Hi Donna,

I would never give the "constitutional" remedy at the moment of an acute excerbation. This is what I learned, and this is what I have read quite often in books/articles etc. on the management of chronic cases. E.G. that one should not give it to hay fever patients at their respective seasonal outbreaks.

During those times one should give remedies similar to their acute states.

It seems to me that in the case posted this might be considered an acute excerbation.

Regards

Luise