as well as other symptoms sim-
ilar to those of the disease. Thus Aconitum
napellus will seldom or never cure either
quickly or permanently if the disposition
is calm and undisturbed; nor will Nux vom-
ica if it is mild or phlegmatic; nor will Pul-
satilla if it is glad, cheerful and willful; nor
will/gnatia if it steady and without fearful-
ness or irritability.
Hahnemann compares some differences
between acute and chronic cases.
A82: ... In this investigation one must dis-
tinguish between acute diseases of sudden
onset and chronic diseases. In the former
the principal symptoms become promi-
nent and recognisable to the senses more
quickly, so the taking of the case requires
far less time and there are far fewer ques-
tions to ask, because most ofthe symptoms
are self-evident; whereas in a chronic dis-
ease that has been evolving gradually for a
number of years, it is far more troublesome
to obtain the symptoms.
A99: On the whole it will be easier for the
physician to take the case in diseases that
are acute or that have arisen recently, be-
cause all the symptoms and deviations
from the healthy condition, which was on-
still fresh in memory, still new and striking.
The physician must of course know every-
thing here also, but he needs to probe far
less, because everything he needs to know
is told to him, most of it spontaneously.
Proceeding with treatment
after using an acute intercurrent
Again Hahnemann guides us very clearly in
Chronic Diseases.
© Sonntag Verlag in MVS Medizinverlage Stuttgart Stuttgart GmbH & (o. KG
CD: The intelligent homeopathic physician
will soon note the point of time when his
remedies have completed the cure of the
epidemic intermediate disease (usually
they appear in the form of a fever) and
when the peculiar course of the chronic
(psoric) malady is continued. The symp-
toms of the original chronic disease will,
however, a/ways be found somewhat varied
(a/tered) after the cure of such a prevailing
intermediate disease .... The homeopathic
physician will then choose his antipsoric
remedy according to the totality of the re-
maining symptoms, and not simp/y give
the one he intended to give before the inter-
mediate disease appeared (1997, p.132-
133). (Author's emphasis and words added.)
Therefore, after the acute event (a strong
one, that is), one must retake the case with
special emphasis on any newly appeared
symptoms. The most recent and perma-
nent symptoms point to the next remedy.
Some of the chronic symptoms a/so persist
during an acute crisis and thus obtain a
higher va/ue for the se/ection of the similli-
mum.lfthe same remedy that was service-
able before the acute crisis is indicated, it
may be repeated. If the symptom picture
has changed, the new symptoms must be
investigated in relationship to ali the data
associated with the chronic strategies used
before. This tells you how disruptive it is to
continue administering the chronic reme-
dy during acute crises! It is also wise, after
the acute episode, to see whether the con-
stitutional state improves greatly without
the administration of any remedy. Better
to wait and watch and give a placebo to
please the patient until the VF has been
able to produce ali the symptoms you must
prescribe on.
Hahnemann further reminds us in Chronic
Diseases to pay attention to another event
which can occur at this point, after treating
the acute event, even when the acute has
been properly treated:
CD: Here is a fitting opportunity to note
that the great epidemic diseases ... when
they complete their course especially with-
out a judicious homeopathic treatment,
leave the organism so shaken and irritated,
that with many who seem restored, the
psora, which was before slumbering (dor-
mant) and latent now awakes quickly, ei-
ther into itch-like eruptions or into chronic
disorders, which then reach a high degree
in a short time, ifthey are not treated prop-
erly in an antipsoric manner. ... The allo-
pathic physician, when such a patient ...
L De Schepper. Using Remedies in Chronic
dies after ali his unsuitable treatment, de-
clares that he has died from the seque/a e
of whooping cough, measles, etc.
These seque/ae are, however, the innu-
merable chronic diseases in numberless
forms of developed psora which (were) un-
known and consequently remained un-
cured (1997, pp.133 -134). (Author's words
added.)
How often do we see a patient in the clinic
who comes to us and says, UIhad this sim-
pie cough (or flu, or small trauma, or small
upset), and I have neve r been well since
then", These statements are explained by
the above quote: this seemingly innocent
event has activated the dormant, often
psoric miasm, leaving the patient in a
worse state than he ever was before. This
is incomprehensible to the patient and his
or her allopathic physician, but easily man-
aged by a well-trained homeopath.
Allopathic recourse
In a footnote to Aphorism 67, Hahnemann
elaborates on situations where allopathic
intervention is justified.
