Lazlo is a boy, four years old, a really wiry little boy, who lives about 10 miles from here with his mother. He has been previously with me for a continuous cough in spring where he got Calc-c Q1 and Q2 for it. The asthma goes back a few years and was treated allopathically.

He arrived back yesterday morning in bad form.
Since 3 days he had a cough. This cough now is almost constant, dry. It is of a dry, hollow character and the pulse-rate is increased with it. The face is rather pale. No heat, no temperature. Before that, he had a cold, runny nose and a lot of sneezing, which had subsided by now. Running around caused a coughing fit for 2 hours yesterday. During sleep, he uncovers himself. No wheeze at this time.
Since the weather got wet over the past two days, the condition got much worse. The child’s mood is really obstreperous. He orders everyone around, rages and screams, and if someone says something to him runs weeping to his mummy. The appetite was not great, rather picky. The child did not want to be alone, yet once in company of others screaming: leave me alone!
I prescribed Lycopodium Q1 to be taken once a day from the first glass 2 teaspoons at the time.

The mammy rang back in the late afternoon, that things have worsened after the first dose of Lyc, and on my advice brought him back around 6 in the evening.

Things had changed somehow:
He was coughing, dry harsh and it sounded like there was a valve in his thought. There was no wheeze at the time. The breathing was laboured, the cough was hollow and barking now. The appetite was gone. No thirst either. The mood was somehow better, he was not ordering everyone around, but sat rather quietly on his mothers lap. Still he knew exactly what he wanted and screamed if he did not get it. the cough came in bouts.
On this account I decided to continue with Spongia.
I gave Spongia 200C one dose liquid and kept him afterwards for half an hour for observation.
Things did not dis-improve, so I sent them home.

She reported back at 8, that he seemed to have more energy and that he was eating and drinking now, yet no change in the cough / wheeze. So I decided to leave it go on.

She rang back at 10 and reported, that after falling asleep Lazlo got a severe asthma attack which caused him to vomit and that he is very agitated now.

On this account, I decided to go and see for myself what’s going on.
I arrived there half an hour later and found a child very scared, pale and breathless. There was a bit of a cough with every breath, every move seems to make it worse. Some foamy stuff came up with the cough. On this I decided to give Arsenicum.
I gave Ars 200C one dose liquid.
Then I decided to wait, and that is probably one of the most difficult things for the homeopath to do, because there is that heavy breading, that coughing, and also a scared mother who is seriously considering to go to the doctors. Well, so we waited, one cup of coffee, another cup of coffee, child up and cough worse, child lying down and half asleap –breading better.
And this went on and on till 12.30. Then something happened—

Lazlo came down the stairs coughing, got violently sick and was so angry, angry. No more fear, no,-- pure anger on everyone, shouting and screaming in-between the coughs. And now he complained of a pain on his belly when coughing.
This was not Ars anymore, this was Nux-v.
I gave it in a 200c in liquid form and then the waiting started again.
Meantime the rain set in outside and all what could be heard was the laboured breeding and the raindrops against the windows. I checked on him every 20 minutes, and he seemed to never fall asleep fully but was wide-awake every half an hour. At around 2 am, the bellyache was gone and the temper had eased somehow. The wheeze and the cough was still very much the same. There were no new indications, so I left it for the rest of the night and returned to my own place, only to be woken by the phone again at 9 am.
I told her to bring him over straight away and by 10.30 they arrived.

Now Lazlo had the following:
The breathing is laborious and fast. The pulse is fast. There are the occasional boats of cough. No more vomiting since, but no real sleep either. The cough is like something stuck in the back of the throat. The pain in the belly stayed away. Cold air increases the cough. He is not raging anymore, maybe he is too exhausted. Some colour in his face. He just cannot settle, is physically restless. Still obstinate. Did not eat or drink since I saw him last. On this I decided on sulphur which I gave one dose straight away Q4 / first glass / 2 teaspoons.
Within the next hour of observation Lazlo settled down, fell asleep, and was thirsty when he left my place.

