DEPARTMENT OF PRACTICAL CASE MANAGEMENT. Constitutional weaknesses and disease tendencies exist in everyone and nutritional deficiencies, food toxemias and the peculiar stresses of the individual pattern of living all tend to wear down the inherently defective parts of the organic structure.


We will assume that the indicated remedy is to be given in the 30th centesimal or higher potency and that repetition will be avoided until the cycle of remedial action has been completed.

Medical cases naturally fall into two main groups, accuse and chronic. Acute illness is usually superimposed upon a chronic, constitutional base. This was recognized by Hahnemann and others who ascribed all acute troubles to a “flare up of latent psora.”.

Constitutional weaknesses and disease tendencies exist in everyone and nutritional deficiencies, food toxemias and the peculiar stresses of the individual pattern of living all tend to wear down the inherently defective parts of the organic structure.

Taking the view of that acute illness is really an eliminative effort of the constitution, a cleansing process, the therapeutic approach becomes a very important matter in relation to the individuals further health. Suppressive measure are absolutely contraindicated and we therefore regard all forms of antipathic medication as extremely detrimental. Drugs should not be given to check secretions, neither should anything be prescribed to break a fever or stop a cough.

Correct homoeopathic prescribing is not suppressive. Colds, influenza and pneumonia are often aborted and really cured without a suppressive effect of any kind. Reaction of the organism to the similar remedy results in a rapid evolution and elimination of the acute disorder. After the remedy the hard dry Bryonia cough soon becomes loose, the effort of the Ant.tart. patient to raise material become successful and the acrid, watery; coryza of Nux vomica soon thickens and becomes bland.

The pace of the process is rapidly accelerated and at the same time the patient experiences a feeling of returning strength and ambition owing to the increased activity of the aroused vital force.

Notwithstanding the brilliant results of homoeopathic medication in acute disease there are occasions when it is inadvisable to interrupt the action of a chronic or constitutional remedy unless the acute condition should become really threatening or alarming.

The following rules will be found generally satisfactory:.

1.When a patient is seen for the first time prescribe unhesitatingly for any acute condition. This will give the prompt results the patient desires and help to sell him as to the efficiency of homoeopathic treatment. There is no danger of interfering with the chronic elements in the case before treatment of the underlying disorder has been undertaken.

A woman employed in a large department store was suffering from a chronic condition presenting a clear picture of Sepia. About two months before she had sustained a severe trauma to the right knee which had not responded satisfactorily to “regular” treatment and from which she was almost incapacitated. The local symptoms were those of Ruta. The first prescription therefore was Ruta, which was given in the 30th potency. The results were exactly as expected-prompt and lasting amelioration and a very grateful patient.

What was the next step? A careful investigation and correction of the diet and mode of life as far as environmental circumstance would permit. Thus while Ruta was acting on the knee we were gradually removing the obstacles to recovery before prescribing the chronic remedy. Improvement in the general condition began and progressed slowly and steadily but the Sepia picture was not in the least obscured during the two months required for Ruta to clear up the local condition. As improvement continued to the point of complete freedom from traumatic symptoms repetition of the remedy was not necessary.

The next prescription was Sepia 200. We stepped above the potency of Ruta in order to insure incisive action, although this was probably unnecessary. The reaction to Sepia was brilliant. Everyone remarks the change that has come over the patient and her family say her disposition is so much better.

It would have been cruel to have withheld Ruta when the local incapacity and suffering were so severe. It would have been a waste of time as well as confusing to give Sepia, then Ruta and finally Sepia again.

2. Patients previously under constitutional treatment but not prescribed for during recent months should be treated for any acute complaints before resuming the offensive against the underlying chronic disorder. We are assuming here that the cycle of remedial action has largely run itself out and that interference will therefore not be particularly obstructive to the progress of the case.

3. The more recently a chronic remedy has been given and the more satisfactory its action the more should one hesitate to prescribe for an acute illness. A young man was responding beautiful to Natrum mur. When through exposure, fatigue and repeated contact with the infection he came down with influenza. This was about a month after he had received the 200th potency of the remedy. The patient was put to bed, given raw, freshly expressed fruit juices and plain enemas as necessary. Sac time was his condition alarming. After recovery which was satisfactory and uneventful Nat.mur. continued to act to so that repetition was not necessary until more than three months after the initial prescription.

4. When an acute illness becomes alarming go right after it. Patients under constitutional homoeopathic treatment rarely pick up acute infection and if they do the illness is apt to be relatively mild. However, very threatening cases sometimes develop quite unexpectedly.

A Calcarea carb. patient was doing well under the remedy but came down with grippe after nursing other members of the family.

She phoned for medicine and as the case was mild the prescription was Sac. lac. plus good advice. The next day she did the washing and became thoroughly chilled while hanging out the clothes. Three days later examination revealed extensive lobar pneumonia and the symptoms were those of Phosphorus. As she was very sick the 200th potency was given at once.

In 24 hours the picture had changed definitely for the better. No further medication was required. An interesting background in this case was a strong family history of tuberculosis and both the chronic and acute remedies were those commonly indicated in tuberculosis individual. It is possible Tuberculinum may be needed in this case sometime in the future. It is over a month since recovery from pneumonia and unfoldment of the case is being awaited before attempting further medication.

5. When the acute illness is mild consider giving the chronic remedy in a higher potency if recovery appears to be retarded. The constitutional remedy, if correct, will arouse the vital force and hasten convalescence in the vast majority of such cases.

Proper treatment of acute conditions, according to individual indications, will often accelerate rather than retard recovery from chronic disease.

Note- Any question will be answered through the Question and Answer Department.

Eugene Underhill
Dr Eugene Underhill Jr. (1887-1968) was the son of Eugene and Minnie (Lewis) Underhill Sr. He was a graduate of Swarthmore College and the University of Pennsylvania Medical School. A homeopathic physician for over 50 years, he had offices in Philadelphia.

Eugene passed away at his country home on Spring Hill, Tuscarora Township, Bradford County, PA. He had been in ill health for several months. His wife, the former Caroline Davis, whom he had married in Philadelphia in 1910, had passed away in 1961. They spent most of their marriage lives in Swarthmore, PA.

Dr. Underhill was a member of the United Lodge of Theosophy, a member of the Philadelphia County Medical Society, and the Pennsylvania Medical Society. He was also the editor of the Homœopathic Recorder.