A67: Only in the most urgent cases, where
danger to !ife and imminent death do not
allow time for a homeopathic remedy to
act - neither hours, nor often quarter
hours, nor even minutes - in sudden acci-
dents to healthy individuais, such as as-
phyxiation, apparent death from lightning,
choking, freezing, drowning, etc., only in
such cases may we and should we as a first
measure at least bring back irritability and
sensitivity (physicallife) by using a pallia-
tive ...
Apart from the previous examples, if an
acute situation becomes dangerously un-
controllable, we can use allopathic pallia-
tive treatment to give us a second chance
to find the curative homeopathic treat-
ment. This situation is an exception - for
example, severe bleeding spells in a patient
with chronic u1cerative colitis - and not at
ali the same as preferring to give your pa-
tients OTe drugs or antibiotics as acute in-
terventions, for fear of disrupting the
chronic treatment. Obviously those home-
opaths do not know the basic principies of
homeopathy. They should know that OTe
drugs (just Iike other allopathic drugs)
cause a dissimilar disease, thus creating a
more complex disease, which is more diffi-
cult to treat. They do a disservice to the pa-
tient as well as to other homeopaths who
inherit such cases. And of course they have
passed up a chance to show how well ho-
Diseases - Hamceapathic Links Spring 2005, Vai. 18: 22-28
meopathy works on acute diseases. The
use of allopathic drugs might be an easy
way out for the incompetent or lazy ho-
meopath, but it will make the management
of that patient's case a lot more difficult.
Antibiotics, for example, may overcome an
acute infection, but they do not help the or-
ganism overcome future infections. After
antibiotics the person is to a certain degree
even more susceptible to microorganisms.
Some side-effects of antibiotics include
yeast overgrowth and destruction of the
normal flora. Besides, homeopathy is supe-
rior to any other treatment that exists for
infectious diseases.
What acute events need
an intercurrent remedy?
Not treating a serious acute event at ali is a
mistake. Owing to its nature, an acute dis-
ease evolves in one of four possible direc-
tions: the patient can succumb to it; it will
suspend the chronic disease and can be-
come an independent chronic state; it will
combine with the existing chronic disease
and create a complex chronic disease,
which will be much more difficult to treat;
or (the last and best outcome) the strong
VF might overcome this acute miasm with-
out causing further sequela. "The physician
amuses the patient while Nature cures,"
Voltaire said-but this is nora reason to re-
frain from treating acutes!
Margaret Tyler wrote in her book Homeo-
pathic Drug Pictures (in the lecture on Na-
trum muriaticum (Nat-m.) about a crisis
situation where she treated a chronic Nat-
m. patient with a severe acute headache.
She advises against the use of the chronic
constitutional remedy at this time because
it may produce severe aggravations. In-
stead, she suggests using the acute of Nat-
m., Bryonia, to deal with the acute crisis.
Afterwards she resumes the chronic reme-
dy to remove the underlying cause. This
advice comes from years of clinical experi-
ence and should not be ignored. It also
means that you do not continue Bryonia
once the acute stage is over, as I have seen
-
some homeopaths do!
Which acute crisis needs an acute intercur-
rent remedy rather than a continuation
with the chronic constitutional remedy?
As usual, Hahnemann gives us definite
guidelines. In Aphorism 73 of the 6th edi-
tion of the Organon, Hahnemann describes
three kinds of acute diseases. Group One
combines those relating to lifestyle/diet
and miasmatic predisposition; Group Two
includes epidemic and acutes belonging to
© Sonntag Verlag in MVS Medizinverlage Stuttgart Stuttgart GmbH & Co. KG 25
 idiosyncrasy; and Group Three includes
acute miasms such as those belonging to
childhood diseases.
Group one acute diseases
Group one is subdivided into three differ-
ent categories.
A. Acute situations caused
by lifestyle or dietary mistakes
A73: ... Exciting causes of such acute fe-
brile conditions are: excesses or privation
in eating, traumatisms, chilling or over-
heating, fatigue (!rom poor lifestyle choices),
strains from lifting, etc., or else psychic agi-
tation and upsets (our modem TV. video
games, magazines, and now Internet expo-
sure). (Author's notes added.)
These issues are also discussed in Apho-
rism 77.
