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Children's
types By Douglas M.
Borland, M.B., Ch.B (Glasgow) Presented by Sylvain Cazalet Dr Douglas M.
BORLAND Introduction Group I Calc. * Sil. *
Sanic. * Æth. * Lyc. * Caust. * Tub. Group II Bar-c. * Bor. *
Nat-m. * Sep. * Aur. * Carb-v. Group III Graph. * Caps.
* Psor. * Ant-c. * Petr. Group IV Puls. * Kali-s.
* Sul. * Thu. * Brom. * Iod. * Abrot. * Flu-ac. Group V Ars. * Cham. *
Cina * Mag-c. * Ign. * Zin. INTRODUCTION A COMMON constitutional
type in children is CALCAREA, usually CALCAREA CARBONICA but sometimes
CALCAREA PHOSPHORICA or CALCAREA SILICATA are more suitable to the individual
case. This leads to a consideration of PHOSPHORUS and SILICEA; it is useful
to know the outstanding characteristics of these remedies and those that
follow on. In association
with the SILICEA types consider also SANICULA and ÆTHUSA. A little away from
the strict CALCAREA type is the possibility of LYCOPODIUM, and following from
that a further possibility of CAUSTICUM. Quite apart
from the above it is always wise to consider giving a dose of TUBERCULINUM
when treating children of the first group. In the second
group BARYTA CARBONICA -the next drug to consider is BORAX- the same type of
child with similar indications. This leads onto NATRUM MURIATICUM, which in
turn raises the possibility of SEPIA. This leads on
to drugs of "depression", and one of the
gold salts must then be considered, either AURUM METALLICUM
Or AURUM MURIATICUM. When dealing with a sluggish mentality or sluggish make-up
there is always the possibility that CARBO VEGETABILIS may be called for. The third group
-GRAPHITES- lead to the consideration of CAPSICUM, and if dealing with any
skin condition the possibility that PSORINUM may be called for must be
considered. Also when dealing wit children, where there are definite skin
indications ANTIMONIUM CRUDUM should be thought of and, although it is not
really like the GRAPHITES picture, PETROLEUM should always be remembered as a
possibility. In the fourth
group -PULSATILLA- there are also a number of possible drugs. After
PULSATILLA the first possibility is KALI SULPHURICUM, and as in every sulphur
compound it is necessary to consider whether the case could be a SULPHUR
type. When the
mentality is very similar to that of PULSATILLA one has to consider THUJA,
and as soon as the PULSATILLA/THUJA group is considered it leads on to
SILICEA. In turn SILICEA
always suggests the possibility of FLUORICUM ACIDUM. If dealing with
hot-blooded patients, think of BROMIUM and IODUM. From IODUM with its
emaciation and hunger pass to consideration as to whether ABROTANUM may be
called for. In the fifth
and last group -the "nervy" drugs- ARSENICUM ALBUM heads the list
with all its terrors. Terrors also suggest STRAMONIUM. Then comes the
hypersensitive nervous system type and CHAMOMILLA comes to mind, and then
CINA, which is a little more violent. The strange
digestive disturbances of CINA lead to consideration of MAGNESIA CARBONICA
Reverting to the strictly nervy type, one considers the possibility of
IGNATIA, and with this nervous restless, fidgety type there is always the
possibility that ZINCUM may be called for. Group
I Calc. * Sil. *
Sanic. * Æth. * Lyc. * Caust. * Tub. Calcarea
carbonica. [Calc.] These children
are typically soft, over-fat, fair, chilly, and lethargic (
lack of energy ) . They often surprisingly fit but,
nevertheless, do not possess much energy either mental of physical. In early
life they are often very over-weight, and although they appear very healthy when
examined one finds soft fat rather than muscle. There is a tendency to rickets (softening
and weakening of bones ), with enlarged epiphyses, big head, slow closer of
fontanelles, and tendency to sweat. The children are chilly, yet they get very hot on
the slightest exertion. They sweat at night and very often will stick the feet
outside the bed covers. This characteristic incidentally is not found only in
relation to SULPHUR. There are
slightly older children of much the same type. They appear fairly healthy
look well-nourished but are sluggish both mentally and physically. They are
slow at school slow at games, liable to sprain their ankles, have weak
muscles, sweat on exertion, and constantly take fresh "colds". They are liable
to have enlarged tonsils, enlarged cervical glands, and rather big
bellies. They lack stamina, are easily scared, and lack initiative. They
are perfectly content to sit about and do little or nothing. Very often they
are peculiarly sensitive and can't bear to be laughed at. They are clumsy
in their movements and bad at games; this tends to push them back into
themselves, so that instead of sticking at it and becoming efficient they
throw in their hands and give up the game altogether as they hate being scoffed at
or laughed at. They are just
the same about work, very often having difficulty with one or other subject
at school. They will not strive at this subject but just give in, and if they
are not sure of themselves nothing will ever induce them to answer questions
in class in case they are wrong and will be laughed at. In early
childhood these CALCAREA CARBONICA children nearly always tend to have a relative
diarrha, and usually the stools are pale, apparently lacking bile pigment. There are two
or three outstanding odd characteristics which clinch the CALCAREA CARB
diagnosis. The one that is easiest to tack on to the
sluggish mentality and sluggish physical make-up is that these children are
much more comfortable when they are constipated and their bowels are inert If given an
aperient ( used to relieve constipation. ) it upsets them; if they have an
attack of diarrha they are ill, but when their bowels are relatively
sluggish they are comfortable. The next thing that
can be added to the sluggish make-up is an aggravation from any physical or
mental exertion, or from any kind of rapid movement; these children suffer
from car-sickness and train-sickness. Another
characteristic is a very definite dislike of too hot food. They are quite
fond of ice-cream; have an aversion from meat and, occasionally there is a
definite craving for eggs -in any form. There is one
other indication for CALCAREA CARB. When the children are below par they
become nervous and scared. They are perfectly happy so long as there is
somebody about, and they sit peacefully or play; but when it gets
dark they are scared to go to bed without a light in the room. They develop
acute nightmares and wake up in the night screaming. A very common type of
the CALCAREA CARB. child's nightmare is seeing horrible faces in the dark. Silicea.
[Sil.] Then there is
another type of child who has fined down slightly; he
is still chilly very much thinner, has not grown
nearly as much as the PHOSPHORUS child, is very much paler, and has a
fine-textured skin. He has not the coarse curly hair normally associated with the
CALCAREA type but rather finer hair, without the reddish glint of the
PHOSPHORUS; it is becoming rather sandy. This child is
becoming much more touchy, more difficult, he resents
interference and is more inclined to retire into his shell. He
is fairly bright mentally, very easily tired out physically; liable to sweat,
particularly about the extremities or about the head and neck. Often he has
developed a dislike of, or intolerance to milk and the cervical
glands may be enlarged. This is the picture of the typical SILICEA child. Sanicula.
[Sanic.] But never think
of SILICEA without considering the possibility of SANICULA, for the
indications of these two remedies are almost identical. The SANICULA child is
perhaps more irritable, and definitely more unstable mentally. Attacks of
laughter and tears follow each other much more readily in the
SANICULA child and he has much less staying power than the SILICEA type. The
SANICULA child never sticks long at anything; he is more
obstinate and more difficult to control. There is likely to be a row if you
interfere with the typical SANICULA child. But it is very difficult to
distinguish between the SILICEA child and the SANICULA child, the physical
symptoms are almost identical, and in most cases of this type, I have given
SILICEA in the first instance and only on failing to get a full response have
I gone on to SANICULA. Æthusa.
[Æth.] One considers
ÆTHUSA here because of the notorious susceptibility to milk of the ÆTHUSA
type. Wherever there is a severe aggravation from
milk in acute attacks, always consider the possibility that ÆTHUSA
will control these attacks. It is the first drug to think of. Also, whenever
there is a milk aggravation consider the possibility of one of the milk
remedies being indicated to control an acute condition, either LAC DEFLORATUM
or LAC CANINUM. Lycopodium.
[Lyc.] Reverting to
the PHOSPHORUS type of child -that is the CALCAREA type that has thinned down
into a PHOSPHORUS type. This in turn, leads to the LYCOPODIUM type. The child
has grown a little, lost weight become thin but instead of
having the fine skin and the unstable circulation of the PHOSPHORUS child, it
has become rather sallow. The tendency to sweat easily is disappearing and
the skin is getting rather thicker. These children
appear to be independent but it is not quite the shyness of SILICEA. They
seem to lack assurance but give the impression that basically they have a
fairly good opinion of themselves. They are liable
to digestive upsets, and although they have good appetites and often eat more
than the average, they are not putting on weight. The abdomen
may be rather enlarged but there are no enlarged palpable mesenteric glands.
Instead of the PHOSPHORUS desire for meaty and tasty things,
these children are developing a definite desire for sweet things. Instead of the CALCAREA
desire for ice-cream, they prefer hot food.
Very like the CALCAREA types they get headaches from overwork at
school and it is a dull type of headache. They are still chilly but much more
sensitive to stuffiness than any of the types we have yet considered. This is
the picture of the LYCOPODIUM type developing. Causticum.
[Caust.] Another drug
which is not nearly sufficiently used in the treatment of children and which
is a counterpart of LYCOPODIUM, is CAUSTICUM. These children are not unlike
the LYCOPODIUM types but are a little more sallow. The CAUSTICUM
type of child is definitely more sensitive than LYCOPODIUM types. They are
not sensitive to pain but are particularly sensitive to any emotional
disturbance. Often these children will cry because they
think you are hurting another child. It is idea of
pain which affects them rather than the actual pain to themselves, and they
often stand pain quite well, but cannot bear to see another child crying. They have much
the same sort of clumsiness as the CALCAREA children; are rather unhandy, and
are liable to strain muscles, whereas the CALCAREA
children sprain ankles. They are inclined to suffer from rheumatism
and liable to get acute muscular rheumatism, particularly from exposure. These
CAUSTICUM children often suffer from acute torticollis ( twisting of muscles ) or an acute facial palsy after exposure
to an icy wind. Associated with
this tendency to torticollis and facial palsy, the CAUSTICUM children get
very definite growing pains which are usually accompanied by stiffness in or about
the joints -a feeling as if their joints were tight. And linking
up with the rheumatic tendency, the CAUSTICUM child when overworked or
nervously distressed, is very likely to develop choreic symptoms, and the
outstanding feature of the CAUSTICUM chorea is that
jerking persists during sleep.
The main
distinguishing feature between the CAUSTICUM children and the LYCOPODIUM type
is that CAUSTICUM children have a definite aversion for
sweets whereas the LYCOPODIUM children desire them. /// Two other
points would confirm the CAUSTICUM diagnosis. The first is that the rheumatic
troubles of the CAUSTICUM child are very much
better in damp weather; and the second is that a CAUSTICUM child
with any digestive upset tends to develop acute
thirst after meals. Two additional
points which are sometimes useful-CAUSTICUM children often develop
endless warts; they also have a very marked tendency to nocturnal
enuresis ( Involuntary urination ). Family
History of Tuberculosis. [Tub.] Wherever there is
definite family history of tuberculosis no matter which drug is indicated,
the child will at some time be helped by a dose of TUBERCULINUM and my
practice is to give one dose about once in twelve months. An article in an
American journal recommended giving two doses of 1 m, two of 10 m, two 50 m,
and two of Cm, on four successive days. It was maintained that this gave
better results and can produce a practical immunity to tuberculosis in a
child of tuberculous parents. There is
another point in which the treatment of children appears to differ from that
of ordinary practice and it applies particularly to the treatment of the
CALCAREA CARBONICA type of child. Time can be lost by following the rule of
never repeating the medicine so long as improvement is maintained. Originally I
would give one dose of CALC CARB. 10 m and, providing the child went ahead
slowly but steadily with no lessening in its improvement, I could find no
reason to repeat the medicine for six months or more. But the average
young child, free from acute illness, will tend to improve even if it has no
medicine at all, and the constitutional drug ought to increase the rate of
that improvement. I therefore started repeating CALC CARB. at much more
frequent intervals whenever the child was not jumping ahead, and in many of
these CALC CARB. cases improvement can be speeded up by more frequent
repetition of the medicine. It is a quite
different matter in the case of an adult. Group
II Bar-c. * Bor. *
Nat-m. * Sep. * Aur. * Carb-v. Baryta
carbonicum [Bar-c.] The second
group are all very much of the same type; they all apply more or less to the backward
child, either a case of delayed development, or a definite mental
defective. The outstanding drug in this group is BARYTA CARBONICA, which is
more typical of the backward child than any other drug in our Materia Medica.
