Minutus

Hello Friends and Dr. Wagar,

Regarding Asthma and 'underneath',

You wrote:
the
always be
ALONE

Maria writes:

I have an almost classical 'arsenicum' case with
a reactive asthma.
The asthma has been getting worse and she is using inhailors more
frequently (not more since the remedy, but more in the past few years).

She has indications for both nat sulph (right sided headaches), but much
more Thuja type symptomology(nail ridges, perspiration, thought patterns,
etc) - underneath the Ars sx of being cold, better heat, particular, good
bone structure, chisled aristocratic features, and the characteristic
asthma type sx ars is known for.

Our literature suggests we 'follow with Nat Sulph or Thuja'? if Ars
doesn't 'cure' the asthma.
Is this a case of our predecessors not having sufficient remedies to find
a better Rx?

Ordinarily I would continue the Ars until it is not working anymore (not
getting any good from it) then move onto the next indicated remedy.
(Which is actually what I did, on Ars LM potency and went from an LM 2 to
an LM4 with recommendations to take more frequently when her asthma is
active. I am hoping a more agressive dosing campaign may just do it,
she is returning in 2 weeks to report results.)

So, this question is hypothetical as the answer may be obvious in two
weeks, but I am looking at this as a case management issue.
My questions:
How and when do I 'use' the second remedy?
Do I discontinue the Ars and give one of the others?
Is there an implied suggestion in our literature to continue the Ars if
it palliates and use it for the acute manifestations of the asthma, and
use a high potency (follow up remedy) to dig out the miasmatic base?
Or, should I retake the case to find a better remedy (considering we have
more remedies at our disposal now and a better 'fit' could be found)?

What have you done in cases like this? How would you proceed?

Thanks for starting an excellent discussion. I am looking forward to
hearing thoughts and ideas on this and how others have managed these
kinds of cases.
Warmly, Maria

Hi Maria,

My thoughts:
I would let the VF activity guide me. I know I am boring when I always use
the Calc/Bell example but I find its simplicity explains what I am trying to
say.

If the child is Calc and they get a high fever with dilated pupils,
throbbing circulatory system etc it calls for Belladonna. Once the acute is
over you look at the chronic state - Calc again. this is in line with
Hahnemann on treating acutes and then looking at the chronic state, not just
being satisfied with the acute success.

So the same in this case. If an acute episode had characteristics of
Arsenicum, i.e. needing to sit up in bed, restless, anxious, maybe sipping
water and in a state which is anxious about disorder around them, then I
would give Ars.alb. I would want ars symptoms. OK, in an emergency we can
maybe palliate with Ars., but thats not ideal. The palliation would be when
the Sx were not characateristic of Ars. Much like giving Bell. for the
fever when the Sx weren't really a match. We won't get a really good
result.

If the chronic remedy is prudently applied (as you are well aware, being one
of the more cautious prescribers regarding dosing) then it shouldn't cause
a severe aggravation of the asthma, IF it is the simillimum. So there might
be some apparent trouble with breathing, but it should be mild and short
lived. If not then perhaps one has to question dose or even remedy.
In which case this might be the next step.

regards,
Paul

You can use the next remedy when the symptomatology shows a definite change
and there are clear indications for a remedy.
Even before we think of our next remedy I would like you to asses whether
Arsenic was her remedy or not.
Suppose arsenic was her correct remedy then your patient must show a
definite improvement either directly or after an initial aggravation.
Ad if there no definite change in state or there is some change which can be
attributed to use of inhalers and some other external factors then Arsenic
happens to e a wrong choice and whatever we prescribe now will be our first
prescription.
We should not continue Arsenic for palliation purpose because continuous use
of a wrong remedy may produce it's own symptoms and make the choice of
simillimum difficult.
Best thing to do now is to asses the reaction of Arsenic and if it has not
done much then to go ahead and retake the whole case.
Analyse your case as if you it is a fresh case and then see which remedy
comes out as most similar.

Hello Maria,
Warm regards,

You can use the next remedy when the symptomatology shows a definite change
and there are clear indications for a remedy.
Even before we think of our next remedy I would like you to asses whether
Arsenic was her remedy or not.
Suppose arsenic was her correct remedy then your patient must show a
definite improvement either directly or after an initial aggravation.
Ad if there no definite change in state or there is some change which can be
attributed to use of inhalers and some other external factors then Arsenic
happens to e a wrong choice and whatever we prescribe now will be our first
prescription.
We should not continue Arsenic for palliation purpose because continuous use
of a wrong remedy may produce it's own symptoms and make the choice of
simillimum difficult.
Best thing to do now is to asses the reaction of Arsenic and if it has not
done much then to go ahead and retake the whole case.
Analyse your case as if you it is a fresh case and then see which remedy
comes out as most similar.

Good luck,
Waqar Taji

Hello Maria,
Warm regards,

You can use the next remedy when the symptomatology shows a definite change
and there are clear indications for a remedy.
Even before we think of our next remedy I would like you to asses whether
Arsenic was her remedy or not.
Suppose arsenic was her correct remedy then your patient must show a
definite improvement either directly or after an initial aggravation.
Ad if there no definite change in state or there is some change which can be
attributed to use of inhalers and some other external factors then Arsenic
happens to e a wrong choice and whatever we prescribe now will be our first
prescription.
We should not continue Arsenic for palliation purpose because continuous use
of a wrong remedy may produce it's own symptoms and make the choice of
simillimum difficult.
Best thing to do now is to asses the reaction of Arsenic and if it has not
done much then to go ahead and retake the whole case.
Analyse your case as if you it is a fresh case and then see which remedy
comes out as most similar.

Good luck,
Waqar Taji