Author:
Dr B S Suvarna
B.A, D.I.Hom[Lond.], M.I.H, PhD, PGDPC (Psychotherapy & Counselling, USA)
HOMOEO PHYSICIAN
MAMTHA HOMOEO CLINIC
Jeevan Shanthi
Karnataka State, India
By the age of two and a half , two out of every three children are dry by day and half also by night . After five years of age only ten percent of children are still wet by night , but this condition may continue until the age of 15 in 2 % of cases . Enuresis (bed wetting) is of 2 types , it is found in children who have never been dry and those who have been and then start wetting the bed again . Nervous control of the bladder in child hood is variable and there may be no specific abnormally other than delayed control , often the difficulty occurs if the parents react with punishment and the child becomes frightened and / or guilty because he or she has wet the bed . certainly , anxiety and loss of security can make a child wet the bed and it can be a sign of childhood depression . Another major set of causes are related to bladder infection ,bladder control and occasionally kidney disease . All these causes can be eliminated simply by examining the urine . Enuresis or bed wetting can hinder a child’s social development if it discourages him from sleeping at friends houses or from going on school trips . The fact that animals use urine to mark their territory shows useful homoeopathic remedies.
Symptoms :
These are usually self apparent and it is important the child is not made to feel ashamed . Some children will sleep right through the night and still wet the bed while asleep ; others will wake up and then wet the bed , any specific symptoms such as pain or general fatigue should be reported . Nocturnal enuresis of children may be simply a delay in the establishment of voluntary control over the act of micturition which in the first twelve months is automatic and some children learn control later than others . Any child having reached the age of 5 years and not having gained full nocturnal control must be subjected to complete investigations . The child itself only is not responsible as considered by the parents since it is beyond his control and if the case is taken up properly and all aetiological factors are taken into consideration the child can be cured off .
Common age – It may last from 3-10 years of age or even until the age of puberty .
Sex – It is more frequently found in boys than girls
Types – there are 2 types of enuresis.
1. Primary :– Means in which the child has never been dry at night .
2. Secondary : –Means is which the child is dry for a period of months or years and then begins to wet the bed .
Primary Enuresis : – Primary enuresis has an organic basis and common causes are
1. Delay in maturation of the relevant part of the nervous system
2. Some children acquire control the bladder late.
3. Psychological cause :
- The mother is likely to smuck the child for wetting may ridicule of try to shame for it especially in the presence of others .
- An excessive anxiety about his toilet training which is likely to cause emotional control .
4 . Mismanagement of toilet training : – It may cause delay in control of bladder . excessive enthusiastic “potting” compelling the child to sit on the potting . when he /she ants to get off and smucking him for not using it , actually the child should be given a chance whenever he wants .
5. Organic causes :
- In boys : 1. defect in urethral valve .
2. adherent / elongated prepuce
3. phimosis
- In Girls :
1. ectopic ureter which may open in urethral of vagina . It is suggested when the child is able to pass urine under normal control at normal interval but in addition dribbles constantly both by night and day .
2. Hooded clitoris
Secondary Enuresis : -Comon causes are —-
- Psychological causes : –
- Worry at home or school have reflex irritation of the bladder resulting in enuresis .
- A move to school to school .
- A move to house to house
- Epilepsy
- Chorea an exciting cause
- Composition of urine :
- High acidity of urine
- Presence of uric acid crystals .
- Skin diseases : Erythema, Eczema, Pruritis
- Diet : Liberal indulgence in saccharine food, Liberal use of articles rich in sugar, Liberal use of a fatty articles, Liberal use of fruit rich in sugar, Drinking of too much coffee.
- Worms
- Traumatic
- After circumcision operation
- Catheterization
Diagnosis : While diagnosing a case of enuresis only general signs and symptoms will not do . All extrinsic causes having been excluded , a full urological investigation will be preferred including :
- Sex : Clinical examination of the external genitals of both sex’s to find out any organic defect .
- Urine : Chemical and bacteriological examination of twenty four hours specimen of urine to determine any change in composition of urine or any sediment exerted in the urine
- Stool : Examination for worms , some times repeated tests are required as worms are not detected in 1st and 2nd stool specimen examination .
- Congenital Malformation : Attention should be paid those rare congenital malformation , folds valuable flaps of mucus membranes in the urethra , narrowing of the bladder neck etc.
- Psychological Investigation : In whom the most searching investigations fail to reveal any abnormality , they will usually be of a highly nervous disposition here a homoeopath will play a role a physician , diagnostician and psychologist as well
Preventive measures : Following measure if adopted , properly , if not otherwise others causes are to be removed , can be very much helpful in curing enuresis .
- Diet : The child should not be given any liquid diet , much salty or spicy in the evening as such ireigmn tend to increase urine out put , such things may be given during day time and not before retiring .The child should be put on light diet especially at night .
- Sleep : Don’t let the child sleep on his/her back as it is an indication of some disease . the child should not be put to bed immediately after food .
- Punishment : the parents should be cautioned against punishing their children fir the act of bed wetting .
- To increase the sensibility of the bladder : To allay the sensibility of bladder , the child should be encouraged to retain water as long as possible in day time . Parents should encourage the habit while going out of house such as picnic etc,
- Before putting the child to bed : she /he should be taken to bath room for urination .
HOMOEOPATHIC TREATMENT
1. Due to organic causes
Causticum– Particularly in children ,incident during first sleep worse in winter and ceases or becomes more moderate in summer with great debility .
Belladonna-— Children with blue eyes , light hair , fine complexion , restless sleep , involuntary urination consequent upon paralysis of sphincter muscles.
