Asthma is becoming important today not only due to the increased number of patients but the concept that this is the era of allergies.I would encourage every homeopath to take up any and every case of asthma as every homeopath can treat if certain care is taken during treatment. Everywhere in the world people are realizing the potential of alternative treatment like homeopathy and acupuncture for it. Some important guide-lines: 1)While taking the case give extra care to how the episode occurs and modalities, severity of the episode. Special attention may be given to the type of parents, pressures the child faces, family history of similar complaint. In most cases there are strict parents, performance pressures, disturbed environment. Due feedback should be given failing which it would become a maintaining cause for asthma. h 2)In elder asthmatic patients always check for cardiac asthma or heart related asthma. 3)In the initial part of treating patients allopathic help may be required till homeopathy takes grasp of the case. This should not be an issue. 4)Patients who are on pump can be allowed to continue depending upon how the usage is. Preventive use can be stopped immediately, however people who need it to control the wheeze should be allowed to continue until the homeopath is comfortable with his line of treatment. It should not be abruptly stopped but tapered off gradually. Approach to case: There are three different types of presentation that one sees in the clinics. One is the typical case where the patient is brought to us inbetween 2 episodes where there is comfort in starting homeopathy.Here start with constitutional medicine and evaluate the scope of mismatic medicine like thuja,medo,nat-s from family history and patients past history. Often after starting constitutional medicine an episode may trigger.This is due to change in susceptibility with more symptoms of the acute state which can help in accurate prescription for acute. The second presentation is the acute state of breathlessness.Do take a complete acute picture and also find out in case there is a change in pattern of symptoms.Inquire into past history of the patients and family history also. The third type of presentation is a subacute state where the patient does all his normal activities,may have a baseline cough and rhonchi on auscultation. Often these cases present a problem as constitutional as well as acute may increase it and cause an episode to flare up.A better strategy in these cases is to explore the miasmatic angle. In case there are clear indications like family history, sycotic miasm then one can open the case with say thuja, medorrhinum, nat-s followed by placebo for best results. Within few days the chest is likely to clear up. Then constitutional can be given. Other problems linked to asthma: As we all know that asthma is a response to allergy. Many times these allergies are in the form of food, especially colouring matter, prawns, particular sea food. In others worms –helminthic group or amoebic are source of foreign proteins in the body and trigger asthma. From miasmatic angle we need to treat this tubercular miasm to get sustained result. Currently due to stress acidity coexists with asthma and so both should be treated. Common Medicines: Acute: Arsenic alb, Antim tart, Cuprum met are commonly used Constitutional Medicines: Calc, Kali, Natrum,Sil, Lachesis are used. Mismatic Medicines: Thuja, Medo, Tub Evaluating a response: Reducing the frequency and intensity of episodes is the first step. Difficulties arise when to begin with frequency is once or twice a year.In these cases if there is a triggering factor like say ice-cream or cold drink ask patient to take it.In case an episode gets triggered then susceptibility has not yet improved. Continue treatment till its totally gone, even if there is a single episode continue treating. Even after its totally cleared under abnormal stress this complaint can trigger so if stress is anticipated preventive medications, talking with patient helps it to abort the episode. Failing to get good response: Generally the right similimum would elicit the right response. Often if it does not or gives inadequate response there may be a maintaining cause like a violent father or marital discord among parents and they are not available to the physician for resolving the problem. Here homeopath can talk to patient to change the patients perception of the problem so that it lessens its effect on patient. Over a period of time the influence of such causes reduces and asthma is cured. Do not hesitate to investigate the case fully so that any pathological state is not missed.Brain granulomas like cysticercosis gives rise to chest congestion probably due to foreign proteins factor.