I asked her to report back this evening which happened at 7.
Lazlo slept for most of the afternoon. He had dinner that agreed and the heavy breading went completely by 6 O’clock. The cough became loose and he has only the occasional bit, nothing compared to what it was 24 hours earlier. The moods improved as one of the first things dramatically. He is now back to his old self and I heard him playing away in the background. On this, I decided to let him take another dose of the Sulph and arranged for a follow-up early next week.
When I asked the mother for permission to post the story, she said to not forget to include all the coffee we consumed over the past two days.
---To be continued--

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Hans Weitbrecht
Consultant Homeopath

Hans,
Thanks for sharing this case with everyone.
Lisa

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"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

a top quality post. thanks hans.

with the benefit of hindsight, any feeling what might have happened if your choice had fallen to sulfur rather than lycopodium for those fairly vague psoric symptoms yesterday afternoon?

Thanks for sharing, Hans.

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Shirley Reischman

Dear Ricky dear members
Quick answers--
why not aconite? Ars has the asthma attack during sleep, which I did not find in Aconite in characteristic manner.
the Sulph prescribtion became clear, when you look over the whole thing as an episode of latent psora becoming active.
In this situation one should first deal with the acute as it unfolds. once this has settled, and the rest is due to psora, the whole picture has to be taken into consideration for the selection of a preferably antipsoric.
Q-potencies are also called LM- potencies.
In more chronic problems i ususally return to the Q-scale.

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Hans Weitbrecht
Consultant Homeopath

Dear Anna
I had it in mind, but there were elemts speaking against it--
In hindsight, the nonpsoric symptoms had developed, and Lyc was close enough, BUT it was unclear what was lurking in the background.
So-- i took a bit of a chance there.
it either would have settled with the Lyc, or the semi- active process would become active and then show its true nature. Well, the second happened, and thats a thing we don't like to see coming our way.

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Hans Weitbrecht
Consultant Homeopath

I understood the reasoning behind the Rx until the Sulphur!! Am I thick? I have to say that I wpould have probably gone with Aconite rather than the Ars. for the fear. Why did you give Q doses ( are these LM's) and why the particular potencies? This to me would have been a nightmare case. I admire you for not sending the child to hospital!!! I would have chickened out at the vomiting!!

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RSHom - Registered Homeopath

Will you keep us posted as to the boy's future progress?

Lisa

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"The significance of a fact is measured by the capacity of the observer."
Carroll Dunham

hans, for a less experienced practitioner facing this kind of situation, would it have been a safer option to open with say nux-v, with a lower risk of activating the psora? in that way, to try to calm the nonpsoric symptoms before giving an antipsoric?

i ask this with the question in mind of how best to minimise and to slow down the risk of a full-scale flare up of psora like this, when faced with an acute condition driven by psora.

Dear Lisa, dear Anna

I will keep up posting on this case, I see the child early next week, unless there is an acute.
On Anna’s question. Symptom similitude comes first, no matter what.
In cases like that, it is unclear, at least in the situation when I prescribed Lycopodium, whether this is Psora latent becoming active, or already the active phase.
If it would have been already active, a few symptoms would have been standing out and the more chronic things would have been more in the background, which did happen then after Lyc was given. It is impossible to know, what would have happened, if no remedy would have been given instead of Lyc, or another less psoric. From the history of this case, attacks came on usually after the child had a normal cold, which went into a cough, and from there on into a full-scale Asthma attack. So,—it is even debatable whether Lyc did anything or nothing.

What can I say to the beginner? Well learn your chronic diseases, so that you know how Psora behaves and how you can get it under control. Without a thorough knowledge of Psora, I would have lost the case the morning after, because I would have not taken into consideration the more ongoing symptoms and would have ended up messing up the whole case.

There is situations in homeopathy where, despite of having tied up many loose ends, it still remains unpredictable. In my experience 90% of these situations arising from Psora [becoming active].

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Hans Weitbrecht
Consultant Homeopath