The
characteristics of the BARYTA CARB child are very definite it is a dwarfish child,
dwarfish mentally and physically. I have never seen a BARYTA CARB child who
was up to standard height, but they may be up to standard weight. The next
glaring characteristic is that the BARYTA CARB child is always
an excessively shy child. That shy
characteristic covers quite a lot of the BARYTA CARB child. It is nervous of
strangers; scared of being left alone; very often it is
terrified of going out of doors; a town-bred
child going to the country is terrified in the open fields. They often
get night terrors without any clear idea of what the terror is; and they
always have a fear of people. Another
characteristic linked with that fear of people is that the BARYTA CARB
children are always touchy; they do not like being interfered with; they are very
easily irritated. The next thing is that throughout their lives they have
been late in everything - late in speaking, late in walking, late in
dentition slow in gaining weight. Another marked
feature is an exaggeration of the normal child's forgetfulness. Every
child is forgetful, every child is inattentive, but in the BARYTA CARB child
this is very much exaggerated. If they are
playing they never stick to it for any length of time, they pick up a toy,
play with it, and drop it; you may hold their attention for a minute or two,
then they turn round and look at the nurse or mother or whoever happens to be
there. They pick up a
thing from your desk and fumble with it for a minute or two, and the next
moment they are playing with the handle of a drawer. It
is that lack of concentration that is the outstanding characteristic. As they get
older the same report comes from school - the
child is inattentive, never concentrates on a lesson, appears to learn
something today and has completely forgotten it tomorrow. The mother
would teach the child its alphabet a dozen times over and ten minutes after
it knew it, it would be allowed to go out and play and half an hour later it
was all forgotten. Another thing
is that they are very easily tired out; any attempt at sustained effort
exhausts them. When they are young they become cross and irritable as they get
older any sustained effort brings on very troublesome headaches - usually a
frontal headache with a feeling as if the forehead were bulging and sitting
right down over the eyes, and it is awful effort for them to keep the eyes
open. The next point
about them - and it is pretty constant to all the BARYTA CARB children is
that they are liable to get colds, and their colds are characteristic. They
always start as a sore throat, and most BARYTA CARB children have
hypertrophied tonsils. To the
hypertrophy of their tonsils can be linked the other glandular tissues; the BARYTA CARB
child very probably has enlarged cervical glands, possibly enlarged abdominal
glands. With the
enlarged abdominal glands linked the fact that the child stands badly, there is often
marked lordosis ( inward curvature of a portion of lumbar ) and a very
prominent abdomen. With the
abdomen condition is the symptom that the BARYTA CARB
child is usually worse after eating - more inattentive, more irritable, more
touchy, and very often more tired after eating. The next thing
about them - linked with the tonsillar hypertrophy is that if that get
enlarged tonsils and get cold they are very liable to develop quinsy. Here is
a tip that is worth remembering. To a typical BARYTA CARB child with an acute
tonsillitis it is wiser to give a dose of BARYTA MURIATICA rather than BARYTA
CARB during the acute phase; and very often they will need an intercurrent
dose of PSORINUM after the BARYTA MUR before reverting to BARYTA CARB. It is quite
easy to tack on the PSORINUM to the BARYTA CARB because many of these
children tend to get a crusty skin eruption on the head and crusty margins to
the eyelids, they may have a definite blepharitis, and most BARYTA CARB
children are worse from washing - all of which are definite PSORINUM symptoms
also. They are very
liable to get intensely irritable skin eruptions, but with intense irritation
and that again is liable to be worse after they have been bathed. As would be
expected with that type of child with low physique, they are chilly, are if
they are exposed to cold their tonsils become affected. One other feature of
the BARYTA CARB children is a marked tendency to salivation; dribbling is a
common characteristic of mentally defective children. Above are the
keynotes to the "mentally defective" group of drugs, and of these
BARYTA CARB is by far the most commonly indicated. Following that come other
drugs mentioned previously starting will BORAX. Borax [Bor.] The feature that
makes one consider whether a child is a BARYTA CARB or BORAX type is the
manner in which the child is frightened. They are both scared children and
they are very often quite similar to look at, but whereas in the BARYTA
CARB child anything strange in its surroundings scares it, in the BORAX
child it is any sudden noise in its
vicinity, which simply terrifies it. The tendency to
salivation and dribbling is equally marked in BORAX, but in the majority of BORAX
children one is dealing with a definite stomatitis ( inflammatory process
affecting the mucous membranes of the mouth and lips ), and associated with
the salivation there are white spots on the tongue
pearly spots round the margins of the tongue, spots on the lips and on the
inside of the cheeks. There is a very
similar history in regard to night terrors in the BORAX, child but there is
usually an exciting cause in these cases; the child has been doing too much
during the day, or has been overexcited in the evening, and then it is almost
sure to have a marked night terror. With the BORAX
child there is not the same degree of inability to learn. The child is simply
idle. If he would give his heart to it he could learn, but he is just idle.
These children never settle to anything, and even at play they do not
persevere but get bored and change from one thing to another. Another thing
that distinguishes them from BARYTA CARB types is that BORAX children are
much more irritable, and their irritability does not end up in weeping as it
very often does in BARYTA CARB, but it ends up in a violent
passion the child kicks and screams. The next point
which distinguishes the BORAX child from the BARYTA CARB child is that the
BARYTA CARB child tends to get a generalised skin eruption, or a very
definite crusty eruption on the scalp, but the BORAX child is much more
likely to get herpetic eruptions -very often herpetic spots
about the lips, or a generalised rash of small herpetic spots on the body. BORAX cases are
also more liable to get acute digestive upsets than BARYTA CARB types, which
have the typical chronic constipation, the hard stool. BORAX is liable to
sudden attacks of diarrha and vomiting. Another characteristic of BORAX, which
distinguishes it from BARYTA CARB, is the peculiar BORAX sensitiveness of
fruit, with violent colic after eating fruit colic
followed by diarrha. Associated with
the tendency to inflammation of the mucous membranes, acute stomatitis etc.,
it is very common in BORAX children to find either enuresis or pain on
micturition; pain on micturition is much more common, and very often it is
without any definite urinary infection. Another thing
that distinguishes the BARYTA CARB child when a little older is that the
BARYTA CARB child gets depressing frontal headache from over-study; whereas the
BORAX child tends to become sick, and tends to get
definite nausea from intense concentration. Then there is
the final clinching point in connection with the BORAX child, and that is the
notorious BORAX aggravation from downward motion. BARYTA CARB
children often get train-sick BORAX children will get train-sick
and car-sick too, but BORAX children have a peculiar terror of downward motion,
and it is that terror much more than the actual feeling of discomfort which
is the characteristic of the BORAX children. It occurs in
numerous circumstances; the typical pointer is the child who screams time it
is laid down in bed if the nurse does not lower is very gently; but it is
equally marked in older children who scream on going down in a lift. It is
the peculiar terror rather than the physical discomfort, which distinguishes
BORAX from any other drug. One useful
practical tip is in connection with airsickness. There are various drugs for
train-sickness and seasickness but BORAX acts in the majority of cases of
airsickness, because it is the sudden dip, which upsets most people and
particularly the terror of falling. Airsickness has
been completely overcome by three or four doses of BORAX before travelling by
air. BORAX is like
BARYTA CARB in being sensitive to cold, but it has much more sensitiveness to
damp than BARYTA CARB. BORAX is one of the sodium salts and immediately one
considers the sodium salts one thinks of the possibility of the others, and
by far the most commonly indicated of these is NATRUM MURIATICUM. Natrum muriaticum [Nat-m.] In children the
majority of NATRUM MUR cases are rather
undersized and underweight. At first sight
they are a little difficult to distinguish from the BARYTA CARB child with
its shyness, because the NATRUM MUR child appears to have a very definite dislike of being handled; it has a very
definite dislike of being interfered with and is liable
to burst into tears, which is not unlike the shy terrified
reaction of BARYTA CARB child. But on closer
investigation the reaction is quite different. It is not shyness in the
NATRUM MUR, it is much more a resentment at being
interfered with. The NATRUM MUR child cries, but
cries much more from rage than from terror. You
can very often stop the NATRUM MUR child's crying if you are sufficiently
firm but try to soothe it and it gets worse. A NATRUM MUR
child will be nearly in convulsions with
screaming when its mother tries to soothe it, whereas as
soon as left alone it will settle down and sit in a corner and watch you. The BARYTA CARB will sit in a corner and play with anything
within reach it has an entirely different mentality. Another thing
which distinguishes NATRUM MUR from BARYTA CARB is that though they both tend
to be awkward in their movements the BARYTA CARB child is awkward because of incoordination it is
clumsy but the NATRUM MUR child knocks things over because it is in too big a hurry. There will be a
history of delayed development in the NATRUM MUR child particularly that the
child was slow in learning to speak. It may also
have been slow in starting to walk but that is not nearly so constant. Often the
NATRUM MUR child's speech is faulty, but it is much more a difficulty in
articulation than a lack of mentality as in the BARYTA CARB child. The next
characteristic of the NATRUM MUR child is that it is probably small and
underweight. In contrast to BARYTA CARB where there is a mass of enlarged
cervical glands, the typical NATRUM MUR child may have very small shotty enlarged cervical glands
in a thin neck. The BARYTA CARB
types have a chain of quite large glands running down the anterior border of
the sternomastoid; the NATRUM MUR children have small shotty glands at the
back of the neck and the neck itself is rather skinny. The NATRUM MUR
child does not tend to run to the same degree of crusty skin eruptions as the
BARYTA CARB child. NATRUM MUR cases get an eruption restricted to the margin of the hair, rather than
spreading over the whole scalp. There is not
the same tendency to salivation in the NATRUM MUR child and instead of the
small patches found in a BORAX mouth in NATRUM MUR. The tongue is
sensitive and is red places and white in places, not with the
little white vesicles of BORAX types but with the irregular mapping which is
associated with NATRUM MUR either in children or in adults. As the NATRUM
MUR children grow older, they develop school headache; when under pressure,
working too hard, attempting to concentrate too much, they get headaches. The headaches
are almost identical with the BARYTA CARB headaches; they are frontal
headaches with the same feeling pressure down over the eyes, and they are
brought on by intense effort -particularly mental effort. The temperature
reactions in NATRUM MUR are definitely different from those of BARYTA CARB.
In NATRUM MUR, often the child is chilly sensitive to draughts, will shiver from a change of temperature and
will start sneezing from a change of temperature; but he
is very sensitive to heat-stuffiness particularly and to exposure to the sun,
and is very liable to develop a sun headache. The majority of
these NATRUM MUR children have a definite salt craving. It is most
unexpected that children should have the excessive desire for salt recorded
in the Materia Medica. But in practice one meets case after case in which
there is a very definite salt craving in these children - they
will steal salt as other children would steal sugar. Another thing
to look for in children needing NATRUM MUR is a very marked tendency to
develop hangnails, splits up the side of the nails, which are extremely
sensitive, very painful and very difficult to heal. It is a small point, but
it is quite useful in practice. A
distinguishing point is the appearance of the skin. Typical BARYTA CARB
children usually have very little colour, they are sallow, rather earthy
looking. BORAX children often have considerably more colour in the cheeks,
the skin is a little more yellow, not quite so earthy looking and a shade
more inelastic, thick and greasy. NATRUM MUR
children probably are a little darker still, they flush a little more easily,
they perspire a little more easily and there is a slight increase of the
greasy appearance. Sepia [Sep.] When considering
skin, the next possibility is SEPIA, which has the same kind of sallow greasy
skin; and SEPIA is a drug, which is far too much neglected in the treatment
of children. The outstanding feature of SEPIA children
is their negative attitude to everything. They
tend to be depressed, moody, indolent, disinclined for work, and not even
interested in their play. If pushed they are liable to sulk or weep. They are usually
nervy children, scared of being alone, very often afraid of the dark, and yet
they dislike being handled. Very often they have a definite dislike of going
to parties, and there is a point which is sometimes confused with BARYTA CARB
- a dislike of playing with other children. It is the thing
that later develops into the typical SEPIA dislike of meeting friends, and is
often confused with the BARYTA CARB dislike of people altogether, but mostly it is pure indolence (LAZINSS) in the
SEPIA children, and once they get to a party they are perfectly
happy. The next point
is that these SEPIA children although so lazy and indolent are definitely greedy, and SEPIA should always be considered for a
definitely greedy child. Another thing
common to SEPIA children is that although they loathe to go to a party, when
they get there and start dancing they wake up at once and are
perfectly happy. It is astonishing - the effect of dancing on SEPIA children. The
heaviest, dullest child when dancing at a party will become an entirely
different being will suddenly come alive. It is a useful tip and the parents
may give it when asked. Another odd
symptom, which appears occasionally in children and is a definite SEPIA lead,
is that these slow-developing children very often acquire the habit
of head nodding ( head gesture tilting head up and down )
. When faced with a head-nodding child always think of the
possibility of SEPIA, do not dash off at once to one of the typical chorea
drugs. Various other
points are fairly common in the SEPIA children. For instance, they are nearly
always constipated, and associated
with this is usually a tendency to enuresis ( Involuntary urination ).
And one thing, which is very constant in SEPIA children, is that
the enuresis takes place early in the night. Usually if these SEPIA children are lifted
about 10 P.M., they remain dry the rest of the night; it is in their first
sleep that they lose control. At the later
age, in the sallow, dull, greedy, locked-up child, there is a history that
she is developing fainting attacks, and these are induced by standing, or by taking
up any fixed position in a close atmosphere - standing
in school, standing in church, kneeling in church -the SEPIA child is very
often liable to faint. All these
children -like all SEPIA patients- are sensitive to cold children are
particularly sensitive to weather changes, and the typical SEPIA child will
develop a cold from changes in the weather apparently without any contact with infection.
Another useful
lead towards SEPIA in children is that they are very often upset by milk. If a SEPIA
child gets a digestive upset and is put a milk diet he will certainly become
constipated. Associated with
their sallow, greasy skin, SEPIA children tend to sweat profusely, and
are liable to develop very itchy skins without much sign of an eruption and
without comfort from scratching. Aurum metallicum [Aur.] With this
sallow, dispirited sluggish type of child, with that depressed,
negative attitude one should always consider the possibility of gold, AURUM METALLICUM,
or one of the gold salts. The typical AURUM child is always an undeveloped
child. It is not so much a question of undersize and underweight as that it simply does
not grow up. The typical Aurum child of 5 years of age is
probably about the level of a 3 year old. The majority
of cases needing AURUM are boys and in majority of these cases there has been
some failure of development -an undescended testicle, a very poorly developed scrotum, something
which indicated that the child was slow in developing even if developing
satisfactorily. It is type of symptom for which one might consider BARYTA
CARB. AURUM children
always give the impression of being lifeless. They are always low-spirited, rather miserable, lifeless, and they are
absolutely lacking in go. They have no initiative at all and give the
impression of finding everything a frightful effort. The report from
school is that they are backward and that they have very, poor memories. One of the odd
things about them is that, in spite of being dull, depressed, miserable, lifeless sort
of creatures they do respond to contradiction; the child has no go in him
and he makes some statement which is contradicted
and he flies into an absolute rage; it is the one thing that stirs them up. Another
constant factor, which is rather surprising in this type of child despite the
impression of being sluggish, is that has a weird
hyperæsthesia ( increased sensitivity ) to pain, they are terrified of it and
extremely sensitive to it. And, in spite of their sluggishness,
they are very sensitive to noise and have a very acute sense of
taste and smell. They are liable
to very persistent very troublesome catarrh. They have very definitely
infected hypertrophied tonsils, practically always with a lot of offensive secretion
in the tonsils, practically always with a lot of offensive secretion in the
tonsillar crypts. They get hypertrophied adenoids, again with very
offensive nasal discharge; with this they get attacks of acute otitis
with perforation of the drum, and very often a stinking, purulent ear
discharge. If they are
forced to exert themselves they very easily get out of breath and suffocative
attacks with acute difficulty in breathing, without any obvious physical
cause. Another odd
characteristic of the AURUM children is that they are
frightfully sensitive to
any disappointment; they will grieve over
it for days, quite out of all proportion to the normal child's reaction.
