I deal with many acutes (acute conditions) in my practice.


We have to distinguish acutes from chronic conditions, but our approach should be less dogmatic.


We are only the human beings and we are prone to split up psyche and physical , mental and somatic, acutes and chronics.


What does it mean from the homeopathic point of view - acute conditions? I will explain it.


Boger writes: "Science is not what we learn, but the tool which helps us to understand facts".


Since the very moment a child is born his acutes begin to be suppressed. Every time we fall sick we can observe the manifestations of the active miasm coming out.


How should we, as homeopaths, regard the acutes? It is crucial that every acute we meet is treated properly.


Firstly we have to measure the degree of the malady and decide what to prescribe - placebo or the real remedy.


It is written in Organon that whenever the howsoever common acute condition happens, it might block the treatment of the chronic condition. For instance, if you have been treating a patient with chronic conditions and he gets injured, do not hesitate to send him Arnica. If you did not give Arnica, he might overcome this acute condition and we will continue to treat his chronic condition. However the treatment of the chronic disease might be stopped since the trauma occurred (the trauma has blocked the course of the chronic treatment). In order to be sure - even when a common trauma happens - give the patient Arnica.


Many people think that the treatment of the acute disease interferes in and impedes the treatment of chronic disease.


This is not true.


After treating the acute situation you have to assess what is going on with your patient. While selecting the new remedy for the chronic condition, you might witness the progress in the chronic treatment, or you might observe the appearance of the new symptoms which have to be taken into consideration. Do not be afraid of treating the acutes - it won't get in the way of the treatment of chronics.


On the other hand, we have to be extremely careful while treating acutes, as the homeopathic treatment has to be carried out properly. If we treat the acute malady with the remedy which is not similar enough, we may suppress it. Especially when such a partially similar remedy is a polychrest.


 A case from the literature.


Tuberculous meningitis with vomiting (from the increased intracranial pressure). The patient got Ipecacuanha, which stopped vomiting. But Ipecacuanha did not affect the course of the disease in general.


If we gave the partially similar remedy, the most bothering symptom becomes better. The tormenting symptoms have been gone, but the disease has been supressed and goes inward, intertwining with the chronic miasm. It is necessary to choose meticulously the right remedy.


The next example.


Five women with involuntary urination that gets provoqued by coughing, sneezing, laughing. They all receive Causticum. There is a probability that four women will get the amelioration of this symptom, as Causticum possess a profound action and works deeply in the economy. But if Causticum does not cover the totality of symptoms, its action is suppressive. No wonder if this symptom comes back in a month and then we have to prescribe another remedy. But we could get lost here.


The chronic disease often is the result of subsequent suppression of acute conditions by antibiotics, hormones, and homeopathic remedies. Homeopaths do suppress things too.


After the acute remedy has been given we have to track the reaction.


Dr Allen writes: "Most of homeopaths are quite successful in their first prescribing. However they do not know about the reaction which follows and make mistakes thereafter."


If the right remedy has been given, what is supposed to happen?


We will see the symptoms of the chronic miasm come out to the surface, the very underlying miasm which is the root of a disease. We will see the orderliness, not a chaos. The symptoms will be organized in a distinctly ?seen totality which points to the chronic remedy.


Our practice ascertains us every day that Homeopathy strings along with the Nature's laws. The deeper goes the disease and the stronger its manifestation progress, the less distinguished are the patient's homeopathic symptoms. The suppression in such a situation - how it looks like? There is an example.


The patient has some digestive problems (heartburns, stomach pains, etc.). The homeopathic practitioner failed to help him.


The patient goes to the allopathic physician, who prescribes him antacids, and so forth. So, all laurels are destined to allopathy. The patient is better with his digestive system, but in a few months a prosopalgia crashes down on him. The patient goes to the homeopathic practitioner again. We see suppression: the disease, when suppressed, penetrates deeper into the economy, because the suppressive treatment goes against the Laws of Nature.


The homeopath tries to do his best, he looks for some trivial symptoms, some concomitants - but there are no concomitants and no trivial symptoms.


Suddenly the patient mentions that he feels pain in the root of the nose and it extends to the occiput.



