Installment 10 of a series on case analysis
© Will Taylor, MD 2001 (bio)
On the Genus Epidemicus
When the genus epidemicus does not fit the case
The genus epidemicus may fail to act - both prophylactically and in treatment of active epidemic disease - when the reaction of the patient is dictated more by the pre-existing chronic disease of the patient than by the virulence of the acute miasmatic organism.
We might imagine (somewhat simplistically) that the direction a disharmony takes in any particular case of disease is a balancing act between the direction a morbific influence is trying to push us, and the direction in which we are naturally inclined to fall.
For most of the population, it seems that the 'flu' virus is a virulent-enough agent that we mostly fall ill in the same manner, in relative disregard to our individual situations. But for those whose dynamis is occupied with an active chronic disease, the reaction to the 'flu' virus may have more to do with the disharmony of that pre-existing disease of the person than it does with the reaction that the rest of the population experiences to the virus.
Consequently, their 'flu' is unique, and does not bear similitude to the genus epidemicus that prevails in the larger community. If their chronic disharmony can in its own individual manner embrace the disharmony invited by the 'flu virus', the 'flu' takes on an individual character in that patient.
If the chronic disharmony of the patient is sufficiently dissimilar to the demands made by the virus, the patient may even be "protected" from this acute illness by their chronic dissimilar disease. 9 We all have seen cases like this, where our patient is impressed that they have avoided colds and flu for the past several years, despite being debilitated by (e.g.) chronic rheumatoid arthritis.
As an example of this, during the '97-98 'flu epidemic, a patient presented ill with 'flu', with acute symptoms indicating Bryonia, and clearly not fitting the Eupatorium perfoliatum genus epidemicus which at that point had already seemed to be well-established for that 'flu' season.
She responded nicely to Bryonia, prescribed on her individual picture, and later returned (inspired by this successful treatment) for attention to some chronic complaints. She had long-standing gynecologic symptoms and premenstrual irritability, and Sepia was found as a clear simillimum to her chronic case. Now Bryonia is a common complementary remedy to Sepia (this is one of the classic pairings of our MM), and it became clear why, when the 'flu' virus came to town, she more easily fell into this complementary Bryonia state than the Eupatorium state that was affecting the larger community.
For individuals with active chronic disease, the most effective strategy for epidemic prophylaxis may be to treat with the simillimum for the pre-existing chronic disease of the patient, rather than focusing on the acute disease as it is seen in the remainder of the community.
Kent introduced the notion that all acute disease is predicated on psora (pre-existing chronic disease); though it is difficult to determine how this belief affected his actual clinical practice in the treatment of acute disease. Kent's assertion would suggest that acute diseases do not occur for those in perfect health - certainly a radical concept, and one that is at clear variance with Hahnemann's views and observations on the matter. The notion that we can address acute disease adequately by always focusing exclusively on the chronic is one that has found its way into contemporary homoeopathy as well as into many contemporary "new age" medical philosophies. In the prophylaxis of acute epidemic disease, when are we best to focus on the epidemic and when is it more appropriate to focus on the chronic?
Some suggest that we should always give the chronic remedy in acute disease. Is there always a chronic remedy indicated or identifiable for the person who appears to be in previously good health? When a chronic disease is present, does it always dictate the direction of acute illness?
It is my impression that simplistic or theoretically derived answers will not suffice here. Many apparently acute diseases clearly represent the acute flare-up of pre-existing chronic disease, sometimes under the influence of an external morbific influence, such as the 'flu' case described directly above. Others appear to represent the direct action of an acute morbific agent on an otherwise healthy dynamis, or the acute diversion of the dynamis from a previously existing chronic disharmony. It appears to me that, in order to ensure and maintain health, we need to attend equally to both the chronic and the acute, assessing the needs of our patient on a case-by-case basis.
When and who to treat prophylactically?
At first glance it might seem appropriate to treat everyone - or anyone who desires it - prophylactically for such epidemic acute illnesses as measles, whooping cough, scarlatina, mumps, influenza, etc. when these visit the neighborhood. However, on greater reflection, there may be some concerns with doing this.
Is there value to our system in spontaneously going through an acute disease? Does the immune system benefit from the experience of sustaining us thru measles? Will prophylaxis of chickenpox as a child open us to the risk of contracting this disease as an adult, when it is of much greater concern? Are some of these acute expressions of disease opportunities for the system to throw off a chronic miasmatic burden that might otherwise contribute to chronic degenerative disease? Does homoeoprophylaxis interfere with the dynamis' response to an acute morbific influence, or does it assist us in making a more balanced response, permitting us any benefits of the experience but tempering the process so that this is done without dis-ease?
We have only to look at our allopathic colleagues and the evolution of their acceptance of universal immunization to see how cavalier one can become with these questions. From cautious application in such ravaging diseases as smallpox, we are now being encouraged to immunize against the common inconveniencing diseases of childhood in order to minimize lost work days for parents.
Until answers to some of these questions are in, my position is to provide prophylactic treatment on a case-by-case and epidemic-by-epidemic basis, always considering the larger issues raised above.
for the homoeoprophylaxis of epidemic and sporadic acute diseases
|Influenza A||Influenzinum; Anas barbariae hepatis et cardus extractum|
|Whooping cough (pertussis)||Pertussin|
|Lyme disease||Lyme nosode|
|Table 2||"Central" remedies|
to consider for the homoeoprophylaxis of sporadic and epidemic acute diseases
|Influenza A||Eupatorium perfoliatum, Gelsemium|
|Whooping cough (pertussis)||Drosera|
|Strep pharyngitis||Mercurius vivus|
|Travelers' diarrhea (e. coli)||Bismuth*|
|Epidemic conjunctivitis / Pink eye||Mercurius vivus (though varies greatly)|
|* This very likely explains the effectiveness of Pepto-Bismol®, a commonly-used and conventionally-recommended preventive and early-treatment option for these conditions|
9. Concerning the Curative Effects of Thuja in Small-pox; Clemens Maria Franz, baron von Boenninghausen; Allg. hom. Zeit, vol. xxvii, p. 21; and in The Lesser Writings of Boenninghausen, L.H. Tafel trans./ed.