A77: Diseases engendered by prolonged
exposure to avoidable noxious influences
should not be called chronic. The include
diseases brought about by:
• the habitual indulgence in harmful
food or drink;
• ali kinds of excesses that undermine
health;
• prolonged deprivation of things neces-
sary to life;
• unhealthy places, especially swampy
regions;
• dwelling only in cellars, damp work-
places, or other closed quarters;
• lack of exercise or fresh ai r;
• physical or mental overexertion;
• continuing emotional stress; etc. ...
Hahnemann refers to these situations also
as "false chronic diseases", since they can
become chronic through continued abuse,
but ali they will require to be cured is a
sensible change to diet andjor lifestyle. He
continues:
A77: These self-inflicted disturbances go
away on their own with improved living
conditions if no chronic miasm is present,
and they cannot be called chronic diseases.
In ali these cases no remedy is required ex-
cept placebo (if called for) to temper the
demands of the drug-oriented or hypo-
chondriac patient. The best treatment is
rest, sleep, appropriate diet, and TLC.
26 L. De Schepper. Using Remedies in Chronic Diseases
B. Acute situations with a clear exciting
factor and strong symptoms
If the exacerbation is moderate to strong,
and a clear causality is manifested, an in-
tercurrent remedy, which acts superficially
on the chronic miasm, may be chosen ac-
cording to the VB method, rather than giv-
ing a deep-acting polychrest. This will calm
the symptoms for the moment without
acting toa deeply on the case. After the cri-
sis has subsided, complementary constitu-
tional treatment is needed to remove the
underlying cause.
Examples of causality include:
• Acute physical trauma - In these cases
the etiology and the organ or tis sue af-
fected will help you identify the reme-
dy. In other words, if the injury is a
puncture wound compared to a blow
(e.g., to the eye), it will correspond to a
different remedy (Ledum and Hyperi-
cum versus Amica and Ruta).
• Emotional trauma - Vou must look at
the kind of trauma as well as the pa-
tient's reaction to the trauma, which
will be determined by the patient's ac-
tive miasmatic state. Remember, the
trauma can wake up the miasm! The
"Mind" section of Kent's repertory
gives many examples of emotional cau-
salities. The patient's miasmatic reac-
tion to these triggers will help you se-
lect the appropriate remedy. For exam-
pie, we have the tubercular jealousy of
Pulsatil/a, the psoric one of Nux vomica,
the syphilitic one tlf Hyoscyamus, and
the sycotic one of Lachesis.
• Poisons and vaccinations - These in-
clude cases of street drug use, allo-
pathic drug use, food poisoning, etc.
The best antidote is not the same or
isopathic substance but the most sim-
ilar remedy. Sometimes you find ef-
fects of poisoning when you look into
the "relationship of remedies" and
when you look at what antidotes that
remedy. This information will narrow
the group of remedies you need to in-
vestigate.
C. Acute exacerbation
of a chronic miasm
For example, in this situation the patient
may have contracted the f1u after losing
sleep or partying toa much. In this case
we do not always want to interrupt the ac-
tion of the constitutional remedy with an
intercurrent remedy. If there is no obvious
exciting cause, it may be a healing crisis
brought on by the constitutional chronic
remedy. Rest, massage, and hot and cold
- Homceopathic Links Spring 2005. Vo/. 18: 22 -28
water treatments (hydrotherapy) might
be sufficient to render the patient com-
fortable until this acute exacerbation sub-
sides.
In Third World countries like Kenya, I have
found myself exposed to situations like
those European and American homeopaths
faced at the tum of the 20th century. Many
people carne to us in an "acute" stage, ex-
cited by physical strain (ali the women in
the village where I worked in Kenya had at
least four children and eight was not un-
common), by becoming chilled or over-
heated, by eating unsuitable food, mental
stress, etc. How many of these cases are
reallyacute?
As you can see in Aphorism 73, Hahne-
mann suggests, and experience confirms,
that most of these cases are acute exacer-
bations of fundamental chronic states and
miasms, activated by exciting causes.
When the symptoms do not represent an
extreme crisis, the simillimum, which suits
their constitutional nature, often clears the
acute exacerbations and then addresses
the fundamental chronic states. That is the
majesty of the grand simillimum. This may
account for statements by homeopaths
such as Massimo Manglialavori who state
that it is possible to find a single remedy
to successfully treat both chronic and acute
situations. However, when the same au-
thor claims that "he does not believe in mi-
asms and knows nothing about thern", I
wonder about the veracity of his state-
ment. Don't we ali owe it to our patients
to investigate before we reject the concept
of miasms - or worse still, we fail to inves-
tigate at ali because of our knee-jerk nega-
tive feelings about miasms? Let's not fali
into allopathic reasoning, which borders
on fear of and hostility towards one of the
greatest discoveries of homeopathy.
