A healthy nation begins from a healthy society and in turn from a healthy mother and a healthy child. Most pregnant women hope to give birth safely to babies and to see them grow up in good health. The successful outcome of pregnancy is a healthy child, who can play a vital role in building a healthy social framework, imperative for development of a healthy nation. In the wake of steadily changing life – style, especially in urban areas and cosmopolitan cities, environmental changes and growing culture of having a nuclear and small family, the concern about well being of their children has taken centre stage. Parents are becoming increasingly concerned about the innocuous and mildest of ailments of their children such as common cold, diarrhoea etc. and consulting physicians for their treatment at sickening regularity. Many times antibiotics available over the counter are unnecessarily fed for viral infections which do not respond to bactericidal antibiotics, and therefore, not required. It is forgotten that the inherent immune response or vital force effectively acts against microbial infections and bestows immunity against them.
It is a little known fact that the vast majority of drugs commonly used for infant and child health problems have not been adequately tested on paediatric populations. Even a report from the American Academy of Paediatrics admitted that “possibly as many as three quarters of the drugs used in the hospital paediatric practice are not officially approved for the purpose for which they are commonly employed.”
Conservative use of conventional drugs with newborns, infants and children is recommended, since their bodies are still developing, the organs and glands are learning how to function in concert, and the immune and defence reactions are in the process of maturation. It is now [finally!] acknowledged that pregnant women should avoid medications during pregnancy; and yet once child is born, they forget that their bodies are still in the process of growth and development, a delicate state that can be significantly affected by many commonly used medications. Symptoms are the responses of the organism to deal with infections or some type of internally or externally derived stress. They represent the best efforts of the body to try to defend and heal itself. Homoeopathy is a medical system in its own right which is quite different from the conventional medicine in its basic tenets, research paradigms and practical approach to therapy, even though both methods share the aim of healing the sick. Homoeopathic medicines are reportedly used with success in the treatment of multitude disorders of childhood and this has been clinically verified. Homoeopathic medicines act very well and effectively in the common ailments of children from infancy to teenage. They are safe, devoid of any adverse side effects, cost effective, build resistance to infection and are exceedingly likened by children.
Success in the treatment of infants and child [and grown ups too] with homoeopathic remedies depends very much on how well the case is taken. Case taking especially in the case of infants who cannot speak, is an art. Even a child able to talk, but in acute distress, is simply not in a position or mood to describe its sufferings and answer our questions. Sometimes a child is positively non – cooperative out of fear at the doctor’s approach. It then becomes the responsibility of the physician to tactfully elicit whatever subjective symptoms he can get the attending mother, who is usually is the best person to give correct information as she watches her child growing. However the physician should guard against accepting their interpretations about the cause. Besides this we should carefully observe the objective symptoms as well. For this purpose we must coordinate the findings by our special senses with our knowledge of Materia Medica.
- SIGHT [Inspection] :-
A careful look at the child tells many things. Whether the face is flushed, pale, dusky or comatose; one cheek red, the other pale. Temperament: irritability, cross, dull or apathy; wants to be carried or left severely alone; averse to being looked at or spoken to, or even touched. Does the infant take its fingers to its ears while crying [denoting earache], or to the mouth [indicating some disease of the larynx] ?, does it bore its head into the pillow [brain affection] ?, tongue coated [digestive upset] ? etc. Coryza watery, thick, green or stringy. Swelling of parotid glands below the ears on one or both sides. Child rubs or presses its nose, or scratches its anus [worms]. Eyes half open, or the pupils turned up [Cuprum], or down [Aethusa] in convulsions, or staring [Hyos., Cic.]. Does it turn its head away from light [photophobia : Bell., Calc., Stramo.]. Colour of skin – blue [cyanosis], yellow [jaundice], or pale [anaemic]. Breathing : difficult, rapid [pneumonia] or shallow or suffocative [asphyxia]. Growth of tonsils or diphtheritic membrane in the throat or nose. Observe the mental disposition of the child : whether of the shy and timid type who hides behind the mother or covers its face with hands but watches through fingers [Baryta carb]; whether it responds to petting and fondling [Puls., Phos.]; whether it is watchful for every gesture [Phos.], one that urinates or defaecates everywhere [Sep., Sulph., Sil.]; a very dirty child [Sulph., Ammon carb.]; lively, curious and wanders about [Tuber.]; jumps up to even least noise [Borax] etc.