And associated with that is the other typical AURUM symptom that the child sobs in his sleep without waking up, and
apparently without having been distressed the night before. Carbo vegetabilis [Carb-v.] A drug, which
also has a very definitely sluggish condition and is sometimes a little like
AURUM, is CARBO VEGETABILIS although the cause is entirely different. CARBO
VEG children are definitely
sluggish but it is more a physical than mental sluggishness and results from physical stagnation, not from
any lack of brain capacity. They are slow
in thinking they are dull mentally; they have a slow reaction time; and they
are lacking in go of any kind. They are very easily discouraged, rather
dispirited and miserable sore of children and if they are pushed
they become peevish, but it is a futile sort of peevishness without much bite
in it. Associated with
the general mental sluggishness there is always sluggishness of circulation.
They are very often heavy sallow complexioned children, and they have bluish extremities bluish fingers, bluish toes,
and the extremities are always cold. The next thing
about them is that if they are pressed at all at school made to work, they
are almost certain to develop of a dull, occipital headache. They may get the same kind of headache from
wearing a tight hat. With these dull, occipital headaches there is complete
inability to work, to concentrate, almost to think. Often the child
has been pushed at school, is developing headaches, seems dead tired in the
evening, and gets the most violent nightmares, so much so that the child is
almost terrified to go to bed, particularly in the dark. In these
nightmares they see ghosts, faces, all sorts of terrifying spectres. These cold,
sluggish children get very hot and sweaty at night, particularly the
extremities, but it is mainly general, and the CARBO VEG
children usually have a sour smelling sweat. Another thing
linked with the CARBO VEG sluggishness of circulation is that they very
easily get a pretty persistent epistaxis; very often these
children have a severe epistaxis in the night. Another symptom
associated with the general sluggishness is constipation. They mostly have
digestive difficulties and tend to have big bellies; they get a lot of flatulence. In spite of
being constipated they very easily get attacks of diarrha -a very offensive, watery diarrha-
and then they return to their constipated state again. With these
digestive difficulties they have marked likes and dislikes of food. They like sweet
things -which often upset them- and they like to have their appetite
stimulated with something tasty, so they like salt things. With their
general sluggish digestion they are upset by fat things, rich food of any kind; very often
they develop a definite aversion to fat and frequently have
a marked aversion to milk. A fairly constant
feature of all these CARBO VEG children is that they are not primarily CARBO
VEG children; this condition has developed as the result of some preceding
illness, sometimes it is a case of measles; sometimes an illness like
bronchitis or pneumonia very often influenzal in origin, and it often dates
from an attack of whooping cough. GROUP
III Graph. * Caps.
* Psor. * Ant-c. * Petr. Graphites
[Graph.] The third group
is headed by GRAPHITES. This group is associated with children who
have definite skin eruptions. Almost any of the other drugs already
mentioned may be required for skin eruptions; for instance, CARBO VEG
children have a very obstinate eczema of the scalp; CALCAREA children have
eczema of the scalp; CAUSTICUM children have a lot of skin eruptions. There may also
be a very obstinate eczema of the scalp with SEPIA indications. But the
GRAPHITES group is the one to think of when a child has a definite skin history. There is a
tendency when treating children with an irritant skin to give a dose of SULPHUR, and there
have been many cases where that dose of SULPHUR has done harm and I am chary
of starting with SULPHUR in these children with skin trouble. The
typical GRAPHITES child is fat and heavy.
It is usually pale, always chilly, and nearly always constipated. In
the majority of instances with obstinate constipation in a small child the
abdomen is enlarged, a factor so constant that one does not stress it. GRAPHITES
children are always timid. They are rather miserable, and have a complete lack of
assurance. The slightly older children hesitate over what they are going to
reply to any questions put to them; the school report states that they are
indefinite -there is the same hesitation here; and most of these GRAPHITES
children are lazy; they have an aversion to work. There is a
queer contradiction in the GRAPHITES children. With the uncertainty and
hesitation, laziness and general physical sluggishness, there is always an
element of anxiety in the children. They always tend to look on the hopeless
side of things; if they are going to a new school, they dread it. They are always
looking for trouble. The next thing
about the GRAPHITES children is that, associated with their pallor, under any
stress at all flush up -they have a definitely unstable circulation. And
under stress, when they are excited, with this flushing up there is a
tendency to troublesome but not very profuse epistaxis, which comes on under
excitement that is the diagnostic point. A constant
feature of the GRAPHITES children, which at once distinguishes them from the
CALCAREA children who look not unlike them, is that instead of the soft,
sweaty CALCAREA skin, they have a harsh dry skin which tends to
crack, particularly on exposure to cold. If these GRAPHITES children have been
playing in water in cold weather they come in with their hands chapped and
bleeding. Associated with
the dry harsh skin, are the GRAPHITES skin eruptions and the type of eruption
is constant, no matter where it is. Cracked fingers,
which tend to bleed, also ooze a sticky thick yellow serous discharge. The same kind
of condition arises in any of the folds in GRAPHITES types, the back of
the ear, canthus of the eye, angles of the mouth the groins, bends of the
elbows, round the wrists and particularly about the anus; in this site are
found deep painful fissures oozing a thin, sticky,
yellowish discharge. As the
discharge dries it forms thick crusts which pile up as secretion of matter
continues beneath; and the crusts come off to reveal the same kind of gluey
yellowish discharge, very often streaked with blood. In my
experience children suffering from asthma who have a history of skin troubles
are not helped by GRAPHITES. These cases of suppressed skin troubles, which
develop asthma, are extremely difficult and I have found that GRAPHITES fails
altogether. Many other remedies have been successful such as PSORINUM,
ANTIMONIUM CRUDUM, NATRUM MUR, SULPHUR, THUJA has helped quite frequently,
and with no other lead it would be wise to start with THUJA. That can be
linked to one or two other typical GRAPHITES symptoms in children. They are
liable to get a very persistent purulent nasal discharge, a chronic otitis
with a perforation of the drum and again the same kind of yellowish
excoriating discharge, with an irritating eczema of the external ear
whenever the discharge runs over. Associated with
the purulent nasal discharge, many of these GRAPHITES children have marked
hypertrophy of the tonsils, with offensive secretion in them, and as a result they often
complain of difficulty in swallowing. They often
suffer with a chronic blepharitis and their lids are completely stuck in the
morning with the same sort of gluey discharge; dried discharge adheres to the
edges of the lids. In spite of
apparent fatness, they are flabby, and there is general muscular weakness.
They are very easily exhausted; are sensitive to motion of any kind; and
stand travelling very badly. There is a history of rheumatic pains,
particularly affecting the neck and the lower extremities. There is
another GRAPHITES symptom which is sometimes useful in these flabby children
-they are liable to attacks of abdominal cramp; this is not surprising in
view of their constipated state. But in these GRAPHITES cramps the abdominal
pains are relieved by giving the child hot milk to drink. In the majority
of cases, with the constipated stool they pass a quantity of mucus-stringy,
adherent mucus. It links up with the type discharge from the skin surfaces,
although it is not commonly yellow. Another useful
symptom, which is common, is that these GRAPHITES children have big
appetites; they are hungry children and are upset if they go long without
food; they are better for eating. But in spite of their fatness and flabbiness,
there is often a surprising and very marked aversion to sweets. In typical
GRAPHITES adolescents it is still more surprising because there is the same
flabby, fat, soft adolescent with, instead of the ordinary cracks behind the
ear or cracks at the corners of the mouth, they have an acute acne, and one
of the questions to ask is whether they eat many
sweets, and if it is a GRAPHITES case the reply is
that they cannot stand them at all, which is sometimes a very useful tip. Another point
about the appetite in the young children is that they have a definite
dislike of fish. Fish is a normal constituent of a young child's diet, and it is
easy to find out if they dislike it. Most of these
GRAPHITES children do have a very definite dislike of fish. Where considering
children with chronic otitis, chronic discharge with an old perforation
possibly with eczema of the external ear, another drug that must be
considered is CAPSICUM. Capsicum [Caps.] The typical
CAPSICUM child is again a fat, rather lazy, somewhat obstinate child who
is very definitely clumsy in his movements -I have never
seen a neat CAPSICUM child. Mostly they have rather
reddish cheeks, but that is not constant; they may be pale and flush up much
like the GRAPHITES child. They tend to be
very forgetful. They will be sent on an errand, and will come back without what
they have been sent to get. It is partly lack of attention. They are always
touchy, easily offended, easily irritated. An odd feature
in CAPSICUM children is a strange dislike
of being away from home. I think it is partly their feeling that they
are not appreciated, partly their touchiness, and partly laziness -they have
to make an effort if they are away from home, they have to be more or less
agreeable and at home they are very often quite unpleasant. The CAPSICUM
children are always rather dull; they are slow at learning in school, and
their memories are poor. These children
tend to have local hyperæmias. In a typical CAPSICUM child with a mild
earache the whole external ear bright crimson.
A CAPSICUM child with rheumatism has usually one or other joint
affected, with a localised blush over the affected area. A CAPSICUM
child with a cold gets very enlarged tonsils, which are very hyperæmic
-bright crimson, and the child complains of a burning heat in the mouth with intense thirst. An odd symptom
sometimes met with in these children with sore throats running a fairly high
temperature, is that the child is very flushed, cross, sleepless an thirsty; wants cold drinks, and yet shivers after taking
a cold drink. This has been seen repeatedly in a child who has a sore throat and is going on
to definite mastoid symptoms ( ear infection ). Where there is
mastoid involvement in a CAPSICUM case - and it is probably the most commonly
indicated drug for mastoiditis there is always a marked tenderness over the
mastoid process, and a blush on the skin surface long before there is fully
developed mastoiditis ( ear infection ) . One of the
nuisances of these mastoid cases is that they usually blow up at night, the
child becomes extremely irritable, sleepless, worried, the mother can do
nothing with it; it is as obstinate as a mule; she sends for you, and you
have to examine it by artificial light and cannot see the blush. Time and again
I have seen these CAPSICUM children at night and could not make out the blush
at all, but next morning in daylight it was perfectly obvious. Associated with
the tenderness over the mastoid area is the general hyperæsthesia of the
CAPSICUM case; they are sensitive to noise; sensitive to touch,
and they have a hyperæsthesia ( condition that involves an abnormal increase
in sensitivity to stimuli of the sense. , )
to taste. In the majority
of these children with acute illnesses there is some degree of urinary
irritation. It may be an acute cystitis with acute burning pain,
intense, irritable pain on passing urine, and it is always of the same
burning character. But even without the acute cystitis; in the majority of acute
illnesses there is some urinary irritation, and it is always of a smarting
nature. In a child of
this type, clumsy, rather red-cheeked, rather sluggish, backward, with a chronic
hoarseness and a history of having had acute sore throats - not quinsies,
just acutely inflamed throats very often with transitory attacks of earache,
not going on to mastoid involvement, the majority of these cases will need
CAPSICUM. The next of the skin drugs in children is PSORINUM. Psorinum [Psor.] PSORINUM
children are fairly common. The majority tends to
be thin rather than fat. They
are always sickly children; have very little stamina; are easily
exhausted by any effort, physical or mental; very liable to become mentally
confused used stress. They are rather dispirited, hopeless youngsters, and,
like all children when they are out of sorts they become peevish and
irritable. They
are unhealthy looking; they look dirty and unwashed. A PSORINUM
child is hardly ever without a pustule ( pimple ) of some sort some - where
about the body. The skin in the child is very rough and dry. In the
adolescent PSORINUM case it is much more commonly greasy. But whether in the
child or the adolescent, on exertion, PSORINUM youngsters tend to sweat and
they are always unhealthy and smelly. The skin
condition of PSORINUM is not unlike the GRAPHITES skin. There
is a tendency for fissures to develop about the hands and in the folds, but
there is not honey-like discharge of GRAPHITES. The discharge is watery or
purulent, and it is always offensive. In all PSORINUM
skin conditions there is intense irritation. Many
of these children suffer utter torture because they are intensely chilly,
feel the cold very badly and are upset by it, but they have an intensely
itchy skin and are driven nearly crazy by wearing woollen clothes. With this
dirty-looking grey, rough skin, PSORINUM children are upset by washing, which
greatly increases the irritation of their skin. Most PSORINUM
children, in spite of their thinness, have abnormal
appetites; one of the constants of PSORINUM children is that any lack of food brings on a violent headache, very
often a definite sick headache. In a typical
PSORINUM child with a skin condition the skin irritation is intense, and the
child scratches its face until it bleeds. Between the
scratches is an unhealthy pustular eruption, very often associated with a
generalised blepharitis. In the acute
condition it resembles the GRAPHITES type, but it is much more intense than
GRAPHITES, often with the eyelids slightly everted looking almost like raw
beef. The child scratches all over the body, and again there is the same
purulent condition. There is the
same type of eruption on the scalp, and PSORINUM
children are never at peace, always rubbing their heads against the pillow. There is also a
yellow, purulent nasal discharge, excoriating ( abraded
area where the skin is torn or worn off ) the upper lip and often a purulent
foul-smelling otorrha ( discharge from ear ). This is the intensely
irritant skin condition, which only PSORINUM will cover, and for one
may be tempted to give all sorts of other things. For hay fever,
associated with the typical nasal discharge PSORINUM is much the most
commonly curative drug given in the interval. There is a very similar
hyperæsthesia in the mucous membrane to that on the surface in PSORINUM
children and a dose in the spring will wipe out hay fever of long standing.