Hahnemann says:
A73: In reality most of these acute diseases
are only passing f1are-ups of latent psora,
which returns by itself to a dormant state
ilthe f1are-ups are not toa violent and if
they are quickly eliminated.
Only if the exacerbation is moderate to se-
vere do we want to intervene with inter-
current remedies as an emergency mea-
sure. Again, the VB method will help you
choose the intercurrent remedy.
In his Lesser Writings, Kent expresses the
same scenario:
© Sonntag Verlag in MVS Medizinverlage Stuttgart Stuttgart GmbH & Co. KG
Kent: The acute expressions of a chronic
disease have a different management from
the acute di se ases, e.g., a child suffers from
bronchitis at every change of weather. It
may grow worse if treated with the remedy
for the acute symptoms. The miasm that
predisposes the child to recurrent attacks
must be considered (Kent, 1994, p.419).
(Author's emphasis added.)
Group two acute diseases
A73: Then there are sporadic acute dis-
eases, which affect a few individuais at a
time here and there, acute diseases
brought on by harmful meteorological or
telluric influences to which only a few peo-
pie are susceptible at any one time.
This was long recognized in Traditional Chi-
nese Medicine: certain c1imate factors are
known to influence specific organs which
have an affinity for those conditions, e.g.,
cold to kidneys or dampness to spleen-
stomach, though only certain people seem
to have a high susceptibility tothat particul-
ar c1imate factor. Sometimes, but not al-
ways, these diseases form acute layers,
which repress the constitutional picture
until they have run their course or are re-
moved by homeopathic remedies. These
acute disorders are so closely Iinked to the
patient's chronic susceptibility that they
can often be treated with their constitution-
ai simillimum.lt is only in emergencies such
as sunstroke, dehydration, severe exposure
to cold, anaphylactic reactions, poisoning,
and severe physical or mental trauma that
these cases are truly an acute crisis. In such
an exigency, the symptoms will indicate a
crisis remedy. Acute miasms present a dif-
ferent situation from sporadic diseases be-
cause they involve infectious etiologies.
Hahnemann discusses a second type of
sporadic diseases.
A73: Bordering on these are the epidemic
diseases, in which many individuais are af-
fected very similarly from a similar cause.
In crowded areas they tend to become con-
tagious. These epidemics cause fevers, each
with its own characteristics; and because
each case of disease in the same epidemic
has the same origin, those affected mani-
fest a similar disease process, which, left
to itself, ends either in death or in recovery
within a Iimited time. War, floods, and
famine are often the exciting causes or the
breeders of such diseases.
In acute miasms, the susceptibility factor is
closely related to acquired and inherited
L. De Schepper. Using Remedies in Chronic Diseases - Homreopathic
miasms and family disorders. For this rea-
son, the remedy for the acute miasm may
also be the remedy for the patient's consti-
tutional condition. This is especially com-
mon to acute miasms that run a non-
threatening natural course with few or no
complications. This may not be the case,
however, when the acute disease is of a
very virulent nature. Because of their inten-
sity, these acute diseases will suspend the
chronic disease and an intercurrent acute
remedy is needed to deal with this new
acute natural disease. It will display a new
symptom image that will either run its
course or be removed by homeopathic
remedies.
In these circumstances an acute intercur-
rent is the remedy of choice. We've ali seen
patients who have been never well since
(NWS) a certain iIIness. The NWS acute dis-
ease has now become a chronic disease,
stronger and dissimilar to the previously
treated chronic disease, which is now sus-
pended. SARSis a good example.
Deep-acting complementary remedies
(constitutional and anti-miasmatic treat-
ment) must remove the chronic underlying
causes after the acute crisis is ameliorated.
Let the constitutional factors, the nature of
the disease, and the totality of the symp-
toms (Organon, Aphorisms 5, 6 and 7) be
your guide to the homeopathic remedy,
and you will have success. Follow the reve-
lations of the VF and it will demonstrate,
through causation, signs and symptoms,
which remedy it needs. Trust your recuper-
ated VF to tell you what to do!
Group three acute diseases
Hahnemann also alludes to the third kind
of acute diseases.
