BED - remain in bed; desire to

By Dr Pushpa Singh
Mob.: 9027143084

Bed – Bed is a place, a space where an individual rests and sleeps, a location where he is comfortable, cozy, relaxed and at ease without any worry or botheration, a place where he rests and rejuvenates and invigorates himself. Every being has some attachment, some fondness towards his bed. He feels himself to be sheltered and secure in his bed, no matter whether his bed is an ordinary or a luxurious one.

Remain – Not wanting to leave or let go; wanting to hang about there only.

In this rubric we can understand the concern and reaction of each patient. This rubric tells us that something has happened in the environment and ecology of the patient that is forcing the patient to leave his secure and comfortable state but the patient is not willing to give up this cozy, warm, and comfy state (his bed).

In this rubric, every remedy has its own bed, i.e. its secure and cozy state and every remedy has a different objective and intention to stay in its bed. If we understand the concern of the patient in regards to his bed, then we can easily get to the right similimum for that particular patient.

PULSATILLA – The bed of PULS is caressing and affection. This patient desires constant, unceasing care and affection and she does not want to leave this person from whom she is getting this continual warmth. This need of a PULS patient increases during sickness and when this person does not get the amount of caresses and affection that she desires, then she gets irritated. At that time, she craves that someone should love her a lot in the way she desires in a soft, soothing manner; someone should take care of her tenderly, nurture her, and caress her (CARRIED - desire to be carried – caressed; and, CARRIED - desire to be carried – slowly). The patient is actually a selfish person with a great need to be caressed. To achieve this, the patient can even feign sickness (FEIGNING - sick; to be). She will actually refuse to leave her bed even if it means putting others to hardship to fulfill her wishes.

CONIUM – Conium is a very narrow-minded individual. He has a lot of suppressed desires, there is an excessive control excised by the patient himself. His mind is full of fixed ideas and this is his soothing and safe state; his bed. He does not like anyone approaching him because he thinks that if he allows others to approach him and come up to him, they may tend to throw light on his problems and this may change his thought process and perception of the issue; this is something he is averse to. This change is what he is averse to and detests and hence does not want to change. He prefers living with his own convictions and is happy doing so. He prefers to stay in dark and does not desire any kind of light. (DARKNESS - amel., LIGHT - aversion to – shuns).

SILICEA – A Silicea person always needs support and grit; the patient lacks stamina, he is in a state of weakness and dread (COWARD, MAGNETIZED desire to be, SPINELESS, UNDERTAKES many things perseveres in nothing). He always has a fear of failure (FEAR - failure of). He does not have the nerve to accomplish anything new (FEAR of undertaking a new enterprise, INITIATIVE lack of). He lacks self confidence (CONFIDENCE - want of self-confidence). He hesitates and falters while appearing in front of people (TIMIDITY - public; about appearing in), as he feels that his weakness would be exposed in front of others and his pride would be knocked down in front of those people. Everyone would come to know that this person would earlier perform all said tasks perfectly well (FISHING – aptitude, for) and that now, he is not capable of executing his responsibilities any more. Contemplating these thoughts, he gets very anxious (ANXIETY – health; about - own health; her/his - menopause; during her). Consequently, he desires to stay in the midst of those people among whom he feels strong and solid. So being surrounded by his own known people, wherein he need not hide his shortcomings, is his bed.

HYOSCYMUS: In HYOS, we get two contrasting states. In one state, he wants to stay in his bed (BED - remain in bed; desire to) and in the other state, he wants to leap out of bed (ESCAPE, attempts to - jumps up suddenly from bed).