Giving Kali carbonicum in different potencies, the homeopath has managed to cure this prosopalgia. Now the digestive symptoms ought to return.


The homeopath gathers the symptoms meticulously and prescribes Natrium sulphuricum for the digestive symptoms in the scale of potencies. Eventually the patient has been cured. Such a case required tremendous efforts and huge knowledge from the homeopath to cope with.


There is another example, when one symptom obscures the rest of them. For instance, let’s consider a renal colic. It is an extremely painful condition, the pain is agonizing. Often this condition is a result of the suppression. One very famous homeopath in India said: "Give the remedy before the stone coming out!"


I remember many cases of the successful renal colic treatment when I worked at the homeopathic clinic in Belgium.


The patient had a renal colic. There were 15 homeopaths who worked there. The patient got Berberis, Lycopodium, Nux vomica. I was at home and they called me. I found out he felt burning sensation all over the inside of his body, as well as in urethra, during urination, as there was a stone passing through. I was lucky, I thought about Cantharis. He was given it in 10m and the remedy helped him in a few minutes. I'm not bragging, I just got lucky choosing that remedy. In such cases you can prescribe focusing on a minimum of reliable symptoms.


In another case, Nux vomica was a good help for the renal colic.


Ocimum canum produces renal colic with vomiting.


In an acute state there is no time for repertorisation. We must test ourselves for the knowledge of the Materia Medica and prescribe the remedy quickly.


There is another example. Pain in the hip joint, contracture, lameness. We have no other symptoms. We know that there is tubercular inheritance in the family. Pale and very pedantic, and for these symptoms Arsenicum album was prescribed. Within a few days it cured this problem with joints.

In this case, which was the splash of the chronic condition, Arsenicum album was administered based on the observations of the doctor. In an acute condition, the deep-acting remedy may be required, and not only the superficial one.


Another example is the case with a few symptoms. A weak child with whooping cough.

Recently, at the seminar in Moscow, I presented several cases of whooping cough in children. Whooping cough can be very dangerous for the children under 12 months of age because it brings complications - pneumonia, bronchopneumonia, pleurisy, and dehydration.


There is a case I would like to mention: the weak child with whooping cough and pleurisy. There was no special symptoms for prescribing the remedy.


The child was angry, irritated while awakened. Nostrils moved involuntarily. These are only 2 symptoms based on which the prescription was made. And it was Lycopodium 200. After 2 hours the child began to sweat profusely, and there was an improvement. That case was not mine. It was described in the literature.


Now I'm going to show examples of acute conditions that I have had in my practice.


Sinusitis, a woman 43 years old, a week ago.


The pain began in the inner corner of the eye and extended along the eyebrows. The pain got worse bending forward (it is common for sinusitis, nothing special). There was no clear modalities. She mentioned the yellowish-brown discharge from the nose. I noticed two warts which were over the right eyebrow – they were there since her childhood. The pain at night was as bad as during the day. Kent added Cinnabaris (a combination of Mercury and Sulphur) to the rubric:


EYE – WARTS, Lids.


I remember that some author wrote about Cinnabaris: "Warts on the face, close to the eyes."


I gave Cinnabaris 30 a few times. There was profuse discharge from the nose and the rapid improvement in sinusitis.


Cinnabaris has pain in facial bones, it starts from the inner canthus and goes outward. Cinnabaris was prescribed based on the symptoms of an acute condition and on the symptoms of a chronic condition (localisation of the warts). Here comes the question: was that condition acute? I think this was an exacerbation of her chronic condition.


Hahnemann writes in Organon: "In the case of an acute condition, we will see the symptoms of an acute condition, while all chronic symptoms fade." But in this case I used the symptoms of a chronic condition (warts) for the prescription. How much should you be flexible and walk away from dogmata! We saw that the case of a child with whooping cough and pleurisy required a deep prescription.


It depends on the dynamics of the case to choose what prescription is necessary (deep or superficial). Very often, but not always, if the symptoms are severe, a necessary remedy will be from plant or animal kingdom, from sycotic or syphilitic field.