- TOUCH [Palpation and percussion] :-
Whether the fontanelles are open [posterior fontanelles usually closed by 6 weeks, and anterior by 18 months]; whether any part of the body is warm, burning hot, or cold or icy – cold to touch; enlargement or induration of glands in the neck, axillae, parotid, etc. Sweating of hand or feet; muscles lax, flabby, weak or wasted [any emaciation of parts about the clavicle – Lyco., Nat mur.] about shoulder [Plumb] or about neck, arms, thighs, legs or buttocks [Nat mur., Abrot., Sanic., Sars.]; difficulty in the movement of neck or limbs. Enlargement of liver or spleen. Painful sensitivity of parts to touch, gentle or hard pressure. Abdomen soft, hard or tender.
- HEARING [Auscultation] :-
Whether voice is feeble or plaintive [disease of abdominal organs]; breathing is rattling or wheezing [bronchial or lung affections]; cough hollow, barking, hoarse, convulsive or whooping.
- SMELL :-
Odours in the sick room; of stools, sweat, vomitus or urine; sour odour of discharges [Calc., Rheum., Hepar.]; Ear discharges [fish brine odour : Tell.]; foul odour of mouth; even of the child as a whole [Psor filthy even after bath.]
Each of these objective symptoms leads to a group of remedies and as they are objective, there cannot be a mistake about them. Many of our remedies can be immediately recognised on actually hearing the coughing spells such as Spongia [barking, croupy], Drosera [fits of rapid choking cough], Rumex [continuous cough amel. By covering the mouth against cold air]. Similarly with the breathing sounds of Ipecac and Ant tart or the dark and dusky expression of Bapt., the purple inflammation of Lach, the oversensitivity of Hepar., the peevish, irritable whining amel. By carrying about of Chamo. and so on. Dr. J.T.Kent, that inimitable teacher and prescriber has advised physicians to actually learn to distinguish between the various sounds of coughing, breathing, etc.
Careful physical examination of the patient is a must. Homoeopathy has been often brought into disrepute by overzealous or misplaced reliance on symptoms alone. Serious conditions like diphtheria [which could be detected by a look at the throat], or dehydration in gastro – enteritis [denoted by sunken fontanelles and the skin of the abdomen coming in the folds between thumb and fingers], or appendicitis [great tenderness in the ileo – caecal region] or cerebro – spinal meningitis or infantile paralysis [rigidity of neck] have escaped notice with disastrous consequences.
The objective symptoms revealed by such a thorough physical examination together with the subjective symptoms if available, will lead the physician to a diagnosis of the disease, the prognosis as well as a group of remedies which may be initially considered. The common symptoms of the disease can then be ignored [as valueless for selecting the remedy], and one can concentrate on the uncommon, rare or peculiar symptoms, the aggravations and ameliorations, and the concomitants, all of which together will help towards ‘assembling the totality’ and finding the similimum.
The Generals which need to be especially looked in children are :-
v Mind : cross, snappish, whining, kicking, gentle, smiling, cooperative, soporous, apathetic.
v Desire : for attention, sympathy, caressing, or aversion to being looked at or touched or even spoken to.
v Motion : fear of downward motion, or desire to be carried or rocked in a cradle or in the lap.
v Foods : that disagree or upset the stomach. Marked aversions or cravings for saltish, sugar, butter, milk, eggs, meat, cold or hot drinks, etc.
v Temperature / weather reaction to : cold or warmth; wet weather, change of weather; likes to be warmly covered or kicks off covers and desires cool open air and draft of air [fan].
v Thirsty or thirstless : thirst for large or small quantities, frequently or at long intervals, for cold or warm drinks.
v Modalities : of time and aggravations and ameliorations from eating, drinking, stool, sleep, waking, etc.
v Partial heat or coldness of body, such as one cheek or leg hot, the other pale or cold.
v Sweating of body or partial sweats on head, hands, feet etc, on covered or uncovered parts, during sleep or waking.
v Position in Sleep : on abdomen or in knee – chest position.
v Discharges : colour, consistency and odour of stool, vomitus, sweat, urine.
v Growth of bones – curvature, softness and muscles – fat, flabby or wasted.