Let us try to understand this journey of HYOS:

Say for example, a HYOS patient is suffering from fever and is under allopathic treatment for the same. This is his bed. One fine day, he gets to know that these medicines (which he is taking for his fever) can produce a side effect, in the form of erectile dysfunction, in the human body after prolonged usage. Now, he is extremely worried regarding this scenario and desires to get out of his bed, and discontinue his allopathic medication. Now he has a fear of being injured (FEAR - injury - being injured; of). At this moment, he is restless in his bed and wants to shift to another trustworthy and reliant bed (RESTLESSNESS - bed - go from one bed to another; wants to). During this phase while he is on the look out for a new bed, he has a fear of being deceived and let down (FEAR - betrayed; of being) and so he does not want to give up on his former bed till the time he does not feel convinced and assured that his new bed is safe and the right choice for him. As soon as he gets this guarantee and reassurance, he jumps from his old bed to his new bed (ESCAPE, attempts to - jumps up suddenly from bed - change beds, to). So, he does want to leave his bed and at the same time, due to his fear of being duped, he wants to stay in the same former bed.

In our clinics, a HYOS patient’s say would be like, "Doctor, I want to take treatment from you for my fever but do not ask me to discontinue my allopathic medication. When I feel that I am better and recovering with your medicines, then I will stop taking the allopathic medicines. HYOS desires a bed of confidence and trust.

ARGENTUM NITRICUM – Basically, Arg-Nit is a very lazy person by nature. He does not want to do any kind of work. He feels that he is sick and doesn’t feel efficient enough (DELUSIONS - sick – being). He believes that his disease can never get cured (DELUSIONS - disease - incurable disease; he has an). All these thoughts are fallacious, as he just doesn’t want to work. He gets frightened and anxious to do any kind of work. He feels that doing any kind of work will harm him (HYPOCHONDRIASIS, FEAR - work; of, DELUSIONS - work - harm; work will do him). To stay in his comfortable position, away from work, he will build up huge stories and tales of his problems (buildings/ forts) and reasons to save himself from work (LIAR - lies, never speaks the truth, does not know what she is saying). He tries to escape from taking up work by pretending to be sick with an intention to deceive and shirk work (FEIGNING - sick; to be). He deceives others (DECEITFUL, sly). He makes a lot of plans only to avoid work (PLANS - making many plans). He wants to stay in his bed of laziness and languor. If anyone makes him work, this patient gets a feeling that the other person is trying to take away his bed and he perceives that person to be a robber (FEAR - robbers, of).

A case:

A 12-year-old child was bought to me in the clinic for breathlessness.

Patient's mother: Doctor, he suffered from cough two months back and then he developed pneumonia. Now he has difficulty while breathing. He also needs to take nebulization and a puff. When his trouble increases, he needs to take the puff twice a day. Now, since he has settled down a bit, he is off the puff or at the most, he may need to take it once a day.

Doctor to the patient: What is your concern now?

Patient: My chest hurts and I tend to throw up phlegm every now and then. My stomach also hurts when I run about.

Patient's mother: He gets extremely angry and irritable. When we ask him not to do something that he wants to, he gets very angry. As long as we agree with whatever he says, he is fine but the moment we tend to unnecessarily poke him, then he gets angry as to why did we stop him from doing what he wanted to do. He feels that everyone should do only as he says; irrespective of whether he obeys anyone or not (ANGER - contradiction; from, IRRITABILITY - spoken to, when). In reference to this rubric, the meaning of the word spoken is conveying an advice or permission to a person through another person. The opposite person did not utter anything but just heard and there was no conversation among the two of them. In this case too, when the patient is told anything, he gets angry. No one says anything to him but yet he is irritated.

Patient's mother (contd): He has been suffering with this since the last one year; it started during the last winter season. We have to be vigilant about everything. We only give him warm foodstuff; we never give him anything cold to eat or drink. He also gets affected with oily foods, like carrot halwa. I have observed that he cannot tolerate anything. Even if I give him a small quantity of some fried stuff, that too causes him trouble.

Doctor (to the patient): And what else? During the time of aggravation, what do you do?

Patient's mother: He cannot breathe. He says, "Mummy I am not able to breathe." At that time, he is very much perturbed; he is very anxious and restless. He is unable to sleep and at the same time, he does not let us lie down either. He says, "Mummy you just sit next to me and keep scuffing (or does he mean, rub my back?) my back (BED - remain in bed; desires to). Bed is a comfortable, snug, and sheltered place where this person is wanting to stay; it is a warm, cozy place where he desires to stay. (When his mother is awake, he feels himself to be safe and when he asks his mother to scratch his back, he feels a great sense of relief and wishes to continue to stay in this state. This state is safe and comfortable for him.) (HELD - amel. being held).