It is often written in literature that flu has a sycotic manifestation. But we must look at the dynamics of the case. There is a big difference between the symptoms of Aconite, Apis, Belladonna (very rapid development of acute conditions often requires these remedies). If the flu develops slowly, the remedies with slow dynamics are required, such as Gelsemium, Bryonia.


Here is another example. The student, 22 years old. She had the pain in the left lower limb (from the hip down to the foot). It is a sciatica. The defecation has been painful recently, she felt the pain in the anus during the stool.


I asked a question:

"Are feces solid? Any constipation? "


"No. Even if there are soft feces, during defecation there is still the pain in the anus, as if it is a wound. "


"What kind of pain?"


"It is burning, very burning."


Let's see in Kent's Repertory:


RECTUM - PAIN - Stool, during;

RECTUM – PAIN - Anus, burning;


In these rubrics the remedy is highly valuable.


EXTREMITIES - PAIN - LOWER LIMBS - Sciatic nerve, left.



I asked:


"Do you have migraines?"


Yes, a few months ago she had a very strong attack of migraine accompanying a visual aura (she could see nothing).


Vision, loss of vision, headache, before.



I looked in Boericke. And I asked about herpes zoster. She was consulted before about the eczema between the fingers.


I gave her Iris versicolor 30C, a few doses.


After 48 hours, the pain in the leg had completely gone and in a few days the pain in the anus disappeared also.


Migraine happen on weekends (migraine while relaxing).


Boericke says: "Left-sided sciatica", Iris versicolor. It was the situation of Iris.


Hahnemann did not prescribed on modalities, but on a combination of symptoms that the patient had. He prescribed without emphasis on modalities and sensations. Benninghausen was the first who emphasized modalities and concomitant symptoms.


Benninghausen developed the concept of the full symptom:


1. Sensation


2. Localization


3. Cause


4. Modalities


5. Concomitant symptoms.


Concomitant symptoms are those symptoms which are not related pathologically with the main symptom. In the case of Cinnabaris, a concomitant symptom was the warts near the eye (it is not directly associated with the sinusitis), although the example with the warts is not very good, because it is important that concomitant symptoms appear approximately at the same time as a main symptom.


I remember the old case of a child with asthma, who was helped with Conium, although it was not given on a spot, but in 7 months, when I noticed a concomitant symptom which was appearing during the asthma attacks: the herpetic eruption on the face. This symptom helped a lot in choosing a remedy. The child had been always brought in an acute condition, and Arsenicum album, Antimonium tartaricum, Ipecacuanha were administered with quite a success, but the attacks came again, as those remedies were superficial and did not touch the miasm. Mom said that herpetic eruptions appeared on the right cheek each time before the attack.



I administered Conium, it fitted the totality of the symptoms. The child was very slow in action, slowly talking. This is a very nice case of Conium.


After the recovery from bronchial asthma, the warts came out. George Vithoulkas said in his lecture, that if you successfully cured the patient, and he had warts afterwards, then this is even better than the appearance of the rash, because you touched the miasm.


I told the mother do not remove the warts. Then they passed by themselves. Sometimes in a snowfall he needs Conium to support his health.



The aggravation during snowfall is typical for Conium. This is a very beautiful case. During the first consultation we do not usually think about Conium, more often about Thuja and Natrium sulphuricum.


Here is an another example.


A few days ago a patient of mine wrote about his son. The boy is 4 years old. The heavy object fell on his thigh and he got a fracture. He lies in the hospital on stretching, has not yet had surgery. I prescribed Calcarea phosphorica 6C (as an organothropic remedy) in the morning and Symphytum 6C in the evening.


Do not be afraid. These remedies can be alternated to relieve pain after fracture and for bone repair. The next day his father wrote to me that the child could not sleep - he shuddered at falling asleep and the pain intensified. I prescribed Sticta pulmonaria 200 - 1 dose. In the repertory there is a rubric: "Insomnia after an accident".



From the next day the boy slept well. A week later, the callus had been formed. In this case, he needed 3 remedies. You could not help in such a case with one remedy. This is a mixed complicated situation, as several different problems exist in different parts of the body.