It does not help in the acute condition, but a dose given in the spring
before the hay fever season starts, can stop fever altogether. PSORINUM
has a spring aggravation. There are two
more common drugs to consider for skin eruptions. Firstly, ANTIMONIUM CRUDUM
and then PETROLEUM, as the ANTIMONIUM CRUD children with skin eruptions have the
same marked aggravation from washing as the PSORINUM cases. Antimonium Crudum [Ant-c.] ANTIMONIUM
CRUDUM children are very interesting. They are always
fat, rather over weight, usually pale, and they have a
very marked tendency to redness round the eyes, and moist
eruptions behind the ears. Mentally they
are interesting because they are such an apparent contradiction. They are
irritable children, peevish, and they get more and more
peevish the more attention they get -the kind of child that will cry if
anyone looks at the more you attempt to soothe it the worse it gets. The ANTIM CRUD
child has night terrors, and is cross
and irritable; and the more the mother attempts to nurse it the worse it becomes. Walking it up
and down drives it nearly distracted. They, in contrast to that, they are
very impressionable children, sensitive, easily upset emotionally,
very liable to burst into tears from any emotional stress if their feelings are
touched at all; and under stress they become pale and liable to faint. ANTIM CRUD
children with skin eruptions tend to get very large, crusty, smelly eruptions -the typical
crusty impetigo seen on a child's face. More cases of impetigo in children
clear on ANTIM CRUD than on any other drug in the Materia Medica. In adults
also, nine out of ten cases
of acute impetigo (one of the most common skin infections among kids, usually
produces blisters or sores on the face, neck, hands, and diaper area. ) clear on ANTIM CRUD. All their skin
eruptions are very much worse from the
application of water in any form, and become very inflamed and painful from
exposure to radiant heat. ANTIM CRUD
children are very clumsy, and very
jerky in their movements and may have an actual chorea. They suffer
from warts on their fingers, either one or two small ones, or masses of
warts, which are usually flat not very painful. Associated with the warty
condition most of these ANTIM CRUD children tend to have deformed
nails - thickened and unhealthy looking. Two other
constant points about the ANTIM CRUD children. Firstly they are very liable
to get digestive upsets from any acids, sour fruits, or
sour drinks. Secondly they have a soft, flabby, coated
tongue usually with a white coating. It
is like a MERCURIUS tongue with a white coating. The outstanding
points of ANTIM CRUD are not unlike PETROLEUM as far as the skin conditions
are concerned. Petroleum [Petr.] But the
majority of children with indications for PETROLEUM will
be thin, rather than fat. Associated with the loss of weight in the
typical PETROLEUM case the child has a very good appetite, and is very often
hungry between meals. PETROLEUM
children are as irritable as the ANTIM CRUD children are but from quite a
different cause they are much more quarrelsome
and easily take offence. The child is often quite bright mentally but
is lazy at school does not want to work and is inattentive and forgetful. They are almost
always sensitive to noise and scared by any sudden loud noise, which they do
not understand. They are just as sensitive to cold as the ANTIM
CRUD or PSORINUM children. There are often
signs of skin eruptions in the PETROLEUM children and the commonest is an
eruption at the back of the ears, deep cracks oozing a
yellowish, watery fluid very often these cracks split and bleed. But the same
type of crack appears in any place in the PETROLEUM child particularly in any
fold at the corners of the mouth, at the angle of the nose, and very often
there are similar around the anus, in the groins, or in the axillæ; the fluid
that oozes out forms thick crusts which are always very sensitive. Almost all the
PETROLEUM skin eruptions itch.
They are more irritable during the day than the night, which is
sometimes a help to distinguish them from SULPHUR eruptions. PETROLEUM
children are very liable to catch cold, and to have acute nasal obstruction,
with an excoriating discharge, a tendency for the nose to get crusty,
sensitive, bleeding and very often crusts form on the upper lip and round
about the sides of the nose. With these
nasal discharge there is also some deafness, with acute pain in the ear, and
a sensation as if the Eustachian tube were blocked. They frequently have an
otitis, with the same kind of watery, yellow discharge and very marked
redness of the external ear an acute eczematous conditions with irritation
and tendency to bleed. Another link
with the itching is very definitely itchy eyes. Often there is blepharitis
with reddened margins, and cracks at the inner canthus, and an infection
spreading down the lachrymal duct - they may even get an abscess in the
lachrymal sac. Pus forms in the lachrymal duct and an excoriating discharge
runs down the side of the nose, raw and bleeding, accompanied by acute conjunctivitis.
With the
infective processes in the throat and nose these PETROLEUM children often
have enlargement of the submaxillary lymph nodes. Another thing
very common to PETROLEUM children is a history of
bladder irritation. It is often an enuresis, but much more
commonly an acute irritation, it may be an acute cystitis, with the same
sensation of rawness and smarting. Another feature
common to the PETROLEUM children is that after any exposure to cold they may
develop acute abdominal colic and diarrha. And with the
diarrha there is always a degree of inflammation about the anus and
perineum, with a burning red raw eruption. In cold weather
the skin of their hands tends to crack, particularly on the fingertips, and
these cracks are very sensitive, very painful to touch, with deep fissures,
which split open and bleed easily. All these
children have the typical PETROLEUM aggravation from
motion that is to say; they get train-sick and seasick.
If the child is pressed it is very liable to develop a severe occipital headache. That
occipital headache is rather rare from mental effort, and it is a little
difficult to cover, but PETROLEUM sometimes meets the case. In cases of
seasickness where there is doubt between PETROLEUM and TABACUM, which is the other
common drug for seasickness, there is almost always
that occipital headache as well as the seasickness in PETROLEUM, and the
TABACUM types do not have it at all. Seasickness
with occipital headache calls for PETROLEUM every time. In prophylactic
treatment against seasickness it is very difficult to decide between TABACUM
or PETROLEUM, but the occipital headache of PETROLEUM children indicates
PETROLEUM. There are
various other drugs for skin conditions in children but these are much the
commonest. There is the possibility of SULPHUR because it is almost automatic
in skin affections, but it is better to take SULPHUR under the next group. GROUP
IV Puls. * Kali-s.
* Sul. * Thu. * Brom. * Iod. * Abrot. * Flu-ac. Pulsatilla
[Puls.] These are the
"warm-blooded" drugs
starting with PULSATILLA, which is the most commonly indicated drug in
children of this type. PULSATILLA
children are very typical. There are two main types. One is the very
small, fine type, with a fine skin, fine hair, unstable circulation, liable to
flush up from any emotion very often going pale afterwards; definitely shy,
sensitive; always affectionate very easy to handle, and always very
responsive. The other PULSATILLA type, is much fatter with definitely more
colour, usually rather darker hair, a little more sluggish in reaction, a little more
tendency to weep than to be bright and gay as the smaller, finer type,
craving for attention without much response to it, always asking for a little
more. If you get one
picture clear you are apt to forget the other. The factor common to both
types is their temperature reaction, all PULSATILLA children are sensitive
to heat, they flag in hot weather lose their liveliness, lose their sparkle
and energy. They hang
about, become either tearful or irritable, and are likely to get
digestive upsets. But they are much more liable to be upset a sudden change to
cold in a hot spell - that is to say they often get an attack of acute
sickness or diarrha from being chilled in hot weather. They tend to
get cystitis, or to get earache. Sudden chilling during hot weather causes their troubles. Whilst generally
they flag in hot weather, their acute conditions are much more liable to be
brought on by chilling. In the same way they are upset by taking ice
cream in hot weather, this factor is quite as common as the ordinary PULSATILLA aggravation from too rich food. Something one
misses a case because of the odd reactions in a feverish attack. The
PULSATILLA children get acute colds in the head, acute coryza, and with this
they are shivery, and very chilly. With the coryza, there is a certain amount
of gastric catarrh, a feeling of nausea, and they may actually vomit. But, in spite
of their chilliness, their sense of blockage in the head is better in the open air and worse in a
stuffy room. A PULSATILLA
cold always has a bland discharge. There is
sometimes an apparent contradiction they are very apt to get conjunctivitis,
and in the PULSATILLA conjunctivitis the eyes are very sensitive to any cold
draught, and water profusely in the open air. There is usually marked
photophobia with itching of the eyelids, and PULSATILLA children are apt to
get styes, affecting the lower rather than the upper lid. A point that is
sometimes a help in PULSATILLA earaches, which are very intense and usually
brought on from exposure to cold, is a very violent pain, which spreads all
over the side of the face as well as into the throat. If the
condition has gone a little further, there is feeling as of something bursting
out of the ear, as if something were pressing right through the eardrum. Another thing is amelioration from cold - their
earaches are better from cold applications. PULSATILLA
children are very often tired, edgy and sleepy during the day, and they become
more lively as the day goes on, they are liable to get the PULSATILLA
nervousness about sunset the ordinary sunset aggravation of PULSATILLA. They become
very lively towards bedtime, are slow in going to sleep, and once asleep tend
to get nightmares, night terrors usually some kind of strife dreams -not
necessarily being chased by the black dog of PULSATILLA- but always something
worrying, terrifying. Most of these PULSATILLA children are afraid of the dark,
afraid of being left alone, as one would expect in the shy nervous type of
child. One thing that
will almost always produce a night terror in these children
is listening to ghost stories in the dark before going to bed; you can be
sure that will give a PULS child a nightmare. Another useful
pointer is that these children are very liable to become giddy
from looking up at anything high. The only other drug that I know in which this
is so marked is ARGENTUM NITRICUM which has an aggravation from
looking down, but it has also an aggravation from looking up, but this is very
much more marked in PULSATILLA. The PULSATILLA
child often lies with the hands above the head and this is a
useful pointer, although it is by no means constant. Kali
Sulphuricum [Kali-s.] When
considering the hot-blooded child of PULSATILLA type, the next thing to
consider is whether it is PULSATILLA or KALI SULPHURICUM. Kent
says that KALI SULPH is merely an intensified PULSATILLA. I do not think it
is. The KALI SULPH
temperature reactions are identical with the PULSATILLA ones, the child is
sensitive to heat it flags in the hot weather, cannot stand
stuffy atmospheres, is better in the open air, tends to stagnate if keeping
still, and is better moving about. It has an aggravation from rich food; and is
liable to be upset by sudden changes of weather. But there is a distinct
difference. The KALI SULPH
child is much flabbier than the PULSATILLA child, it certainly
does not approach the thin fine type of PULSATILLA although it approaches more
to the sluggish heavier type of PULSATILLA. Its muscles are flabby, it is
easily exhausted by muscular effort. It is more liable to sit about, and has
a much more sluggish reaction generally. There is more
obstinacy in the KALI SULPH type than in the typical PULSATILLA. The PULSATILLA
child may be irritable, it may flare up in a temper but it is over; KALI
SULPH is much more liable to be obstinate. Also the
PULSATILLA children are shy, but the KALI SULPH children tend much more to have a lack
of confidence in themselves -it is not shyness. They are lazy,
they dislike work and there is not the keenness and interest of the
PULSATILLA children. The KALI SULPH
children are not bright they get tired out by mental exertion, whereas the
PULSATILLA children are very often bright and sharp and do quite well at
school. There is a
certain similarity in that they are both nervous, both afraid of the dark,
are very easily frightened, easily startled at strange noises, strange
surroundings. The typical KALI
SULPH child tends to be more sickly than the typical PULSATILLA child. The
PULSATILLA child may not be strong, but the KALI SULPH child tends to have
less colour and if flushed it is much more a circumscribed flush on the
cheeks rather than the variable circulation of the PULSATILLA. Another thing
that indicates KALI SULPH rather than PULSATILLA is that nearly all KALI
SULPH children have a yellow-coated tongue, particularly
the root of the tongue although the coating may spread right over. Another point,
which helps, is that there is a slight difference in the type of discharges.
The typical PULSATILLA discharge is a thick, creamy, non-irritating discharge. The typical
discharge in KALI SULPH is a
much more watery, stringier, yellowish discharge. As far as
liability to actual acute illness is concerned, PULSATILLA is more often needed for acute
gastric catarrh, acute gastritis, acute colic and diarrha; but if the
gastritis has gone on to a jaundice in a PULSATILLA child the indications are
more for KALI SULPH than for PULSATILLA. With a
PULSATILLA type of child who has caught cold and developed bronchitis, which
has gone on to a bronchopneumonia with the ordinary PULSATILLA indications,
that is to say, aggravated from
stuffy room, relief from air, sense of suffocation possibly a loss of voice,
very dry mouth without much thirst, with a yellowish, watery sputum and
probably patches of consolidation at the left base -left base more commonly-
the response is better from KALI SULPH than from PULSATILLA. With a
PULSATILLA child who has whooping cough with a lot of rattling in the chest,
and the ordinary PULSATILLA modalities, KALI SULPH does more good than
PULSATILLA. That is perhaps
what Kent means by saying KALI SULPH is PULSATILLA intensified -in these
acute conditions the symptoms are very similar and yet the more severe the
condition the more definite are the indications for KALI SULPH. It
is sometimes useful to remember that the heavy PULSATILLA child is liable to
go on SULPHUR whilst the finer PULSATILLA child is much more liable to become
chilly and go on to SILICEA or PHOSPHORUS. I usually give
PULSATILLA in low potency in chronic cases. They are mostly sensitive
children, and where you are dealing with the sensitive type you do not want a
high potency. When dealing with bovine ( rough and tough ) types I go high, but in a
sensitive type like PULSATILLA they blossom on 30 potency. PHOSPHORUS is
exactly the same, PHOSPHORUS children respond beautifully to lower potencies.