Doctor: Tell me about his nature?

Patient's mother: He is unable to socialize with people around. He will behave as if he is a leader and that we all should obey him and abide by him. He starts hating the person who disobeys him. Like, only when his younger brother acts upon his orders, he will play with him but if the younger one refuses to comply with him, he gets angry with him and will run away while playing. If he is in a good frame of mind, then he will play or else he just cannot get along with people. He is only fine with those who agree to whatever he says or else he cannot co-exist and survive with others. He has a little 5-year-old cousin sister; when she does not obey him, he gets angry even with her (ANGER - contradiction; from, ARGUING – not arguing; convictions and keeping them: despite of having firm). Now he is such a grown up boy, but when he wants water, its me who has to give him water or else he will not even drink water. When he feels like, he may do some work, he will even complete work for others around but its very rare that he would feel like doing some work.

Doctor: And what else?

Patient's mother: He is just not interested in doing his studies. He used to study earlier but now he is gradually lacking interest in his studies. Even if we tell him that he has played enough or he has been on the television for long time, he gets annoyed, as to why did you interrupt me? (IRRITABILITY - spoken to, when). He would score good grades at school in the past but now his grades have drastically gone down. He remains sick very often; the moment the exam dates are declared, he falls sick. He gets apprehensive as he is never prepared for his exams. We never have to tell his younger brother anything regarding his studies or exams; he is very good with lessons and schoolwork. If at all we happen to praise his younger brother, he gets infuriated. Besides this, let him tell you everything else.

Patient: (In a hesitating tone with a smile on his face) When I start reflecting or thinking too much, my head hurts.

Doctor: What is it that you keep thinking?

Patient: Like, he does not get me the pen.

Patient's mother: When both brothers are playing on the roof top and if the ball flings on the ground, he will never go to fetch the ball. He always will command his younger brother to go and get it. If the younger one refuses to do so, he will throw his bat and dart away. He will finish his batting and run away when its the younger one's turn to bat; he gets provoked very easily.

Doctor: What does he do when he is very angry?

Patient's mother: He just sits in a corner and start crying. He would never cry earlier, off late, he has started shedding a lot of tears too.

The following rubrics were selected to arrive at the similimum:
• RESTLESSNESS - heat - during.
• HELD - amel. being held.
• BED - remain in bed; desires to.

This patient was given a dose of SILICEA 30. He was much better in the first week itself. He was totally cured in a span of two months. Now he does not lose his temper so easily and has also started taking charge of his studies!!

MINDING THE MIND IN THE CLINIC

APPROACHING CHILDREN - 10

BY DR ASHOK MOHANTY

A little girl aged 8 years was brought to me with severe bronchial congestion which was not allowing her to breathe properly restricting her to sit bending forward, her head almost touching the knee at home.

Since last two days she had been suffering from this problem after exposure to the cold winds during the change of climate.

As her father was a defense personnel, they had given her allopathic medicines with which she is able to at least sleep in the night but again from morning the wheezing and cough starts incessantly making the child very restless and the parents feel pity for her.

While in the clinic she was sitting calmly on the chair looking mostly towards her father evading my look. But when asked, she used to look towards me and nod. She was holding a handkerchief and almost played continuously with that till the time she was in the clinic.

His father told till the time they were giving antibiotics she was sleeping during night time but yesterday night after the course was over she stopped sleeping at night. Through out the night she was changing her position restlessly on the bed. When we tell her to sleep without any movement, the cough used to increase and she used to become more restless. She will listen to us and stop for sometime controlling her cough but after few moments when we fall asleep again she starts moving on the bed.

She never calls her parents for any help though she continuously coughs through out the night. It is only when the parents get up after hearing the sound of her cough, they ask her if she need any medicine or help but she tells them calmly to sleep and she would manage on her own.

