James Kent on Acute & Chronic Remedies
There are some "classical homoeopaths" who speak against treating acute diseases and always look for the complete "constitutional remedy". It is true that some individuals demonstrate the symptoms of the same remedy in an acute state as in their constitutional condition, but in true crisis, this is not always the case. It is the nature of the constitution, causation and symptomatology that decided the cases management strategy that is needed. Many modern "constitutionalists" consider themselves to be following in the footsteps of the great practitioner, Dr. James Kent. Did Kent only give constitutional remedies? Did he avoid the treatment of acute diseases? Did he mix the acute and chronic symptoms together in one grand totality? Where can we look to find out what Kent really thought on the nature of acute and chronic treatment? In true acute crisis the active layer of symptoms must be used as basis for the prescription of the remedy rather than the suspended chronic symptoms.
The following quote is from the article called The Examination of the Patient (Continued) from Kent's Lectures on Homeopathic Philosophy .
"It is important to avoid getting confused by two disease images that may exist in the body at the same time. A chronic patient, for instance, may be suffering from an acute disease and the physician on being called may think that it is necessary to take the totality of the symptoms; but if he should do that in an acute disease, mixing both the chronic and acute symptoms together, he will become confused and will not find the right remedy. The group of symptoms that constitutes the image and appearance of the acute miasm must now be prescribed for. 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 symptom that the patient has in a lifetime. "
When an individual is suffering from a dangerous crisis, a serious accident or emotional trauma, or a virulent acute miasms, the treatment of choice is the acute remedy or acute intercurrent. After the acute state has subsided the underlying fundamental cause must be removed by complementary constitutional treatment to prevent reoccurrence and complete the cure. No remedy is exclusively an "acute remedy" by nature. A remedy becomes acute or chronic depending on the strategy of the homoeopath and how he applies the remedy. Deep acting remedies like Arsenicum, Mercury or Sulphur are often used in acute diseases if the symptoms of the acute layer calls for them. The key in such situations is not to mix the acute and chronic symptoms together in one grand totality as this confuses the case.
Kent truly followed the teachings of the Organon on the use of acute and chronic remedies. He correctly reminds homoeopaths that when a strong crisis mistunes the vital force it suspends the chronic symptoms while the acute disease runs it course (Refer Org. §38, Layers). Many of our modern constitutional homoeopaths are much like the diligent physician of whom Kent was speaking. They mix all the symptoms of the acute diseases, chronic miasms and innate constitution altogether without paying attention to layers of symptoms. They always search for the 'one constitutional remedy' that treats everything at once. This can be a great mistake in a crisis caused by a strong exacerbation of a chronic miasm, an acute shock or trauma, physical injuries, or a virulent acute miasm. The proper remedy for such conditions are crisis remedies and acute intercurrents.
The well respected British homeopath, Margaret Tyler, gives a graphic example of a crisis situation in her lecture on the remedy Nat-m in Homeopathic Drug Pictures. She speaks of her experience of treating a chronic Nat-m. patient during an severe acute headache. Dr. Tyler advises against the use of the constitutional remedy at this time because it may produce severe aggravations. She suggest instead the administration of Bryonia, an acute complement of Natrum Mur., to remove the acute symptoms, She then followings up with the chronic remedy to remove the underlying cause. This is advice comes from her years of experience experience in the clinic and should not be ignored. Not everyone is ready for their constitutional remedy the first time they are seen because the acute state is often what brings them to the homeopath.
Kent echoes Mrs. Tyler advice on acute and chronic states in his Lesser Writings in Class-Room Talks (page 269).
"Chronic tendency to congestion of the head, when Bell. has been the remedy that gave relief to the acute expression of the diseases, Calc [is complementary]. Now, I don't mean you to understand that during the attack Calc. would be the better remedy. Bell. corresponds more fully to the acute manifestation. Calc. would aggravate to strongly; but after the attack a dose of Calc. will cure the tendency to repeated return of these congestions."
James Kent and Margaret Tyler truly followed Hahnemann's teachings on the nature of acute and chronic states and their similar remedies. If an acute crisis dominates the symptoms, the remedy of choice must focus on the active symptoms. If one reviews the modern simplified version of "Neo-Kentian Homoeopathy" one finds that it bears little resemblance to what Kent actually practiced. Kent was a Hahnemannian Homoeopath.
Dr. David Little