In paragraph 40 of the Organon, Hahnemann allows to alternate remedies in such situations.


This is another case that happened a few weeks ago.


An acute gouty inflammation of the joint of the big toe on the right leg. This patient has a gouty constitution (so-called lithaemic diathesis). The level of uric acid is increased. Drinking a lot of beer aggravates.


According to Kent, we have to consider firstly general symptoms, then local.


It is crucial to know Boericke by heart. Homeopathy is a difficult thing. But knowing Boericke by heart, you can prescribe well, if nothing else you have up your sleeves. Repertorisation is important, but it can drive you crazy. You take 40 symptoms - and you get lost. It is better to take a few symptoms into repertorisation and go to the Materia Medica Boericke afterwards.


Back to the case. Beer provokes the attack of gout. During the aggravation the finger is swollen, red, touch hurts, cannot bear the pressure of shoes. He's got problems with his back. Stuffy nose.




GENERALS - FOOD AND DRINKS - Alcoholic drinks, agg.




GENERALS - WEATHER - Wet weather, agg.


He is thirsty at night. Sweaty at the slightest stress. Pulsating and stitching pain in the joint of the big toe.


"When your back hurts the most?"


"Especially when I'm turning in a bed."


Kent says in the Lectures on the Philosophy of Homeopathy, Chapter 26 that you should take into account both the symptoms of a chronic and acute condition, if the chronic symptoms do not disappear in an acute condition.


Be careful when mixing symptoms of acute and chronic conditions. With an exacerbation of a chronic disease or an acute condition, chronic symptoms usually subside. “The chronic symptoms will not, of course, be present when the acute miasm is running, because the latter suppresses or suspends the chronic symptoms, but the diligent physician, not knowing this is so, might wrongly gather together all the symptoms that the patient has had in a life time.” (Kent, "Lectures on the Philosophy of Homeopathy", Chapter 26).


If, during exacerbation of the disease, chronic symptoms subsided, and one or several remain active and in an acute condition, then they must be taken into account in a combination of symptoms.


The symptoms of acute gout and a persistent chronic back problem are to be treated together.


The computer repertorisation displays “the soup from polychrests”: Sulph, Nux-v, Calc-c, Puls, Phos, Sil.


I opened Boericke and began reading about the very interesting remedy for an acute gout.


"How do you sleep? What is the position of your legs? "


"Usually 2 legs are together, or the one leg is stretched out."


"Are you crossing your legs?"




I asked such a question as that symptom is the key symptom of the remedy which I thought about.



This does not mean that you can not prescribe the remedy because you don't have this confirming symptom.


Joints are edematic, there we see a gouty inflammation of the thumb.


I prescribed Rhododendron 5C every 3 hours, after 8 hours it became much better.


In this case all the symptoms were present, except the thirst at night and the desire for meat.


Some remedies are specific for certain conditions, we should not deny this, for instance:


- constant hiccup during pregnancy - in 99% of cases Cyclamen will help;


- bronchopneumonia after measles - almost always will be Chelidonium majus.


The old masters, say, Lippe, Hering, often prescribed keeping in mind a tropism to a particular organ or a specificity to a particular situation. We should not ignore this.


I told you about the concomitant symptoms.


The prescription on "keys" is, on the one side, dangerous, on the other hand, we should try to include "keys" into the totality.


A localization is also very important!


Many remedies have an affinity to the certain organs. It is important to know the organotropic remedies. Very often they have not been tested enough and little described.


Baryta carbonica is the example. While reading the pathogenesis of Baryta carbonica, you will find nothing about its influence upon a heart.


In this regard, I recommend you to read Boger's Synoptic Keys and Materia Medica. This is the most important book on organotropic remedies.


We will see in Boger the description of Baryta carbonica's action upon the heart. Where did he get this information from? He did not get it from provings, but from other sources.


We know the three main information sources for remedies’ pathogenesis: tests, clinical observations, toxicology.


Boericke says: "Cardiac symptoms after suppressed footsweat."


Baryta carbonica in one case healed both heart valves and sweating of legs.


Every time the case is considered, see Boger in Synoptic Keys about the affinity of remedies.