Rhus tox-— Enuresis due to weakness of bladder with constant dribbling of urine .
Ferrum met.— As under change of composition of urine .
Sabal serrulata –— Due to paralysis of sphincter ,constant desire to pass urine at night
Gelsemium-— Due to paralysis of spincter muscles , does not like to talk with any body .
Dulcamara –— Enuresis after some disease of bladder , worse from cold and damp . the child desires different things, but rejects on receiving them , copious turbid foul smelling urine .
Petroleum – Due to weakness of bladder , urine drops out even after urination , involuntary at night in bed .
2.Due to psychological causes
Kreosotum – Enuresis with dream of urination in a decent manner , wets the bed at night . A girl 16 years of age suffering from enuresis has been cured on the basis of this particular symptom .
Borax –Frequent urination at night , children who are frightened when being laid in a cot or carried down stairs .
Argentum nitricum – Great nervousness with restlessness , urine passes unconsciously and interruptedly , pale fetid urine , drinking coffee aggravates .
Sulphur – wetting bed at night , copious discharge who suffer from chronic cutaneous eruption .
Psorinum—Worse during full moon . Intractable cases , when there is an eczematous history . In children when there are psoric manifestations. Secretion have filthy smell . the child is very sensitive to cold .
3. Constitutional basis :
Calcarea carb –complaints of children who are fat , fair and flabby too much emission of urination at night . Sour vomiting of children during dentition with a tendency to eat indigestible things such as chalk , pencils etc.
Medorrhinum : in children where there is a psychotic history nocturnal enuresis weak memory , fear in the dark as if some one is behind her/him .
Sepia : The sepia child is dull , depressed moody indolent with a greasy skin disinterested in work worse from change of weather . A tendency to diarrhoea from boiled milk , the child is prone to enuresis during the first sleep (Causticum).
Tuberculinum : Enuresis in a child with primary tuberculosis psychotic persons
Sulphur : for pale lean children with loose abdomen who love sugar and highly seasoned food and aversion to be washed , micturition midnight .
In young girls :
Pulsatilla—suited to cases of nocturnal enuresis occurring in children of tearful habit , conscious of its leakage but unable to control it . the urine passed drop by drop
Kali phos : Enuresis in longer children due to nervous factors .
Calcarea carb : scrofulus children sweat easily wetting the follow and catch cold easily .
Kali brom : Nocturnal enuresis from profound sleep of children or young persons .
Lac canninum : As under psychological causes .
Opium : As under psychological causes
When with out any apparent cause but due to more habit
Equisetum ; Enuresis by day and night , it acts well when it remains a mere force of habit ,after removal of the primary cause , dreams of seeing crowd of people
Due to defective digestion
Nux vom : Loves fats and tolerated them well , nausea in the morning after eating . Irritable bladder from spasmodic splinter , frequent calls little and often with dribbling of urine .
Carbo veg : when associated with acidity of the stomach
Iodine : Children eat too much but still emaciates all the time .
Change in urine composition
Benzoic acid : when enuresis is accompanied by a high colored and strong smelling urine , benzoic acid will turn the urine normal and prevent its escape .
Ferrum met : more in day time than at night . floods the bed 5-6 time at night stains the bed very dark and smell very strong . clay colored sediment adhering to bottom of vessel .
Cubeba : urine foamy with smell of violets . Frequent urination due to some organic disease as uretherities prostates
Viburnum : urine of a foul odor like cat urine ,can not hold urine walking while
When due to worms
Cina : the chief remedy for worms . the child is very irritable useful for round and thread worms (not pin worms) urine turns milky on standing . Enuresis during first sleep ,great appetite soon after leaving the table .
Silica : useful for children suffering from worms due to weakness of urinary organs
Santon : Especially useful for children suffering from ascaris , lumbricroides and thread worms and not tape worms, urine greenish if acidic , reddish if alkaline
Sepia : Incontinence of urine at night especially 1st sleep the urine is very offensive and deposits a clay colored , sediment which adheres to the chambers .
Nat. mur. : Hungry yet looses flesh , craving for salt , aversion to bread and fats , child emaciating from neck urine passing involuntarily when walking and coughing , has to weight a long time for it to pass if others are present .
“Kreosotum” and “Belladonna “ – who sleep so deeply that they loose control of their bodily function . “ Sepia” wets himself during the first part of the sleep , while his days are spent tidying up in order to restore a sense of cleanliness and order .
“Capsicum” has never recovered from a house move or other displacement .
Kali bichromicum : is trying to define his boundaries just like an animal marking its territory
Lac canninum : is the main remedy for long standing enuresis ,which may continue through in to adolescence . the patient believes he is worthless and that he will never achieve any thing .
Bed wetting case history
Case No.–1
Kreosotum—Enuresis with dream of urination in a decent manner , wets the bed at night.
A girl 16 years of age suffering from enuresis has been cured on the basis of this particular symptom
A man age of 60 years suffering from enuresis have been cured with acid phos 1M enuresis or bed wetting can hinder a child’s social development if it discourages him from sleeping at friend’s houses or from going on social trips . the fact that animals use urine to mark their territory shows the usual of the problem . there are many potentially useful homoeopathic remedies including ;
Kreosotum and belladonna , who sleep so deeply that they lose control of their bodily functions
Case No.-2
A little girl , 19 months old presented symptoms ,the case described above except that the discharge was less profuse , thinner and some what acrid.
She kicked the covers off at night , was always hungry and cried all the time she was getting her bath , I gave her a powder of sulphur . In half an hour, she had a profuse diarrheic stool and in 5 days the eyes were back to normal .