I
have found very good results from ANTIMONIUM CRUDUM 12, repeated three times
a day for two days, in impetigo. With CALC CARB or GRAPHITES I would give a
high potency every time -a 200, or higher, as one is dealing with an
insensitive type. Sulphur
[Sul.] From the point
of view of children, there are two definite SULPHUR types. Much the commonest
is a fairly well nourished, well-grown child, always with a definitely big
head. They are usually fairly heavy in build and rather awkward and clumsy in
their movements. They are apt to
very coarse, strong hair, and always a fairly high colour. Their skin
tends to be roughish, it will roughen in a cold wind, and they sweat easily.
They tend to have rather red extremities, red
hands and very often, red feet. They always have the red lips, very often red
ears, and they easily run to redness of the margins of the lids. That is one of
the exceptions to the coarse hair, because that type of SULPHUR child very
often has poorly developed eyelashes; they have had repeated attacks of
blepharitis they have crusty eruptions about the eyelids which they have
picked and scratched and consequently the eyelashes
tend to be undeveloped or poor. The other
SULPHUR type which is usually thin, with a fairly big head but rather spindly
legs, very often with a biggish abdomen, rather poorly
development chest, very often not so much colour, tending to be paler, with a
definitely rougher skin. They type has a
drier, coarser skin, with a very marked tendency for the skin to split, to
crack on exposure, and the child is rather more miserable generally. The
child looks more seedy, has less vitality, is more easily tired and always
stands badly. The heavier
SULPHUR type have much more bite about them, they tend to be quarrelsome,
impatient rather critical, fault-finding discontented, very often generally
dissatisfied; are apt to feel they are not getting a fair deal, often feel
they are being under-estimated. They are lazy,
but it is often very difficult to say whether it is real laziness or lack of
stamina, because they do get tired out on exertion. They have a great dislike
of interference, they think they know how to do thing, they know what they
want to do, and strongly resent
their parents butting in, they think would make a better show of it if they
were left alone. The thin SULPHUR
types are much more inclined to be miserable, low spirited. They have
much less vitality much less bite about them. There is the same sort of
resentment of outside interference, though it shows itself differently. These
thin SULPHUR children are liable to weep, and any attempt to comfort them is
apt to annoy them, and they will turn on you. These thin
SULPHUR children have even less stamina than the fat ones, they are more
easily exhausted and, like all SULPHUR patients, they cannot
stand for any length of time. They stand badly in the ordinary instance, and
if they are kept standing they go to pieces. There is one
outstanding characteristic of all SULPHUR patients, whether children or
adults, and that the is they have a large appetite -it does not
matter whether they are fat or thin and their appetite is well defined in its
likes and dislikes. All SULPHUR
patients have a desire for something with definite taste; they
like highly seasoned, spiced foods, and they have a very marked desire for
sweets. Occasionally a
SULPHUR patient will crave salt, but it is not really a salt craving, it
is much more something with a taste. Another point about SULPHUR children is that
they have an almost perverted desire for out-of-the-ordinary
food, the unusual dish that the average child
dislikes, the SULPHUR child eat with relish. Another
constant feature in both children and adults is that they are always very
sluggish after meals, they get heavy and sleepy, they want to lie about and
are irritable when disturbed. One very useful
pointer about SULPHUR children is that they are liable to get digestive
upsets from milk. The small SULPHUR baby very often gets
sickness, and may get diarrha and vomiting from milk, and this marked
aggravation is often overlooked. The next thing
that is constant to all SULPHUR patients is the skin irritation. Most SULPHUR
patient have irritation of the skin somewhere, and it is characteristic. It
is very much worse from warmth of any kind; warm room, warm bed, warm sun,
warm clothing; all start up the SULPHUR irritation. When the
irritation is present they get definite comfort, and sometimes a peculiar
sensation of pleasure, from scratching and occasionally the scratching does
relieve the irritation. It always tends to be much more troublesome at night,
quite apart from being hot. When they are
about, active and occupied during the day the irritation does not worry them
much, but when they are at rest in the evening or at night the irritation tends to become
much worse, and much more worrying. SULPHUR has
every skin eruption known to the dermatologist. The point that distinguishes
it as a SULPHUR eruption is the reaction
to temperature, and the fact that it always irritates. It is an
intense irritation that they cannot leave alone; they describe it in various
ways -itching, feeling of animals crawling over the skin, sensation of
stinging nettles, any description that fits an
intense irritation of the skin. In addition to
the general irritability these children tend to get very marked irritation of all the orifices-nose,
ears, mouth, urethra, anus -any orifice tends to be congested, red, hot and
itchy. In all acute or
chronic conditions they tend to have a red-coated
tongue, with very red tip, and very often a red margin running along the
sides, not unlike a RHUS TOX. tongue. Most of these
SULPHUR patients have a dry mouth, a hot mouth, and they are thirsty. This
applies more in acute conditions than in chronic. Another point,
which is sometimes helpful in the SULPHUR type children -SULPHUR patients are
always aggravated by heat, but one is apt to forget that SULPHUR
patients have unstable heat mechanism; they are very liable -certainly in
feverish conditions- to waves of heat and also waves of chilliness.
Very often they
get extremely hot, break out into a sweat and become shivery -very much the
type of condition associated with MERCURIUS. Covered up they
get hot and very uncomfortable; but when uncovered they feel a draught on the
skin and are immediately chilly. But do not overlook SULPHUR because the child
does not want to be uncovered all the time. Another
constant in the SULPHUR patient, no matter what the condition whether it is a
skin eruption, or a child with rheumatism, or a child with a tummy upset, no
matter what condition. It is aggravated by bathing. And SULPHUR
children nearly always look dirty. Some children
may at first sight appear to be not unlike CALCAREA children, that is to say,
they are heavy, with big heads, are rather pale with a tendency to flush,
have rather big bellies, and are clumsy; but they have not the CALCAREA
chilliness, they are hot-blooded, and have a very marked tendency to the
development of blackheads all across the forehead. These children
are nearly all SULPHUR cases. They have rather paler lips than the average
SULPHUR child but, particularly with blackheads scattered over the forehead, always
consider the possibility of the child being a SULPHUR type. Another
contradiction sometimes met with in SULPHUR children is that they have
disturbed areas of heat; they have hot heads and
cold hands, or hot hands and cold
feet; or hot feet and cold head -very often cold, damp heads- local
disturbances of heat and cold as well as general disturbances of heat and
cold. A child with cold does not automatically rule out SULPHUR because the
child does not put its feet out of bed. Typical of
SULPHUR subjects is sluggishness. They are better for exertion; better when they are stimulated and better when they are moving
about. Some SULPHUR patients can be very lethargic, dull, uninteresting
people but if they are stimulated in the proper kind of society they wake up;
they clever; and you would not recognise them as the same beings. It is the same
with SULPHUR children; badly handled they are dull heavy, cross, irritable;
and properly handled they can be bright interesting, quite friendly, and very
often clever. Some of the SULPHUR children have a most astonishing command of
languages. A fairly
constant characteristic of all SULPHUR children is constipation. This majority
of SULPHUR children suffer in some degree from constipation and very often it
is quite severe. Associated with
that is an enlarged abdomen, frequent enlargement of the liver, abnormal
appetite, sleepiness after meals and a very definite tendency to attacks of
colic. The above
applies more to the heavier SULPHUR type, the thinner type is more liable to
get attacks of ordinary SULPHUR modalities, that is to say, diarrha tending
to come on early in the morning any time after four am and the stool is
always offensive. The other
constant SULPHUR characteristic is an offensive odour. Discharges,
eruptions, perspiration all are malodorous, and the SULPHUR child is very
difficult to get clean and wholesome. Another feature
often met with in SULPHUR child is that they are often heavy and lethargic and sleepy during the day, and very sleepless at
night; also they are liable to get most terrifying nightmares. These are most
constant in character, but the child is always being frightened, very
commonly being terrified of fire or something of that sort. Another point,
which occasionally occurs in a SULPHUR child -it is quite
lively in the evening, slow getting to sleep gets off to sleep, and wakes up
soon after in fits of laughter. It is odd symptom, and always in SULPHUR
children. Also they get a hungry period about 11 am, and
all SULPHUR children are liable to be seedy, headachy irritable and tired out
if they have to wait for
their meals. Nearly all the
actual acute diseases from which they suffer are associated with some skin
irritation. SULPHUR is commonly indicated in acute styes with intense
irritation of the lid margins, the lids are very hot and burning, aggravated
by heat, and particularly aggravated by bathing -they smart and sting if an
eye bath is used. There are
commonly indications for SULPHUR in chronic nasal discharges; in these
children with a nasal discharge there is always the same SULPHUR
offensiveness. The discharge is always excoriating, there is a
redness about the nose, with intense irritation, the children tending to pick
at it until it is raw and bleeding. SULPHUR
children often get chronic tonsillitis, a deeply injected throat, very
swollen, feeling very hot, with very offensive breath. And most SULPHUR
children with tonsillitis tend to get masses of glands in the neck -more than
ordinary tonsillar gland enlargement and it tends to spread, and involve
particularly the submaxillary glands. The tonsillitis is accompanied by
irregular heat and cold, shivering attacks, sweaty attacks and thirst for cold
water. There are
indications for SULPHUR in chronic conditions, chronic ear discharge, with
the SULPHUR characteristics
the excoriating, offensive discharge, redness about the external ear, intense
irritation; the aggravation of any pain from hot applications, particularly
hot fomentation. Chest
conditions in SULPHUR children vary from a mild bronchitis to an acute
pneumonia; and again certain features are constant. A tendency to waves of
heat and sweat very often occasional shivers, very often, burning extremities
and a very definite heavy smell about the child. There is one
constant feature that runs through all SULPHUR chest conditions, it is a very
marked sensitiveness to lack oxygen -they cannot stand a stuffy atmosphere, they want
plenty of air, and yet they are chilly in draughts. The disturbance is more
commonly on the left side of the chest than on the right, but it is too slight
a difference to be of much importance. SULPHUR is one
of the most commonly indicated drugs in jaundice of children -acute catarrhal
jaundice, particularly with the marked intolerance that SULPHUR has
to milk in its acute conditions, intense skin irritation, feeling of
burning heat on the surface very often with attacks of colic, frequently with
attacks of diarrha. A SULPHUR diarrha produces an excoriating discharge, redness
and rawness about the buttocks, intense irritation, scratching. The thin type
of SULPHUR patient often suffers from acute rheumatic conditions with the
usual characteristics -irregular sweats,
feeling of heat, thirst, red tip of the tongue. The actual
painful condition is worse from heat, it is rather more comfortable from cold,
it is very much better from movement, although it
is painful when starting to move; and there is liable to be a red blush of
the affected joint. There may also be a history of the attack having been
precipitated by bathing, either sea bathing or swimming. The desire for
fat is very variable in children. It is very common in adults, most adult
SULPHUR cases want fat with
hot roast beef, for instance but it is by no means so constant in children.
Some do not like fat. If they do it is a help, but it is by no means
constant. A number of adults also do not want it. Butter
does not come into the fat craving at all. The majority of PULSATILLA patients with a
definite aversion to fat, like butter and like cream; but they
dislike meat fat, and particularly hot fat. Many PULSATILLA patients will eat fat cold but
not hot. But most PULSATILLA patients will take butter, very often in
large quantities. The tendency to
sweat is constant in the fatter type of SULPHUR. The thinner types usually have a dry harsh
skin and do not tend to perspire. Another thing
which is sometimes a help about SULPHUR children is that they are extremely
pleased with their possessions. The SULPHUR child's
toys are the best that could be, and the SULPHUR child's family is the best
ever. They also have an astonishing money sense; quite a small child
has a very definite sense of values. SULPHUR is not
nearly so often indicated as it used in urticaria. But is very commonly
indicated in urticaria in children, particularly if associated with digestive
upsets. Children respond well to any potency and most SULPHUR children
respond very well to a 30 or 200. Thuja
[Thu.] To continue
with the PULSATILLA type of drugs, although majority of these are hot-blooded
drugs, there is one other that is always associated with PULSATILLA
and that is THUJA, although it is chilly in its reaction. It is a little
difficult to give a mental picture of the typical THUJA child because in the
majority of outstanding cases there is an element of mental deficiency. In
many THUJA children there has been some mental deficiency, some merely
backward, some actually deficient. In some there
is an obvious pituitary dysfunction, and that tends to colour one's idea of
THUJA. But there are THUJA children who are not mentally defective and who
have not got a pituitary dysfunction, and that type of child is very like a
PULSATILLA child in reaction. The outstanding
characteristic of the THUJA child is the fact that
it is sensitive; sensitive to people. It is responsive to any kindness; it is
conscientious in what it does, and it is easily upset emotionally. And there
the first strong indication comes in: THUJA children have a peculiar sensitiveness to
music and this is one of the things commonly associated with mentally
defective children. Eighty per cent
of the mentally defective children that I have treated have been abnormally
sensitive to music. Much more sensitive than the average child; and even in the
normal child with THUJA indications you get this
emotional sensitiveness to music. They are affected by it; they
may even weep from it. Associated with that emotional disturbance
THUJA children have a sadness, a depression, very like the PULSATILLA
depression. The THUJA children,
even the mentally defectives are astonishingly conscientious. They are very
often sensitive to motion, are very often carsick. Another
symptom is a strange contradiction often found in a perfectly lively child
-they are apparently keenly interested, and yet have a strange hesitation in
speaking, a difficulty in finding the words they want, or a difficulty in
saying them. Very often the
difficulty in speaking gives the impression that the child is slow mentally,
when it is not really slow, it is really seeking words. That may go on to a
definite disinclination to talk; they are rather silent and appear to be
rather heavy. The majority of
THUJA children are rather under than above average height, many are
definitely small and rather finely built. Thuja applies equally well to
either fair-haired or dark-haired types. A definite factor is that they
appear to get wakened, the more active they are. If
they are made to sit about they become dull, heavy and depressed, but any
activity brightens them up mentally. Another common
feature in many of these THUJA children is very faulty development of the
teeth; with irregular dentition and very early decay. The enamel of the
teeth is definitely faulty in places. THUJA children
are sensitive to cold, although they are mostly better in the open air. They
are very sensitive to damp and liable to be much worse in the morning. Most THUJA
children perspire on exertion, and even when they are not exerting themselves
they mostly have a rather greasy skin, which is more commonly noticed in the
dark-haired type than in the fair. Some fair-haired THUJA children have a
rather fine skin and very often a downy growth on the skin, particularly on
the back. THUJA children
do not stand up well to mental stress. They are liable to get a typical acute
neuralgic headache under stress, from getting over-tired or over-excited, and
the point about the neuralgic headache is that it very often picks out
definite areas, which are extremely painful and very often extremely
sensitive. These children
tend to get chronic catarrhal headaches. They get thick, purulent,
yellowish-green nasal discharge, possibly with crusts in the nose and
bleeding. They are liable to chronic otitis media, and may develop
mastoiditis with very severe and localised pain, and tenderness over the
mastoid region. If they are old enough they will tell you it feels as if
something were being bored into the mastoid bone. Another common
feature of THUJA children is a poor digestion. The typical
picture of the pituitary child with an almost pendulous abdomen is an extreme
example, and these children are extremely liable to develop a chronically
irritated cæcum. Often there is a full, boggy cæcum in the right iliac fossa,
with a history of recurring attacks of diarrha; and the diarrha is fairly
characteristic. It consists of pale greasy, almost fatty stools and these are
always passed with a good deal of flatus; and the attacks are accompanied by
a lot of gurgling in the abdomen. Very often
these children give a history of having crops of warts. The THUJA
warts are soft and bleed very easily on handling if knocked the surface may break
and bleed. THUJA
patients sweat on the uncovered parts. A girl of about
twelve years of age was stripped to be examined, and the sweat poured off her
when her clothes were removed. She was not sweating at all when covered. Occasionally
that odd symptom of sweating when uncovering is found, but usually THUJA
children are chilly and shivery when uncovered. A particular
case was of interest because there was rare bony deposits in the muscles in
quite a young child, and she did very well on THUJA. The first pointer to the
possibility of THUJA was the odd sweating when uncovered. The other
constant THUJA feature in children is their strange susceptibility to onions.