Baryta carbonica and Apis mellifica affect the lymphatic system (the blood vessels, according to Boericke, as it is circulatory system too).


Apis mellifica is prescribed in acute cases of Baryta carbonica if there are problems with the lymphatic system. Both remedies have similar symptoms. Modalities are also important.


Boger also has a book about the phase of the moon. He recorded the remedies which work better in the certain phases of the moon. Nash admits this moon influence too.


Clematis erecta is a very good sycotic remedy. It has moist eczema during the crescent moon and dry eczema in the last quarter of the moon.


Boger saw many confirmations in his clinical practice.


Time of the remedies.


Different remedies have different times of aggravation throughout the day. We have to ask ourselves: is it important to consider the time of aggravation in a particular case?


The time of aggravation is important if a disease does not have a periodicity.


For instance, the attacks of malaria occur every 3-4 days; therefore time is not so important for a prescription.


The remedies which have the most pronounced periodicity are Cedron and Aranea diadema.


Cedron: typically its symptoms are aggravated at 3 pm, and the next day also the aggravation takes place at 3 pm.


Aranea diadema: an aggravation is typical in a certain period. But this is not what we are talking about.


Periodicity is intrinsic to both of them, like it is to malaria, but we do not often prescribe them for malaria.


While treating malaria we use rather Natrium muriaticum than Aranea or Cedron.


When do we use them? They are used for atypical malaria or for neuralgia of malarial origin.


Natrium muriaticum has an aggravation at 10-11 am.


Belladonna aggravates at 3 pm (in case of otitis media the child wakes up at 3 pm with a pain in his ear, this is the Belladonna's case).


Apis mellifica has an aggravation between 3 and 5 pm.


The Doctrine of Signatures explains the aggravation of Apis at 3-5 pm: bees are most aggressive at 3-5 pm. The Doctrine of Signatures stays in connection with nature and is not a far-fetched mental construction.


Chelidonium majus: this plant has a yellow-colored juice and flowers; in Homeopathy it is used for treating jaundice and hepatic pathology.


In nature there is synchronicity and there is no coincidence. There is a consistency of patterns which follows the law of nature.


Worsening of all symptoms after sleep is typical for Lachesis. The poison of the Surukuku is the most poisonous after sleeping.


Lycopodium has an aggravation from 16.00 to 20.00.


Thuja has an aggravation at 3 am and 3 pm. This is important to know. In the Materia Medica Pura of Hahnemann it is written about Thuja, that it has neuralgia of the trigeminal nerve on the left, pain is much less when the head is drawn back, and is worse when bending forward.


From the Materia Medica Pura: "Headache as if his head were compressed from without, with pulse-like beating and shooting on the temples, which pains are removed by external pressure and bending backwards, but return by bending forwards."


In the Hering's Materia Medica it is mentioned that Lachesis can be used in cases of acute intussusception in children with aggravation after sleep (an intussusception occurs after sleep). Lachesis is a specific remedy for this condition. Strong abdominal pains appear immediately after sleep. If you give Lachesis quickly, you can avoid medical intervention. If there is fecal vomiting, this condition requires surgical intervention.


Intussusception is a very acute, sudden condition, where there are no special symptoms, no modalities. In case of intussusception we see strong colic, vomiting and a little mucus from the anus.


Lachesis is a left-sided remedy, the symptoms go from left to right. If there is a case of Lachesis with crosswise symptoms, then there are the left upper part and the right lower part.


An aggravation after retrocession or suppression of excretions and eruptions. Pharynx is worse when swallowing fluid and empty swallowing, and better when swallowing solid foods. There is an aggravation from alcohol, in the spring. It is often prescribed for pollinosis.


Otalgia worsens when a plane is landing, this is a Lachesis' symptom. It is characterized by aggravation during downward movement.


A marked trembling of a tongue. Ask the patient to show the tongue, and he forgets to put it back and sits with his tongue stuck out. It is Lachesis.


In severe pathology there is a sticky mucus in a mouth. It is also Lachesis. He likes to talk. When talking, the frothy saliva accumulates in the corners of a mouth.


