DR. R.E.S. HAYES: I would like to make one exception – I might call it an addition – to Dr. Roberts statements. We do not usually give the constitutional remedy in acute diseases, but there are cases of acute diseases, where the constitutional symptoms are quite prominent and the constitutional remedy will act and act better than at any other time. There will be no other remedy needed afterwards either.
DR. E. UNDERHILL, JR. : I wish to endorse that statement.
DR. C.M. BOGER: It has been mentioned this morning that we are told to remove all the external influences, outside causes, and so on, and then treat the causes with the indicated remedy. In that, Hahnemann does not differ in any sense from our modern allopathic friends at all, only after the causes are removed, bear a distinct relationship to the constitution of the patient, and therefore are likely to correspond to one of Hahnemanns remedies. That brings us down to the crux of what I want to say. The patient who is under a chronically acting constitutional remedy and is taken down with an acute disease is not being affected by your constitutional treatment. In other words, he has not gotten his indicated remedy, because if the constitutional remedy does anything, it so stabilizes the vital force so that one will not be subject to acute diseases.
How far we may allow the patient to apparently go down before our eyes before resorting to the complementary remedy is sometimes a difficult question to answer, but by being patient, waiting for your reaction, watching the concomitant symptoms very carefully, and not being in too great a hurry, you will see your reaction come in due time without the interference of the acute remedy, even in low potency.
When we look back and think of the demonstrations made in the Vienna Hospital, by comparing the results of the Homoeopaths in Homoeopathic treatment of pneumonia with the allopathic, homoeopathic death rate 16 per cent, allopathic 25 to 40 per cent, we can hardly have a more conclusive evidence of the truth of this statement. In my own work in pneumonia, I have frequently seen a case of pneumonia entirely through without giving a single remedy. And the same has been true with typhoid fever. It requires close attention, but the patient is better off afterwards, much better off. Your remedy, if chronic afterward, goes right along doing the work you are not able to do beforehand. In other words, the acute disease was simply a new exposition of a disordered vital force.
DR. A. H. GRIMMER: I am in accord with what Dr. Boger has just stated, providing we are all as competent to select the deep constitutional remedy as Dr. Boger is. Some of these cases with acute conditions really are alarming to patients friends and even to the doctor himself. Unless you are absolutely certain that you have that patients constitutional remedy, it might prove dangerous to leave some acute condition, such as pneumonia, untreated and you may have to interfere with the best indicated acute remedy at that time. I believe that in those vicious cases, with this exposition of psora, we have indications for a remedy that will aid nature in her attempt, but as has been stated by other essayists and commentators, there is danger of suppression if the exact remedy isnt given. It is a hard question, a question that will make us all think. Dr. Bogers idea is really the ideal Hahnemannian way, wherever you are certain of the constitutional remedy.
DR. J.M. OVERPECK: A question comes to my mind. If you have a case of pneumonia or some other acute trouble, and a good, thorough prescriber of Homoeopathic remedies finds symptoms pointing to a chronic remedy, why not give it?.
DR. C.M. BOGER : This question opens up a whole new subject. I dont want to start talking on it. The acute disease is still demonstratively caused by the reacting constitutional remedy. The most careful evaluation of the patients vital force and strength and power of reaction will enable you to decide whether you are justified in giving it or not. The examination and conclusion has to be very carefully made and weighed.
DR. W.J.S. POWERS: There is one point that has not been emphasized enough, the constant recurrence of acute conditions, despite careful homoeopathic prescribing. Why is that? I believe, in a case of that kind, it is very essential that we go into the psychical relationship of the patients, the family relationship, the psychical atmosphere under which he is living. Very frequently by straightening out this outside causes, our homoeopathic prescribing is much more effective.
DR. R.W. SPALDING: It seems to me that the discussion has really brought out two angles to the acute and chronic proposition, as I understand it. The discussion has mainly brought out the assumption that people who are coming down with acute disorders are already under a constitutional remedy, whereas I think Dr. Roberts brings out, in his last paragraph, particularly the point that these cases may first be seen by us as acute cases, not having previously been observed, and therefore great care is necessary in the observation to later point out the proper constitutional remedy.
DR. J.M. GREEN: Let us remember that Hahnemann treated first acute patients, and had one acute case after another, the same patient returning with a different acute manifestation, which made Hahnemann puzzle as to the cause. The very collection, for years and years, of these acute cases was what led him to his theory of chronic diseases. Therefore, the chronic patient should, with good prescribing, not come down with an acute manifestation very often, and when he does, perhaps his chronic remedy is the one to be prescribed. At least we ought to think of that before giving a more acute or temporary remedy.
DR. R.E.S. HAYES: It seems there is one thing more that should be said. The suppression of the acute disease with acute remedies is not always such a serious thing in the end, if the patient is handled carefully afterwards. I have found that where the acute condition is cleared up with an acute remedy and several prescriptions are given afterward of a constitutional nature, the patient did not have the best of health until he got around to the remedy that he had before the acute trouble. He goes right around in a cycle. But when he gets the cycle completed, and gets around to the original remedy, the remedy that he had before the acute trouble. He goes right around in a cycle. But when he gets the cycle completed, and gets around to the original remedy, the remedy that he had before the acute trouble, he will be vastly improved.
CHAIRMAN DIXON: I have noticed so often, through the grippe epidemics, that the chronic cases do not come down with grippe or influenza, or if they do, it is so mild that I seldom find it necessary to take them off their chronic remedy. I suppose that has been the result with their men who have a list of chronics, but I thought, in connection with what Dr. Boger said, I would like to make that remark.
DR. H.A. ROBERTS: I feel very pleased indeed to have had you discuss this paper as thoroughly as you have, because it is just what I wanted you to do. for that reason I did not write much myself. We should emphasize more and more the opportunity the homoeopath has in observing acute diseases. By so doing we are going to learn much. If we only see them in the chronic state, we have missed out. I feel that very strongly.
Now in regard to the carrying through, on the basis that we should never interfere with acute diseases, there are so many times when the system is so overwhelmed with acute manifestations that unless there is interference you are going to lose your patient. I think it takes a great deal of patience and a great deal of judgment to know just where that point is.
Above all, dont forget that acute diseases give us the opportunity that we long have sought, of finding our constitutional remedy better, because it is more manifest. It will come out just at the close of the acute diseases. Very often we homoeopaths, who treat only chronic cases, do not have the opportunity we ought to have. I beseech each one of you to take pains to court the acute diseases instead of confining yourselves entirely in your own office to chronic work.
DR. C.M. BOGER: In a neighboring city there is a family that nearly always needs Mercurius. They are too far away for me to see them, except as chronic patients. One of the children was taken with a serious trouble with the middle ear, tonsils, and so on, and the local homoeopath, who was a very good prescriber, did not seem to be able to get her over it. He finally brought her back to me. I looked her over for a little while. I could not decide which one f the Mercurius group she needed. She had been broken down and was not coming back. I finally concluded that she needed Mercurius cyan. and the response came right away.