They are very liable to gastric upsets and an attack of diarrha
from eating onions, cooked or raw. Another common symptom, although not met with
in young children, may occur in the adolescent -they
are liable to get acute digestive upsets from tea. A history of
vaccination is also a great help in deciding on THUJA. Bromium
[Brom.] The next common
warm-blooded drug is BROMIUM. It is one of the drugs, which is very
frequently missed. The common BROMIUM type of patient is usually over-fat,
fair skinned, fair-haired, and the majority are friendly, cheerful, fairly
happy types. There are
contradictions. The fairly cheerful happy friendly type, are very easily put
out, and if upset they very commonly flush up, and explain that they get a
feeling of heat and tension in their heads. They become nervous,
anxious, very often frightened, in the evening, very much
about the PULSATILLA time. They do not like to walk home in the dark and have
the impression that somebody is following them, and they get scared very much
like the symptom of PULSATILLA -they look not unlike PULSATILLA, and
occasionally bouts of depression in the BROMIUM patient are not unlike
PULSATILLA. But BROMIUM is a much more placid depression, much more a
melancholy outlook than the acute tearfulness of the PULSATILLA. The BROMIUM
patient is a rather fat, fair type tending to run to crops of boils, either
acne about the face or over the shoulder, and an adolescent needing BROMIUM
always has some acne spots about. There are
further symptoms very like PULSATILLA. They are very
sensitive to heat, uncomfortable in the sun and definitely uncomfortable in a
hot room. They are better for motion and for exercise; and better in the open
air. By contrast the
typical BROMIUM patient is very much better after
food, whereas the typical PULSATILLA patient is heavy after a meal; and another
contrast -in spite of the fact that they are better in the open air, they
are sensitive to draughts. The majority of
the BROMIUM cases are of two types, one with
chronic catarrh of the upper passages, the other the typical acute hay fever.
Taking the catarrhal type first, the child with chronic hypertrophy of the
tonsils, not the type who is liable to recurring quinsies, but one with an
enlarged fibrotic tonsils, and often with a general enlargement of the
submaxillary glands which tend to be hard, and tend not to break down. With the
chronic tonsils they are liable to acute attacks of catarrhal extension to
any of the sinuses, and in BROMIUM cases it is more commonly the frontal
sinuses that are involved, rather than the antrums; with the involvement of
the frontal sinuses the patients complain of intense pain, fullness, and a
feeling of swelling at the root of the nose. The nose feels
choked up, and there is a thick, yellow purulent discharge, and if any
violent effort is made to clear the nose the discharge is liable to be
bloodstained. Another point about that type is a thickened rather inflamed,
reddened upper lip. Occasionally
one of these children will get an attack of very intense croup, with a
sensation of tackling in the larynx. The very violent croupy cough, goes on
almost to suffocation, and is relieved by cold drinks. They may
complain of a feeling of pressure, or constriction, of the throat, and the
larynx in these cases is usually very sensitive to touch. There may also be
the typical BROMIUM hoarse voice. BROMIUM
is useful for the fat, warm-blooded child, with rather
hypertrophied tonsils, who gets an attack of hay fever coming on usually about
June; rather later in the BROMIUM child than in many of the others. Some
start in the middle of May, but the BROMIUM cases do not usually start until
June. The outstanding characteristic of the BROMIUM hay fever is an extreme
hyperæsthesia of the mucous membranes and dust of any kind will set up an acute attack
during the irritant period. One small boy
had a typical BROMIUM hay fever, and if he went into a room, which was being dusted
would start a violent attack right away, quite apart from any exposure to
irritant out of doors. A few doses of BROMIUM completely stopped it. These BROMIUM
hay fever cases may get asthmatic attacks, which are fairly typical. They get
very sudden spasmodic attacks with a sensation of extreme constriction of the
chest, and extreme difficulty in swallowing. Another point
is that although their apparent hay fever does not entirely subside at the
seaside their asthma entirely goes. &&&&& Another type in
which BROMIUM is very useful is similar, the child is fat, tonsillar, and
sensitive to heat, with a definitely sluggish tendency and in addition there
are generalised rheumatic pains, a type of muscular rheumatism. They are also
very liable to cardiac affections, more likely a poorly acting cardiac muscle
than a definite valvular lesion, but in some cases there is definite cardiac
hypertrophy in that of child and they have improved very much indeed on
BROMIUM. The constant in
all these cases is the feeling of constriction in the
chest, feeling of tightness or constriction over the heart. Another
constant is that feeling of constriction has developed when they have been
facing any wind; there is also the sensitiveness to draughts which is particularly
noticeable in BROMIUM heart cases. Iodium
[Iod.] The majority of
the IODIUM children are dark-haired and rather
dark-skinned, and intensely restless. They
are very thin children, never still, always on the move, wandering about,
fidgeting, restless; this is an outstanding feature of these cases. On questioning
you will be told that these children are definitely irritable, and their
irritability is characteristic. They are perfectly happy playing with other
children and then suddenly, apparently for no reason,
they break out into violence. Very often they are playing perfectly happily
with a brother or sister and suddenly they pick up
something and hit them. It is that sudden
impulsive irritability that is the typical IODIUM mental characteristic.
Very often after such an attack of irritability, the child is
extremely depressed, not weepy but just silent, depressed, rather losing
interest in things. These children
usually have very large appetites; they are hungry
for their meals, and they are hungry between meals. They become utterly
exhausted if they go too long without a meal, and are very liable to get
headache for hunger. Although these children eat well they can never be
fattened; they remain thin, and may actually be losing weight. IODIUM
children are very sensitive to heat of any kind, hot rooms, hot sun, hot
fire, hot baths; heat in any form aggravates the typical IODIUM child. These IODIUM
children often have a rather inactive skin. They get attacks of acute
infection of the nose, with a tendency to spread into the frontal sinuses,
and with such an attack there is an irritant, watery discharge, and a feeling
of obstruction at the root of the nose, and it is tender on pressure. Frequent with
the coryza there is a very hot discharge a tendency to sneeze and with the
discharge always very watery eyes. There may be a history of repeated attacks
of that sort, followed by development of typical asthmatic breathing. With these thin
children with a good appetite, with that sort of history, and with asthma, which
is definitely better in the open air, IODIUM will usually meet the case. These IODIUM
children with that kind of extending catarrhal infection very often get a
degree of deafness, which is usually associated with a chronic Eustachian
catarrh. Another feature
of IODIUM children of that with catarrhal infections, is in involvement of
the larynx. They are very often hoarse, and have a painful larynx, which is
tender on pressure. With the laryngitis they are apt to get acute croupy
attacks, which are extremely painful. One of the distinguishing points about
these croupy attacks is that the child gets very hot and
has an intensely hot dry skin. Very often in
these croupy attacks the child is terrified. They could be mistaken for croup
of ARSENICUM type; there is the same feeling of heat, the same burning in the
larynx, the same kind of restlessness and anxiety, the child is very often
terrified, and there is the same kind of choking feeling. But the
ARSENICUM child is chilly whereas the IODIUM child is hot and wants air. The ARSENICUM
child will perspire slightly; the IODIUM child will
be dry and hot. IODIUM children
are very liable to get all sorts of abdominal disturbances. Most of which are
associated with very typical diarrhic attacks, with very frothy, fatty,
whitish stools, and may be associated with enlarged mesenteric glands (
intestinal lymph nodes); they may be associated with a general enlargement of
the liver and spleen without any very definite blood change; or with definite
pancreatic dysfunction, with the typical pancreatic fatty stool, and there
may be glycosuria. The IODIUM
children with a fair amount of colour, quite bright red cheeks, are very
liable to get rheumatic symptoms. It is usually an acute rheumatism, with
violent pains which are eased by moving and are very much worse from heat. The pains are
usually very sharp and stabbing in character, and there may be a pericarditis
(A swelling and irritation of the thin saclike membrane surrounding the heart
(pericardium).) with very acute sharp
pericardial pain. One thing about
the pericardial cases, is apparently a contradiction to the ordinary IODIUM
restlessness and relief from motion, the chest pains are aggravated by
moving, the pains are brought on and are made more acute by movement. It is very easy
to confuse the rather dark skinned, flushed type of patient, rather
depressed, with sharp, stabbing pains which are worse from motion, with a
BRYONIA case. They are both
worse from heat, but there is not the typical BRYONIA
tongue in the IODIUM patient, not the intense thirst as a rule. Most BRYONIA
cases are more dull and heavy whilst the IODIUM patients are more mentally
alert. There is usually a complete aversion to food in the BRYONIA cases,
and very often a surprising amount of hunger even in the acute IODIUM
condition. There is
certain similarity between the IODIUM child and the BROMIUM child, but it is
an entirely different type. The various symptoms are very much alike, but
once the type of child is recognised it is not possible to confuse them.
IODIUM can easily be confused with SULPHUR but there is not the intense
irritability of skin, the intense itching, in a similar type of SULPHUR. One other
feature of IODIUM quite frequently met with in rheumatic cases, is a history
of an acute diarrhic attack immediately preceding the rheumatic attack. Abrotanum
[Abrot.] !! The clinical
picture of the ABROTANUM small baby is characteristic of a congenital pyloric
stenosis. The child is emaciated with a dehydrated wrinkled
skin which when pinched up, does not
return to its normal state. It has an
inordinate appetite because it is vomiting all its food, and is hungry all the
time. It has a comparatively big abdomen and spindly legs, it is
always cross and peevish as it is being starved. It is usually chilly, is
very often sensitive when handled, and it is tender to touch. In these
ABROTANUM babies there is not infrequently a delay in the healing of the
umbilicus after the cord has dropped off from lack of vitality and lack of
nourishment. Several cases who either had a pyloric stenosis or spasm,
recovered perfectly on ABROTANUM. Another had a pyloric stenosis, lost all
symptoms for a period of four weeks after receiving ABROTANUM, but relapsed
and was operated on, had a typical pyloric stenosis and completely recovered.
Whether the others were really a spasm or a true stenosis is not known, but
three with a diagnosis of pyloric stenosis did recover with ABROTANUM. An older type
of ABROTANUM child is also a hungry child, with an
inordinate appetite, and again it is thin child. It always has a tendency to recurring
attacks of diarrha, usually attacks of diarrha alternating with rheumatic
pains, and always with a certain amount of in co-ordination, clumsiness,
tremor, probably a certain amount of numbness in the hands, feet or legs. The child cannot be trusted with any valuable
china or it will knock it over or drop it; it is verging on a chorea. They are usually rather peevish and
bad-tempered, and very often have a strangely cruel streak in their make-up.
These children are definitely chilly; they are aggravated by cold, and by damp; and their
rheumatic pains are liable to be very worse at night than during the day. Fluoricum
Acidum [Flu-ac.] !!! The last of the
hot-blooded drugs mentioned earlier is FLUORICUM ACIDUM. The majority of
FLUORICUM ACIDUM types, both children and adults, are fair-haired
and fair skinned. At first sight they are not unlike the SILICEA children.
