After two weeks on Natrum sulphuricum, Mary was only wheezing slightly in the morning on waking, with some coughing at 6 A.M. She was still very chilly at night in bed. She complained of sinus congestion at the root of the nose, and had a thin nasal discharge. Her wheezing was better from exertion. She had a desire for ice water and candy. She was not worse from damp weather now. She was sleeping well. She was continuing to be quite competitive in sports and band. Her irritability was worse, especially in the morning. She did not like drafts of air. She was getting cramps in her side during exercise. Natrum sulphuricum was discontinued and Nux vomica 6C, TID was begun because it fit her symptoms and was expected to be her constitutional remedy which would finish the case. Six days later she developed a red, itching rash on her face after exposure to cat dander. Her face was puffy. She had some wheezing on exhalation. Her sinuses were not congested now. She wasn't as chilly and had no cough. Within a week, she complained of nasal discharge that was yellowish and clear, a barking cough which had come and gone. Her wheezing was only in the morning and not severe. She was paler than usual and felt tired. The rash had disappeared. During sports she had been knocked down several times and had the wind knocked out of her, which gave her a fear of suffocating. At this point, the remedy action was unclear with the skin eruption and discharge possibly indicating signs of cure.

Three weeks later, Mary's asthma was much better. She coughed up a little clear mucus in the morning. Her runny nose had stopped. She had broken out in itching hives on her knee for 25 minutes after icing it. She was able to be around a dog without reacting to it. She had a rash on her forehead once for a few hours. Mary was sleeping well now, but still somewhat chilly at night. She had a sore throat for a few days which didn't develop further. Her energy for sports was a little less than usual. At this point it looked like Nux vomica was working.

Nighttime wheezing at 2-3 AM returned, however, several weeks later. It began after slight cold symptoms. Kali carbonicum 30C, given acutely, relieved her. Hives after exposing her body to the cold returned. She felt cold after drinking ice water. She would get a blotchy discoloration on her face if she touched cat fur. There was no family history of tuberculosis which might have indicated the nosode, Tuberculinum. The allergy to cats might lead to its possible prescription in the future, even though she did like cats, rather than hate them. She went to Arizona for a soccer camp and while there, wheezed a little during practice. She still desired sweets and ice cream. Nux vomica was continued at this point, although in retrospect, the fear of suffocation, her chilliness, and hives from cold applications were beginning to point to the next remedy.

Two weeks later, Mary was not much better. Her toes would break out in blisters and swell after exposure to the cold. She had occasional nasal congestion, but much less in general. She had had one episode of hoarseness. She would sometimes wheeze at night now and clear out mucus, but no severe attacks.. There was not much coughing. Her eyes itched a little. She was having some difficulty writing complex sentences, similar to her difficulty in second grade.

At this point, the case was reviewed and seemed to be off track. Nux vomica had not given as much relief as expected, and Mary was still not as well as she had been after the first remedy. Asthma and congestion were continuing, although in a reduced way. The initial success of Natrum sulphuricum had not continued after Dulcamara was given.The major symptoms now were nightly aggravation of asthma and aggravation and skin eruptions from the cold. Since the focus had shifted to skin eruptions with asthma, aggravated by cold, and at night, Kali carbonicum and Arsenicum album were considered. Arsenicum 6C TID was begun.