A73: Then there are those acute miasms
that always recur in their own particular
form, which is why they are known by an
established name. Some of them are con-
tracted only once in a Iifetime, Iike small-
pox, measles, whooping cough, ... scarlati-
na ... mumps, etc., while others recur fre-
quently in fairly similar ways, Iike ... the
yellow fever of coastal regions, Asiatic
cholera, etc.
Ali these acute diseases should be treated
with remedies reflecting the picture of the
acute miasmatic state alone - the acute ge-
nus epidemicus. A follow-up with constitu-
tional and anti-miasmatic remedies to re-
move the underlying susceptibility is then
necessary.
links Spring 2005. Vai. 18: 22-28 © Sonntag Verlag in MVS Medizinverlage Stuttgart Stuttgart GmbH & Co, KG
Hahnemann warns us to not pay attention
to the na me attached to the epidemic dis-
ease, Iike the yearly flu in modern times.
A100: In investigating the totality of symp-
toms of epidemics and sporadic diseases, it
makes no difference at ali whether some-
thing similar, by the same or a different
name, has ever appeared in the world be-
fore.
Whether or not such an epidemic is new or
unusual makes no difference either in the
examination or in the cure, since in any
case the physician must presume the true
picture of every epidemic to be new and
unknown and must thoroughly examine it
as it is in ali of its details if he wants to be a
true and thorough physician who never re-
places observation with guesswork, who
never lets himself assume that the treat-
ment of any given case in his care is wholly
or partly known in advance and that he
need not carefully seek out ali its expres-
sions.
This is ali the more necessary because
every epidemic is in many ways unique
and upon careful examination is found to
be very different from ali previous ones
falsely bearing the same na me, the only ex-
ceptions being those caused by the same
unvarying infectious agent, such as small-
pox, measles, etc.
What a scathing condemnation of present
allopathic practices where the severe flu
strain of this year was treated, of course
unsuccessfully, with a vaccination of the
previous flu variety!
Conclusion
We can emphasise that the proper use of an
acute intercurrent in the treatment of a pa-
tient is essential for a speedy cure of a
chronic iIIness. When and where to use
these acute remedies are equally impor-
tant issues as when to continue the chronic
treatment, especially when the homeopath
should recognise where the acute manifes-
tation is nothing more than an expression
of a cltronic miasmatic state. Homeopaths
throwing one acute remedy after another
to the unsuspecting patient for trifling
matters are just as guilty of misconduct as
those homeopaths who refuse to use acute
intercurrents under any circumstances.
Knowledge of Hahnemann's teachings is
the only guide!
This article is an excerpt from the new
book by Dr Luc, "Achieving and Maintain-
27
 ing the Simillimum: Strategic Case Man- and P. Pendleton. Washington: Cooper
agement for Successful Homeopathic Pre- Publishing, 1982
scribing." Full of Life Publishing, PO Box 3 Kent jT. Lectures on Homeopathic Phi-
31025, Santa Fe, NM 87594, USA. Dr Luc losophy. California: North Atlantic
is the founder and sole teacher of the Ren- Books,1979
aissance Institute of C1assical Homeopa- 4 Kent jT. New Remedies, C1inical Cases,
thy, with schools in Boston, MA, Secaucus, Lesser Writings, Aphorisms & Precepts.
Nj and Las Vegas, NV. For more info write New Delhi: B. jain Publishers Pvt. Ltd.,
to drluc@cybermesa.com" and see http:// 1994
www.drluc.com. 5 von Boenninghausen CMF. Lesser Writ-
ings. New Delhi: B. jain Publishers Pvt.
Ltd., 1991
References
1 Hahnemann S. The Chronic Diseases: lue De Sehepper, M. D., Ph. D., Lic.Ac.,
Their Peculiar Nature and Their Homeo- C.Hom
pathic Cure. Translated by L. Tafel, PO Box31025
edited by P. Dudley. New Delhi: B. jain NM 8759 Santa Fe
Publishers Pvt. Ltd., 1997 USA
2 Hahnemann S. Organon ofMedicine. 6th E-mail: drluc@eybermesa.eom
edition. Translated by J. Künzli, A. Naudé

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28 l. De Schepper. Using Remedies in Chronic Diseases - Homceopathlc Links Spring 2005. Vol. 18: 22 - 28 © Sonntag Verlag in MVS Medizinverlage Stuttgart Stuttgart GmbH & (o. KG