They are rather thin, underweight, usually fairly fine-boned, fine
skeletoned. Not unlike the
SILICEA types they have a yielding disposition, but none of the SILICEA
irritability. They are very often extremely patient, and unlike most of the
drugs in the Materia Medica they often have a strange enjoyment of life, and
find it very pleasant indeed; quite simple things seem to give them an
inordinate amount of pleasure. That is the normal peaceful state. Mentally they
are not unlike the SILICA children in that they are very easily
tired by mental concentration. They get headaches or brain fag at school, and
are not exceptionally bright as far as bookwork is concerned. A surprising
feature of the FLUORICUM ACIDUM type of child is that they are liable to get quite
pointless and unreasoning hatreds of one or other individual in school. It is weird
difference from the ordinary child's make-up, which is striking. It applies
to adults as well. Unlike the
SILICEA children, they are better from physical
exertion. Playing games does them
good, it wakes them up, and they are better for it. The
SILICEA child will be tired out by it. Like the SILICEA children, if they are
kept standing for any length of time they get faint,
headachy, and tired out. Again, unlike the
SILICEA children, they usually have a good appetite, and get hungry between
meals, with hunger headaches. Quite a number
of these FLUORICUM ACIDUM children need extra food at school in the middle of the
morning or they finish the morning with a headache. They wake up hungry
in the middle of the night unable to sleep unless they have
something to eat, and in spite of the amount of food they eat they
are still fairly thin. But many
FLUORICUM ACIDUM children are not markedly thin or under-weight. Their type
is small and fine but not definitely under-weight. With their big
appetites, they have a desire for highly seasoned food; it does not
matter very much what it is as long as it has a strong taste. All the
FLUORICUM ACIDUM patient are sensitive to heat; they are worse
from hot rooms, from hot sun, from too
many clothes and from too many blankets at night. A FLUORICUM
ACIDUM child who comes home school with a slight headache, rather a flushed
face feeling extremely hot, can very often get rid of the headaches by
putting his head into a basin of cold water, or by bathing his face with cold water. Another factor
in FLUORICUM ACIDUM children is that they get a headache if at all
constipated. These children also get the typical FLUORICUM ACID headache from
being unable to get out of school to pass urine; again it is
the same type of congestive headache. Some of these
FLUORICUM ACIDUM children have the fine hair associated with the SILICEA
child, but with a tendency to patchy bald areas, without a
definite skin disease. It is patchy areas of thinning of the hair rather than
actual baldness. Another feature
associated with the FLUORICUM ACIDUM child is very
faulty dentition, very poor enamel
of the teeth, liability for the teeth to decay early, and very often
abscesses at the roots of the teeth. FLUORICUM ACIDUM children rarely have a
really sound dentition and associated with that is the other important
characteristic -unhealthy fingernails, which
are brittle cracked and splintered. Another feature
is that they have red, sweaty palms to their hands and very offensive foot sweat, which tends to
make the feet hot and sore. Another pointer to a possible FLUORICUM ACIDUM
patient is a dry, red, fissured tongue. The majority of these children have digestive upsets
or a tendency to a breakdown at school, or rheumatic conditions. The outstanding
point about the digestive upsets is a tendency to attacks of diarrha; there
is a liability to acute gastritis, and jaundice, and all these digestive
upsets are very much aggravated by
any hot drinks. The typical
FLUORICUM ACIDUM child with diarrha will get a violent attack after any hot drink, which is very
often a useful pointer to the FLUORICUM ACIDUM case. In acute attacks they
are liable to run a fairly high temperature, with a feeling of intense heat
and complete intolerance of any bedclothes. In their
breakdown at school, apart from headaches from concentration -the type of
congestive headache, which is better from cold bathing- one constant
feature is that they make mistakes in writing. They transpose words,
transpose letters and the mistakes seem most senseless. The teachers complain
it is pure inattention, and say the child could not make such mistakes if it
were paying attention; but the child cannot help it. Their rheumatic
complaints have the ordinary FLUORICUM ACIDUM temperature aggravation, and
the pains are very much worse when keeping still and better by moving about. Another symptom
of the FLUORICUM ACIDUM child who is tired out at school is a feeling of numbness in the arms or legs. An odd thing about this numbness is that it
does not come on from pressure; even when the child is still the arms and
legs are liable to become numb. The diarrhic
attacks of FLUORICUM ACIDUM are always irritant diarrhas; there is a good
deal of perianal ( AROUND ANUS ) irritation and possibly a
number of painful perianal fissures. FLUORICUM
ACIDUM is really a hot-blooded SILICEA, with amelioration from motion, and with a
cheerful outlook instead of the flat tired outlook of SILICEA types. FLUORICUM
ACIDUM and PULSATILLA patients are not easily confused for the PULSATILLA
types are usually very much heavier in build, they have much less tension
about them, are softer both mentally and physically. There is not
the activity in PULSATILLA of the FLUORICUM ACIDUM case, they have a slower
brain, are much more yielding, much less active.
The PULSATILLA patient gets tired out with exertion, and the FLUORICUM ACIDUM
patient is rather stimulated by it. PULSATILLA is
aggravated by exposure to cold water, gets chilled; the FLUORICUM
ACIDUM types will bathe in cold water and it will wake them up. It is very
much a question of degree; in one the patient is more taut ( strong / tens ),
the other is gentle, yielding depressed. FLUORICUM
ACIDUM will suddenly get irritable, much more violently irritable than
PULSATILLA, will strike when the PULSATILLA would probably
break out into wrath and then weep. FLUORICUM
ACIDUM is very much more like PHOSPHORUS, much more intense mentally, more
active, more alive than PULSATILLA. GROUP
V Ars. * Cham. *
Cina * Mag-c. * Ign. * Zin. Arsenicum
Album [Ars.] The last group
of drugs includes all the outstandingly nervy children, and the key
to the whole group is ARSENICUM ALBUM. ARSENICUM children are possibly the
most attractive of the children. They are very highly strung, usually finely
made, finely built, often with a very fine skin and fine hair; they are
delicate looking children. They are always very
nervy, very easily scared, very easily frightened, anything unusual will
frighten them, they are afraid of being left alone in the house, afraid of
going out alone, terrified of the dark, and they always have a very vivid
imagination. They suffer from night terrors and wake up in the middle of the
night terrified, jump out of bed and wander through the house to find
somebody to talk to. It is always
the feeling of some horrible occurrence hanging over her; very often she does
not know what it is and is just terrified. When comforted and consoled, she
will quieten down and go to sleep again, particularly if taken into the
parents bed and has somebody near. They are
usually of a variable colour and tend to be rather pale but flush on
excitement. They are not sallow. It is a rather fine skin, and when flushed
they often get hot heads, and cold hands and feet on excitement or
over-exertion. In spite of
their delicate appearance these ARSENICUM children are always restless,
always doing something, and not just sitting about looking at their
fingers. They may take up a thing do it for a while, then go on to something
else, but they never spend their time doing nothing. When they are
nervy they go from their mother to their father, from their father to the
nurse, then back to their mother. Each one gives them a certain amount of
comfort but not for long, and they turn to someone else. In spite of
their restlessness and their activity, they get completely exhausted. They
will be all right for a couple of hours, busy, happy, occupied, rather
restless, and too mentally active, then suddenly become completely exhausted,
grow pale, tired and lie down. Often they become depressed, and in a nervy,
frightened state, feel they are going to be ill and want to have
somebody near. These children
are inordinately tidy. A small girl will keep her dolls in a most astonishingly
tidy condition. Even small boys, who normally break their toys and leave them
lying about on the floor, if of ARSENICUM type, will put them away and be
distressed, not because the toy is broken but because it is in a mess. They are upset if
they spill jam over themselves and get into a mess, and their distress is out
of all proportion to the cause. Another very
definite thing about them is that they are liable to catch cold, particularly
from exposure to cold, and these colds are fairly typical. They usually start
as an acute coryza, with watery, excoriating discharge, very violent attacks
of sneezing and a tendency for the cold very rapidly to spread on to the
chest. In 24 hours the
history of an acute coryza develops rapidly to bronchitis. With that
extension the ARSENICUM child becomes hoarse between the development of the
coryza and the onset of the definite bronchitis. The other
ARSENICUM types get a very similar mild coryza without any hoarseness at all,
without any sign of bronchitis but they suddenly develop an acute asthmatic
attack. The asthmatic
attack in ARSENICUM children is a very typical, very tight, dry, spasmodic
asthma and it is always accompanied by acute terror. It is always terrifying
for a child to get asthma, but ARSENICUM children are almost beside
themselves with terror. They are liable
to get asthmatic attacks either early in the afternoon abut 1 P.M. to 3 P.M.
some time after lunch, or early in the morning any time after midnight. Another typical
asthmatic characteristic is that the attack subsides the dryness seems to
disappear and the chest gets flooded with mucus with quantities of white,
frothy sputum. When the attack is subsiding the dry whistle disappears and
the chest gets moister. ARSENICUM will clear up the whole trouble. ARSENICUM
children are very sensitive to cold, and exposure to cold is certain to upset
them. It either provokes an acute respiratory attack, or an acute digestive
attack. These children get digestive upsets very easily; from exposure to
cold, and also from over-indulgence in any watery fruits. Melons,
strawberries, any of the juicy fruits may give the ARSENICUM child acute
gastritis, usually with diarrha. ARSENICUM
children are extremely chilly, and in most of their chest and general
conditions, they are thirsty with a desire for cold drinks, but when
suffering from gastritis or gastroenteritis, the condition is
aggravated by cold drinks. The gastritis
may be brought on by ice cream, and a mixture of fruit
and ice-cream is particularly dangerous for ARSENICUM children. During the
acute stage of gastritis the pain is usually severe and is eased by warmth,
either warm fluids or external heat applied to the abdomen. When
a child likes warm drinks and is made easier by them, one should not ignore
ARSENICUM. Another point
about these acute abdominal attacks is that the child is rather delicate and
one that can go downhill extremely rapidly; an ARSENICUM
child with an acute diarrha will become collapsed in a few hours. With this
collapse they are restless, worried, anxious, and liable to have constant
small stools, little spurts of diarrha, and a marked aggravation of the
exhaustion after each stool. The child appears absolutely grey, cold and
sweaty. Nearly always in the ARSENICUM diarrha the
stools are offensive. In summer after
over-indulgence in strawberries, etc., the
children have been perfectly well the previous day and the next morning they
are in a collapsed state after purging all night. It is
remarkable how quickly the ARSENICUM children recover if given ARSENICUM. In acute cases
with violent onset ARSENICUM CM every fifteen minutes will clear up the
trouble immediately. But ARSENICUM in low potency is not effective. The
patients do not have enough vitality to respond to low potencies, and in
extreme cases satisfactory results are unlikely from potencies of under 10 M.
There is also a
general hyperæsthesia in the
ARSENICUM children. They are over-sensitive to everything, to smell, to touch, to
noise, to excitement; smells will make them all jumpy and nervy, excitement
will give them a nightmare. They are
highly-strung children. If pushed at school they are liable to get chorea ( jerky
involuntary movement esp shoulder , hand and face ); and if they
are not very gently, quietly handled they develop periodic headaches,
recurring once in 7 or 14 days, violent sick headaches lasting anything up to
from 24 to 48 hours and they may last two or three days making the child
completely prostrated. It is always an
intense congestive headache with intolerance of noise light, or disturbance
of any kind. And this is one of the ARSENICUM contradictions, with these
congestive headaches they want their heads as cool as possible. The child feels
its body may be cold, sweaty and damp; it has extreme nausea; it is restless
and frightened, wants to be well covered -and yet wants its head
cold, cold cloths, Eau de Cologne applications- anything to keep it cool. ARSENICUM is
less valuable in skin conditions than might be expected. It is more valuable
in some of the chronic conditions than in the acute dermatitis. The secondary
syphilitic eruption is the kind of condition in which ARSENICUM is indicated.
Alternation of asthma
and skin conditions is a very definite ARSENICUM indication; where asthma
and diarrha alternate it is useful. A case of recurring headaches in which
asthma developed cleared on ARSENICUM. ARSENICUM very definitely has these
alternations, but more frequently in adults than in children. Chamomilla
[Cham.] The symptoms of
CHAMOMILLA are almost identical to those of ARSENICUM and yet they are
entirely different drugs, and entirely different children. First there is
hyperæsthesia, oversensitiveness to noise, pain, people; there is exactly the
same hyperæsthesia in CHAMOMILLA. There is the
restlessness of ARSENICUM, moving from one person to another, never still;
and exactly the same in CHAMOMILLA, the child goes from one person to another
and is never completely still never at peace. And yet the two types are
different. In CHAMOMILLA
there is extreme hyperæsthesia, the CHAMOMILLA pains
are more intense probably than any other pains from which patients suffer; but the
reaction is entirely different from that in ARSENICUM. CHAMOMILLA
cases have an absolute frenzy of rage; they resent it; they resent having it;
and they are furious that the doctor has not cleared it off at once. A
CHAMOMILLA child is liable to strike out at you because it is hyperæsthetic. There is
intense restlessness in the CHAMOMILLA child, it goes from one person to
another, and each time it is dissatisfied with the person it goes to, and as
it leaves them it is quite liable to strike at them. It is quite
different from the soothing that the ARSENICUM child gets from each one. The CHAMOMILLA
child, who is oversensitive to noise, does not get the nightmare the same
night, the child is wrought up into a perfect frenzy, and liable to scream and stamp
when disturbed. It is quite a different reaction. In the ARSENICUM
case the child is restless, always moving about whilst the CHAMOMILLA
child is better from motion, but particularly better from being carried about -it is passive motion.
Jogging about an ARSENICUM child will probably terrify it. Jog about a
CHAMOMILLA child and it will probably stop screaming and begin to crow. You
stop and it wants you to go on, and if you do not it will pull your hair. The
reactions are entirely different although the symptoms in the Materia Medica
are almost the same. The CHAMOMILLA
child is never still, it is never satisfied with any thing it is doing. But
it is not a question of passing form one occupation to another. It is a question
of getting tired of one thing and throwing it away. It never puts away its
toy in a cupboard, it just tosses it down, and picks up something else; if
told to put the first toy in the cupboard it is liable to yell. Another
constant factor about the CHAMOMILLA children is that they get more excitable
as the day goes on, more irritable, more difficult to manage, and they are
liable to be particularly troublesome about 9 P.M.. The
CHAMOMILLA child often is quite impossible after it is put to bed until about
midnight, then it appears to wear itself out and falls asleep. All these
children who get into a fury tend to get flushed with red faces and hot
heads, but the CHAMOMILLA child tends to get flushed
on one side of the face, it is flushed generally but one side will be redder
than the other. CHAMOMILLA is
almost universal for the teething child, but it is a mistake to give
CHAMOMILLA to any teething child, the indications for it are quite definite.