China has an aggravation from the slight pressure and an amelioration from the strong pressure.

There is another case. A few weeks ago my son returned from fishing in France, where he ate some hamburger and contracted hemorrhagic escherichiosis.


He had diarrhoea with an abdominal pain and a strange feeling of water in the ear. He was very, very cold, as if ice were in bones.


I took the Materia Medica Boericke - a feeling of icy coldness and a feeling of water in a ear.


The feeling of coldness - think of Cistus canadensis (icy coldness in an acute condition), Aranea diadema, Camphora.


Camphora has the following: if it's cold - he opens himself up, when it's hot - he wraps himself around. Therefore, it is easy to distinguish Camphora from other remedies.


I was worried that hemorrhagic escherichiosis could result in a syndrome of kidney failure. Generally, children or the people with low immunity may develop this syndrome.


Menyanthes helped in 12 hours, after a few hours he was getting better. The determinant symptoms were a feeling of icy coldness and a sensation of water in the ear.


Menyanthes has an unusual symptom: the sensation of water in an ear. On the one hand, this is a local symptom, and on the other - it is a symptom from paragraph 153 (unusual, rare, special symptoms). If a patient with an intestinal pathology complains of a concomitant symptom of water in the ear, then this symptom becomes strange, unusual, and determines the selection of a remedy. In general, my son was indifferent to his hobbies. There was also a symptom: "a crackling noise in the ear, worse when chewing". This symptom is not so important, since it can be explained.


I promised to speak a bit about the repertorisation.


In repertorisation we go from general symptoms to local ones. For instance, "the tennis player's elbow" (epicondylitis) is found in the rubric in Kent's Repertory. In this rubric we see Rhus toxicodendron, Ruta, Arnica. I repertorised this case as was recommended by Kent and I did not succeed.


GENERALS – SIDE – Left, then right.


While making repertorisation, we should be very selective about the symptoms and go from general to local symptoms.


Feeling of stiffness in the elbow, and burning pains.


Worse, when stretches out his hand.


Aconit, Rhus toxicodendron, Lachesis came out. But most prominent was Radium bromatum:


  • on the left - to the right,
  • stiffness,
  • aggravation from stretching,
  • burning pain.


I gave Radium bromatum with a good result. I began with general symptoms and have come to Radium bromatum.


Here is another case.


Whooping cough in a child of 7 months of age.


He was hospitalized. His uncle and aunt took a video and showed it to me.


The child had not been vaccinated and was treated by another homeopath. The doctors from the University clinic said that the child might not survive.


In allopathy, there is only a palliative treatment for pertussis. Antibiotics help very little. I did not know what to give. There were no ideas.


He had a viscous, like thread, sputum stretched endlessly and did not rip. The excretions were transparent. The doctors suspected that the urinary pathology (pyuria) accompanied pertussis.


The relatives have been giving him secretly Coccus cacti 200 every 3 hours. After 2 days there was no mucus in the lungs.


Respiratory pathology in combination with urinary pathology: think about Coccus cacti.


Coccus cacti stands between Lachesis and Cantharis. Just like Lachesis it does not tolerate tight clothing.



Cases of whooping cough become numerous. I have had 17 cases of pertussis in six months.


I was impressed by the flexible joints of the child and the epicanthus. The mother had a twin sister, she died at 4 months of age. These 3 symptoms made me think about an active syphilitic miasma.


The children with a syphilitic miasma often develop life-threatening conditions. If Coccus cacti had not have the effect I expected, I would have given him Syphilinum 10M or 50M.


In the case of the life-threatening condition, if you do not know what to give, give Syphilinum 200, because the syphilitic miasm is the closest to death.


The presence of twins in the family points out at the syphilitic underbrush.

Young athletes die from a heart attack - it is a syphilitic miasm.


The child dies at 4 months of age - it is a syphilitic miasm.


In this case, Coccus cacti saved the child from the life-threatening state, in other cases there would be convulsions.


The very syphilitic symptom is a linear pain. Syphilinum has a linear headache.

Symmetrical symptoms (pain, rash) indicate the active syphilitic miasm.