An Approach to Standstill Cases

After thorough case taking and careful selection of the remedy, administered in the most suitable potency in the least possible dosage, some cases might not get cured as expected by the physician.

However, the patient gets relief from a few symptoms first and a few more symptoms when given in higher potency.  But, there is never really “a complete cure”. Many homoeopaths might have encountered such standstill situations in their treatment of chronic diseases.

According to Aphorism §2 as stated Dr. Hahnemann cure, is “removal of disease in its whole extent” which leads to complete restoration health. In order to attain this cure the patient should be treated as a whole with the simillimum, which is based on his totality and miasmatic background.

Whenever there is an obstacle in the way of cure it is better to interrupt the chronic or constitutional remedy with an intercurrent remedy. The chronic intercurrent is used whenever there is a suppression, miasmatic block or any such obstacles to cure.

1. Miasmatic block: In chronic cases when the progress of cure ceases and the case comes to a standstill despite the best selected remedy, administration of an anti-miasmatic remedy will be useful. While selecting the intercurrent, the predisposing and dominant miasm is to be considered. Once the cure seems to progress, the constitutional remedy can be continued.

2. Suppression: When the miasm is suppressed due to incorrect mode of treatment or the existence of a stronger dissimilar disease in the patient, it may cause an obstruction to cure. Usually in such cases the symptoms keep changing or several drug pictures might come up at the same time. Administering an intercurrent nosode may make the path clear to one constitutional remedy.

3. Acute exacerbations: Any acute diseases which seem to relapse or recur at certain intervals and sometimes with increased intensity than the previous episode (eg. tonsillitis) indicate that there is an underlying block preventing the cure. An intercurrent nosode may help in removing the block and the recurrence of disease.

4. Scarcity of symptoms: In conditions where there are very few symptoms, i.e a one-sided case (§173), the vital force is unable to produce the symptoms because of prolonged suppression of physical or mental symptoms An intercurrent prescription might help the vital force express the suppressed symptoms. That in turn might lead to a better picture of the disease.

5. Never well since syndrome: In patients who did not recover completely from the effects of a past acute disease which has now become a chronic disease (eg. joint pains after Chikungunya), using an intercurrent may remove the remnant symptoms and aid cure.

A chronic intercurrent need not be a nosode. It can simply be an anti-miasmatic remedy. But when it is a nosode, remember that they are deep and long acting remedies. Though it paves a way to cure, it is advisable to use them sparingly with the least possible repetitions. It is better to prescribe it in LM potencies, so that the unwanted aggravations can be avoided.

REFERENCES

1. Hahnemann S; Organon of Medicine.6^th edition; New Delhi: B Jain Publishers.
2. Luc De Schepper; Achieving and Maintaining the Similimum; New Delhi: B Jain Publishers.
3. Ajith Kulkarni; Dr. Ajith Kulkarni discusses intercurrent prescribing, including indications for its use and cautions. April 15,2014; Hpathy; https://hpathy.com/homeopathy-papers/intercurrent-prescribing/