Have a small child comming tomorrow with increasing protein in urine. Has been 'medically' diagnoses as Nephrotic Syndrome and has previously been on prednisone. Parents would like to avoid another round of prednisone. Phone description of history and symptoms looks like Sulphur is most likely the constitutional remedy. Reading on the subject shows Apis Mel is 'first choice' when you see edema and protein in urine. Child has history of eczema (yes it was 'medicated' with Elidil - so is lurking and I expect it will return in some form during the healing process - particularly if Sulpur is used).

Yes - I will take the full case tomorrow and consider the facts at that time - however - If after taking the case Sulpur is still the best choice for a constitutional remedy I am concerned at how to proceed. If the protein was not at a critical level (family doctor wants to start prednisone again now) I would likely start Sulphur low and slow and warn parents that the eczema may come back as part of the healing process. Given the current condition, I would like to halt the protein and try to normalize the 'critical' symptom (as far as the medical profession is concerned) without causing any aggrivations, then allow him to go through the full healing process when he was more stable - and not under the microscopic scruitiny of the family doctor (who is not a supporter of any alternative therapies).

Another approach would be to use Nat Sul cell salt (for edema) at this time and once the parents decide if the protein level was at the 'critical threshold' (and use or not use the prednisone), then start working after this crisis was over (if they chose the 'course' of the drug or not).

Has anyone had experience with this situation? This is posed as a general question about approach in a time critical situation, and in a pediatric situation.

Your input is greatly appreciated.

Hi,

Details of what prompted you on Sul are nor mentioned. What was the health status of the parents when the baby was conceived and what are siblings how is their health.

Any modalities to bank upon. Sleep cycle and feeding habits are also to be taken into account. The constitutional remedy will help the child if its action is not interfered with by allopathic medication.

Best,
V.T.Yekkirala.

Thank you for your response. Sulphur was the constitutional solution, however, the child is close to 'crisis' situation - the MD wants to start prednisone due to sustained high protein levels in urine (they have been at this juncture before - and was he hospitilized). My concern was that even though sulpher was the best choice for the totality of the case -- it was likely to bring forth old stuff - there is a lot of it in the case. If this were an adult in reasonably good condition - there would be no hesitation. My experience with sulphur is that it is a powerful remedy - and the healing process is more intense then with many other remedies. The hesitation - and thus the question for the group - is proceeding with a child in - or close to 'crisis' with sulphur, when another remedy fits the symptoms of the crisis, and is perhaps less likely to cause an intense chain of events in the short term. Once the 'crisis' is passed, there would be no hesitation proceeding with sulphur.

The components of this problem were :
a. young child with major physical problem (and lots and lots of past stuff) and quickly deteriorating vital force
b. need for immediate care of that problem
c. extreme scrutiny of the medical doctor
d. caring parents who sought out alternative help (for the first time) at the last possible moment

I am sure many of you have faced similar situations, and was hoping to find guidance, reassurance, or clarity in approaching this case.

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

I have been in a similar situation, with a child getting worse, worse and worse from whooping cough. If you have to use allopathic drugs to keep the little one alive, do it. Remedies are always available afterward. We have to work with what is before us, and use the best tool for the job at hand.

beth

Still not sure what one means by 'constitutional remedy' - one should aim for the simillimum for the case in hand if it is an acute or a chronic state.

However, as you mention Hay Fever and I am inundated at present with cases regarding this, I have to say that over the past couple of years I have come around to looking very carefully at these case and have decided for many to prescribe what I would consider to be the simillimum for the whole case which includes both the acute phase of the Hay Fever as well as the out of season state and I have to say that I have recorded more success with what I might have prescribed for the out of season state. In other words the client doesn't move from a chronic to an acute but stays in the same state throughout.

But Hay Fever might be a special consideration and I am not sure if this should be applied to the case mentioned.

Best wishes, Joy

The meaning that I became accustomed for for "constitutional" is simply as in contrast to acute. It's not the very specific Eizayagan meaning. Maybe we should instead use the term "chronic remedy"?

Shannon

OK fine but if someone is in a sulphur state then they need sulphur - whether it be chronic or acute - if they are in an apis state they need apis obviously. if time is of the essence you have to decide to 'enclose' the case, i.e. it becomes an acute and not confuse it with what might lie behind this acute. In other words - know what needs to be cured at any given stage.

All remedies can be powerful and aggressive, even though some have a reputation for being fast or slow etc (many will say calc carb will never act quickly but there will always be someone who says it can, myself included).

if you feel an individual will be sensitive to the simillimum then you adapt to a careful choice of potency and dosage, not change the rx

Best wishes, Joy

Hi Donna

when it comes to priority of symptoms and treatment, my approach would be, in this case to treat the presenting critical picture. Even in a chronic case, when there is an acute picture presenting, it is imperative to respond to that.

Some remedies that are important for chronic nephritis - nephrotic syndrome are Lycopodium 30, Ars 6, and Apis 6.

I would give you some more indications for these if you wish to contact me privately.

Eizeyaga offers Apis as the main remedy, but also includes Hyos, Ignatia, Lach, Nux-v, Puls, and Staph for consideration, due to his ovservation that Jealousy can be a provoking cause of pediatric kidney infection.


Best

Robyn

Hi Donna, Luise, everyone,

The lines of demarcation needs to be very clear.

Donna, you seem to need a stop gap palliative that will soothe the kid at this moment. Right. But your methodology seems a bit off track- at least in choosing the symptoms. IMHO the best bet in such situations is Boenninghauusen or Boger's method. There, for you to put the method to work, you need symptoms that we can perceive well and on which a credible prescription could be based. The quartet of location-sensation- modality-concomittant will work both for acute and chronic situations. The concomittant being the clincher in most situations.

But masters like Boger are a different lot. He gave a dying man with anasarca, slightest jar agg, creamy stools, sleepy before a storm all since quinine- formica 10m on the key sx of creamy stools and sleepy before storm and he got well.

In this case there was a good palliative - Arnica which stands high in repping in acute symptoms. But Boger overlooked all these. (This case posted recently by V T Yekkirala)

Regards
Venkat