A teething child who needs CHAMOMILLA tends to get much more fractious at
night and to have very swollen, inflamed, tender gums, and they
tend to be one-sided with a marked flush on that side of the face. The
tender gums are made much worse by any application of heat and they are very
much better from cold applications. They are much worse in a hot
room, and the attack is
liable to subside about midnight. It is worth noting that the toothache pains of
CHAMOMILLA have entirely different modalities from the other pains. CHAMOMILLA
children are subject to attacks of acute colic possibly because their parents
give in to them; they see something they want and scream until they get it,
and that evening they go down with acute abdominal colic -mostly the fault of
the parents. These attacks of colic are accompanied by a lot of wind and very
much relieved by hot applications. With these
attacks of colic they are liable to get bouts of diarrha, with the
typical green CHAMOMILLA diarrha stool. A CHAMOMILLA child with colic and diarrha
gives the best illustration of CHAMOMILLA irritability they scream the place
down. It is painful, fairly acute colic, and the child makes it very
clear that it is in pain. Another
contrast between CHAMOMILLA and ARSENICUM children is that
CHAMOMILLA children are usually hot-blooded. They have very
hot heads, very often hot and sweaty, and they are liable to have burning hot
feet, which they push out of bed at night. CHAMOMILLA
children are ungoverned children, and they have mostly been allowed to get
out of hand, but in addition the CHAMOMILLA child in a tantrum of temper can
get into such a state that it gets blue in the face starts careful
convulsions from pure rage. So one has to be a little careful about the
handling of the true CHAMOMILLA child. One typical
CHAMOMILLA child, about three years of age, when in a rage was
liable to beat her head against the wall, merely because it distressed her
mother. One night about
10 P.M. after she had been quite impossible for the previous hour and her
mother had left her to scream, she had gone into a
convulsion. She was practically unconscious, dusky in the
face, and twitching all over. So one has to be careful about the wholesome
neglect of the CHAMOMILLA child. Quite a number
of CHAMOMILLA babies, teething and with acutely inflamed gums, develop convulsions,
and this indicates an explosive nervous system in the CHAMOMILLA child, which
should be watched. Teething
children do well on a low potency. A few doses usually stop the disturbance, CHAMOMILLA 12
to 30, two hourly, in the average case, but in a violent attack
repeat every half-hour until they quieten down. CHAMOMILLA is
also useful for acute otitis ( inflammation
of the ear ) in children. It is an extremely painful condition, and in most
cases the child does not want to be touched, and is intensely irritable, very
often screaming with pain. If the trouble has been brought on form exposure to cold
CHAMOMILLA is one of the greatest standbys in the small child,
particularly if the one-sided flush is present. CHAMOMILLA has
cleared more acute otitis in small children than any other single drug. And
it clears up clears up without any puncture of the drum. But the child must have
the CHAMOMILLA make-up as well as the otitis, or CHAMOMILLA
will not work. The nervous system has to be all on the fret,
and the child has to be irritable and touchy. The PULSATILLA
child develops otitis media from the same cause exposure to cold -has the
one-sided flush- but it is a PULSATILLA
child, not a CHAMOMILLA one, and CHAMOMILLA will not do it any good.
These are the two commonest drugs for acute otitis in children. Cina
[Cina] The next drug
is CINA, which makes a very interesting comparison with CHAMOMILLA. Most
people start with a dose of CHAMOMILLA. Most people start with a dose of
CHAMOMILLA and if it does not get results they give a dose of CINA. This is
not a very scientific way of proceeding. It is better to know clearly what
the CINA picture is like and where the difficulties arise. The outstanding
mental distinction between the CHAMOMILLA child and the CINA child is that in
CINA there is a degree of obstinacy never met with in
CHAMOMILLA. The CHAMOMILLA child is always unstable; the CINA
child can be as obstinate as a mule. That is the
main mental distinction. In CHAMOMILLA
there is the irregular flushing of
one cheek and pallor of the other. The whole face
may be red but more likely there is irregular distribution. In the CINA child
much more commonly there is a circumscribed red
patch on the cheeks, and very often a noticeable pallor about the
mouth and nose. The next
distinguishing thing about them is that although both dislike being handled
and resent interference, in CHAMOMILLA it is much
more mental resentment whereas the CINA child definitely tender to touch. There is very
often the same description of the two that they will scream when handled, but
once the preliminary discomfort of handling is over the CINA
children are quite peaceful and they allow themselves to be carried about and
it will quiet them down; whereas in CHAMOMILLA
they want distraction all the time, and are always wanting to be doing
something new. The
CINA child will want to be carried because the steady, passive motion soothes
him. Another point,
which distinguishes CINA from CHAMOMILLA -CINA children
are very apt to vomit, as are the CHAMOMILLA types, but almost immediately
after the CINA children have vomited they are hungry. Often the CINA
children will cry for more food immediately after a meal, and the CINA child
often suffers from nightmares, and night terrors if it he had a late meal. Another
distinguishing factor between CHAMOMILLA and CINA is their diarrhic
upsets. Both types have attacks of diarrha. The
typical CHAMOMILLA green stool is absent in CINA. The typical CINA stool is a
very white, watery stool. A
constant characteristic of the CINA child, both in its
digestive upsets and in general, is its relief from
pressure on the abdomen. If it has colic it will turn over on to its
tummy, if carried about while it has colic it will turn over the nurse's arm
so as to get pressure on its tummy. If it is restless at night, it turns over
on to its abdomen. CINA children
are always chilly and are sensitive to any draughts of
air. These children are liable to irregular muscular twitchings,
particularly after any excitement, and often in the muscles on the face. In the slightly
older children mental characteristic of the CINA child is that they are
frightfully touchy. They have of complete inability to see a joke of any kind
particularly if it refers to themselves. CINA children
all have a hyperæsthesia of the head, the head is sensitive to jarring, and
they have a hyperæsthesia of the scalp. To soothe down a CINA child never
stroke its hair. They have an inordinate habit
of yawning, and keep yawning as if they would dislocate their jaws, and in
some cases a definite history of acidosis links up with the tendency to yawn.
Two other
points which indicate the possibility of a child needing CINA. One is that
with their intestinal upsets they become very restless and liable to get
meningeal irritation, with constant agitation of
the head rubbing, it into the pillow. Even without definite meningitis they tend to
develop a squint -an internal squint. The other point
is that all these CINA children appear to develop an irritation of the nose,
it is red, itchy, and they pick at it -and that is quite apart from getting thread
worms or anything of the kind. A yawning child picking
its nose always indicates the possibility of its needing CINA. Magnesia
carbonica [Mag-c.] MAGNESIA
CARBONICA and CINA are the two most commonly indicated drugs for diarrhic
attacks accompanied by peculiarly white stools. In addition
MAGNESIA CARB is an interesting drug in children. The ordinary
MAGNESIA CARB child is a sensitive, nervous type and as a rule they come for
treatment either as very young children or at about ten years of age. The most
outstanding feature of the MAGNESIA CARB children is their
lack of stamina. Some of them are quite well nourished but they
all have very poor muscular power. In an ordinary healthy
child the muscles are quite firm, but the MAGNESIA CARB child has soft,
flabby muscles, and any physical exertion tires him out. There is exactly
the same sort of mental reaction. The older child at school gets mentally
tired out and comes home with a severe neuralgic headache. The pains are
violent, they may be in any part of the head, and tend to come on at night. They are
accompanied by very marked sleeplessness, the child cannot get to sleep at
all, and a strange feature is that they are better if the child is up and
moving about. MAGNESIA
CARB children always have very definite likes and dislikes in food. They have a marked
craving for meat and anything with a meaty taste.
And they have a complete aversion to
vegetables of any kind. In small children there is an intolerance of
milk; they get sour vomiting, and pasty, pale, undigested stools, which are usually white and soft putty-like. If the
digestive disturbance goes further, there are watery stools, which are
usually excoriating. The type of child is very liable in acute enteritis to
develop an attack of bronchitis or definite broncho-pneumonia. In their
bronchial attacks the MAGNESIA CARB children tend to get stringy
sputum, which is very difficult to expel. It is not unlike the KALI BICH
sputum in appearance, but they have great difficulty in expectorating it at
all. MAGNESIA CARB
children tend to have a very dry skin. In small children
it is particularly noticeable, they get a dry almost scaly, skin, and a
peculiar dry, almost coppery-coloured, scaly eruption of the scalp, almost as
if it has been pained on to the scalp. The adolescent
MAGNESIA CARB children are always dead-beat in the
morning, even after a good night's sleep. It is an
effort to get them off to school. Another useful pointer
to MAGNESIA CARB children is that they are very easily startled by any unexpected touch, and in spite
of this very inert type of skin, after taking any hot food or drink they flush up and
sweat about the head and face. These children
are all sensitive to cold, and yet they are rather better in the open air.
They are usually aggravated by changes in the weather. Ignatia [Ign.] The next of the
nervy drugs is IGNATIA. It is unfortunate that IGNATIA has been distorted in
the homopathic textbooks and has come to be looked on as the hysterical
female. Using it in that way misses a great deal of the value, which can be
had from IGNATIA in other cases, which are not hysterical females at all. A child with a
highly developed nervous system; a highly strung, sensitive, bright,
precocious child, doing very well at school and being pushed -be it a boy or a girl- and the nervous
system is getting over-taxed, will often present IGNATIA indications. The first
indication is that the child is beginning
to develop headaches, a nervous, tired headache coming on at the end of the
day, after a period of stress. Then they begin
to become slightly shaky their writing is not so good as it was, their finer
movements begin to suffer. The next pointer is a rather strained
expression, and this is a major keynote to IGNATIA in the non-hysterical
type. It may be anything from a mere tension of the muscles to definite
grimaces when the child is speaking, and it may go on from that to facial
chorea, generalised chorea, difficulty
in speaking, difficulty in articulation. The child is
becoming unduly excitable -either up in the air, or down in the dumps, and is
incredibly hyperæsthetic to noise. If the child is attempting to do homework after school any noise
nearly drives it crazy; it is liable to fly
into a rage and then lapse into tears. After
any stress of that kind the child is quite incapable of working, its brain
will not function, it cannot take anything in, cannot remember, and cannot
think. There are
definite indications for IGNATIA in the peculiar modality of the headaches. The
children come home from school with a congestive headache, which, strangely,
is relieved by hot applications. If their nerves
begin to get frayed these children become scared. They may have been up
against the stress of examinations, they lose their nerve altogether, and are
in constant dread of something unpleasant going to happen, and they may become scared
of doing anything on their own initiative-even scared of going out alone. They get all
kinds of digestive upsets, and the typical IGNATIA hysterical stomach
develops, that is to say the child is upset by the simplest
food but can digest the most indigestible meal. Exactly the
same kind of contrariness appears when the IGNATIA child gets a bad throat,
an acute inflamed throat, and the only relief is from
taking something solid, something to press on it, and the pressure relieves
it for the time being. These
overstressed children get all sorts of disturbances. If they are in
any confined place, particularly if there are a lot of people about, they get
nervous, distressed, choky, and they are quite liable to faint. But it all
keys in with the general picture of nervous stress. As would be
expected in a child of that type, who has been very bright, clever,
successful, and is now rather going to bits, she is very apt to blame herself
for it. It is very
often a child of poorer parents, who is doing
quite well on scholarships, and now cannot do as well as she did. She starts
to reproach herself, thinks that the failure is due to lack of effort on her
own part, gets thoroughly depressed and almost melancholic. Linked with the
choreic tendency is liability to get troublesome, irritating spasmodic
coughs, which come on at inconvenient times, and once
started go on, and on, and on. That is one type of IGNATIA cough in the
stressed child. The other type is very definite, acute laryngitis, with a
tendency to laryngeal spasm. They are very
liable to get rheumatic pains, and may even get acute rheumatism; and most of
the rheumatic pains are better from definite firm
pressure. Zincum
[Zin.] The last of
these drugs is ZINCUM and one adds it to IGNATIA because of the choreic ( jerky
involuntary movement ) tendency. The typical
ZINCUM child is very nervous, sensitive and excitable. They are
easily distinguished from the IGNATIA children. The IGNATIA child, to begin
with, is a very bright, quick
reacting child, whereas the typical ZINCUM child has a reaction time. When IGNATIA
children are tired out they may not be able to take things in, they have
difficulty in learning, difficulty in remembering, but the ZINCUM children are
slow of grasping what is said, slow in answering, and they are much more
docile, less unstable than the IGNATIA children. The ZINCUM
child will come for treatment at about the same age, possibly a little older,
and will present a history of delayed development. Delayed
puberty very often gives the indication for the ZINCUM child. The impression
is that they are tired, mentally and physically generally weary. And yet
they are restless, twitchy, and fidgety. When they are
tired they get a very persistent, aching pain in the lower cervical region,
very often with burning pains going right down the back. Another feature
of these ZINCUM children, particularly the very fidgety ones, is that they
are liable to get cramp in bed at night, more often in the hamstring
muscles ( thigh muscle ) than in the
feet. They are very
sensitive to cold, and are always chilly. They get inflamed eyes from
exposure to cold. These ZINCUM children have definite thickening
of the margins of the lids, chronic blepharitis, and chronic conjunctivitis,
and they develop intense photophobia. They are
acutely sensitive to noise, as sensitive as the IGNATIA children, but talking
worries them excessively, and if the child is attempting to do work and
anyone is talking in the room it upsets them more than the noise of other
children playing. Also in adults, who are completely
exhausted by people talking to them, it is very often a definite lead for
ZINCUM Another strong
indication for ZINCUM is a history of a well-marked, generalised skin eruption in early
childhood, and a chorea developing about adolescence. Many of these
ZINCUM children develop an acute hunger about 11 am
and they simply bolt their food and their drink. Copyright ©
Sylvain Cazalet & Douglas Borland 2000 |