In treating the more deep seated abnormalities such as rickets, marasmus, paralysis, mental retardation, late learning to walk or talk, behavioural problems – in these condition in addition to the above the family history which may call for nosodes like Tuberculinum; ailments and emotional upsets suffered during pregnancy or labour by the mother, history of falls and injuries, effects of immunizations – vaccinations, triple antigens, B.C.G., past illnesses, nutrition history [whether breast fed or bottle – fed], whether the child crossed the milestones at normal time, past illnesses and drugs used in chronological order. Also the home environment has profound influence on the child psychology. It has been noticed in child guidance clinics that the ‘broken home’ is a frequent cause of juvenile delinquency. Equally damaging to the child is a feeling of insecurity engendered by ambitious parents who make the child feel he is valued for his achievements rather than himself – all such factors leading to behavioural problems. In relation to infant feeding practices, cooking in aluminium utensils causes harm producing proving symptoms of aluminium – child sensitivity to aluminium can be known by 3 symptoms – they tend to rub their eyes frequently, there is straining at stool and they are slow eaters.
Though it appears to be a too long process, but in reality it is not; when practised, it becomes quick with some experience and gets to be routine and a practised eye would in due course notice abnormalities very quickly. This requires persistence which rewards well.
For searching the similimum we should always take the help of Repertories in our hand which expands our field of selection in an unprejudiced way. In paediatric cases the Boger – Boenninghausen Repertory [BBCR] serves the purpose well. There is a big rubric Infant, Affections of with many sub – rubrics in the chapter ‘Sensations and Complaints in General’. This is unique and very useful in paediatric practice. I have presented a few case reports to show how with only a few rubrics from the above Repertory the curative remedies have been found for different ailments of infants.
- A ten month old child, playful and excitable with persistent sleeplessness during dentition. Coffea the only remedy with four marks cured on the first night itself.
- The rubrics i.] irritable, ii.] wants to be carried, iii] Diarrhoea during dentition iv.] stool green and v.] stool, bad odour, gave the following marks : Ars, 16/5; CHAM, 18/5; Merc 14/4; Sulph 14/4, Chamomilla stopped the diarrhoea and also improved the mood of the child.
- A child, 8 months, crying and screaming, has sour body odour, and sour stool and sweaty head was cured by Rheum in a few days.
The selection of a homoeopathic remedy in childhood is made in the same way as in adults. The difference lies mainly in case – taking and in interpreting the symptoms against the normal pattern of behaviour at any particular age.
Case reports are apt to mislead the readers into thinking for example that Chamo. is the almost the only ‘remedy for dentition’, or that Puls. or Bell. are for earache, or that Borax helps the baby who cries when being laid down in bed. The remedy must represent the totality of symptoms. “Unless you combine the particulars with the things that are general, and the generals with particulars – unless the remedy fits the patient from within out, generally and particularly – a cure need not be expected. That is why, I say, do not prescribe on keynotes….” – J.T.Kent; (Lectures of Homoeopathic Philosophy)
After giving the remedy, the changes can be watched and even physically measured : the increase in weight, in circumference of the arm, etc and the healthy teeth, nails and hair, the smile on the face and of course the joy of the parents. The results of the treatment should be recorded.
We should always bear in mind that out of the two ways to fight diseases, viz., prevention and cure, prevention is better than cure. The child who falls sick frequently has low immunity. Since good nutrition gives better immunity, much attention should be paid to this and easily available cheap and palatable food should be suggested for the child. The temptation to prescribe costly baby foods even at request of parents themselves should be strongly resisted. Rather cheap but more nourishing foods like ragi, green gram, khicidi, drumstick leaves, fresh seasonal green leafy vegetables and fruits available in local market should be suggested. The mother should be encouraged to breast feed the child upto 18 months as breast milk is the best food for baby providing complete nourishment and much needed immunity in early years. Good nutrition which need not necessarily be costly and simple hygiene would prevent malnutrition and infections. Here I would recall paragraph 4 of the Organon, “He is likewise a preserver of health if he knows the things that derange health and cause diseases and how to remove them from persons in health” . The physician should always maintain a proper balance between both preventive and curative aspect of therapeutic science.
Also in Aph 284, footnote, Organon of Medicine, Master Hahnemann elucidates the intrauterine treatment during pregnancy for which he advises the physician to give antipsoric treatment, especially with Sulphur dynamizations prepared according to directions given in 5th edition of Organon, in Aph. 270, which is indispensable to destroy psora – the producer of most chronic diseases passed to the child through hereditary taint – which destroy the psora within the mother and foetus – resulting in the birth of a more healthy and stronger baby. So health care of a child begins with the onset of pregnancy.
It has been said that child is the father of man. By caring for the health of the child, right from its conception and removing hereditary taints and carrying it through a period of as good health as may be possible by us by use of homoeopathic system of medicine, we can build up a new generation of comparatively less ‘sick’ people; a healthy mind can also be developed which may not be affected by stresses and strains. This is something which cannot be achieved. AUDE SAPERE.