She would never miss her school even during the extreme state of her sickness. She is the house captain and her house is the best in the school in junior category. She topped in the class and at the same time managed her house to bag the best in category award. She used to bring works related to her house even during her bronchial congestion and work till they are finished.

The peculiar thing the parents told me that till the time she is totally down with the sickness when ever she is free from her work she used to run on the bed in circular manner and enjoy doing the same. Only when she is totally down she lie on the bed but she never disturbs any body for any help and try to manage her problems on her own.

A dose of Cocculus Ind. 30 was given to her which reduced her cough immediately and she got total relief in a week.

The following rubrics were taken for prescribing the remedy.

RESTLESSNESS - bed - tossing about in - amel.
PLAYFUL
CARES, full of - others, about
RESPONSIBILITY - taking responsibility too seriously

Let us try to understand this case from different facets.

In a case the most important point where you should prescribe is the Concern, Adaptation and Reaction of the patient during the sickness.

Here the adaptation is very vital as the girl was trying to manage herself to be at ease during the sickness with out troubling her parents.

The adaptation was tossing about which gives relief to the patient. The girl used to be very restless because of the cough but continuous movement up and down helps her to ease the suffering. (Toss – throw up, to move impatiently, to be flung to and fro, toss up a coin)

We have two remedies in this rubric, Chamomilla and Cocculus Ind.

Now we can easily differentiate these two remedies by understanding their concern and reaction during sickness.

Chamomilla individual is totally uncivil in her behavior towards others let it be her own parents or any fellow person.

ANSWERING - civil, cannot be

She is very abusive and reacts very violently during suffering.

ABUSIVE
VIOLENT - pain, from

These children can not tolerate suffering and keep quiet, rather they keep on complaining about their problem even to the extent of exaggeration, never allow their parents to be at peace for a moment, always wanting them to do something so that they get some relief from the suffering. Though the parents try their best to help them during the crisis but they are never happy with their parents and never hesitate to abuse them in front of others.

COMPLAINING - disease, of
EXAGGERATING - symptoms; her
IMPATIENCE – wants the doctor to cure him at once (Complete Repertory)
CARRIED - desire to be carried
DISCONTENTED - wrong, everything another does is
ABUSIVE - children - parents; children insulting

In the above case the girl is very caring and sees to it that during her cough and extreme suffering also her parents are not being troubled by her. She tries to control her cough when her tossing disturbs her parents from sleeping but when it goes beyond her control then only her parents come to know about her suffering.

CARES, full of - others, about

Though she is suffering during cough but she takes full responsibility of her house and unmindful of her own condition. She feels that others shouldn’t suffer because of her illness.

RESPONSIBILITY - taking responsibility too seriously

Cocculus Ind. individuals always gives precedence to other’s welfare. They enjoy taking responsibility and fulfill them happily. They keep themselves occupied with play without disturbing others. You will notice these children play on their own without asking for any partner. Like moving their car on the bed during sickness, crossing the fingers of both hands and playing with them, they just love playing. They are so mild that they will never complain for little disturbances they face. Even if there are problems they will not complain and try to manage by making some compromise as they feel it will help other to be at peace.

PLAYFUL
MILDNESS
YIELDING disposition

Though both the remedies are in the same rubric but their presentation during the case will differentiate them easily.

Cocculus Ind. child will toss about on the bed as the suffering is at the peak and only by tossing she gets relief but she will see to it that it does not disturbs her parent and will try to control the tossing when they gets disturbed.

Chamomilla child will toss on the bed with lot of noise (NOISE - inclination to make noise). She will purposefully disturb her parent and make them to carry her till the time she gets relief.

We have to be very careful in considering rubrics for repertorization not just mathematically but by understanding their purpose, why and how they are present in the rubric from the source books. This will lead us to the similimum.

AUDE SAPERE, bi-monthly homoeopathic journal: STUDY OF RUBRICS

AUDE SAPERE, bi-monthly homoeopathic journal: STUDY OF RUBRICS: "AFFECTATION Affectation is not the innate, inborn attribute of a person but it is his behavior, his demeanor through which he hides his we..."

MINDING THE MIND IN THE CLINIC

UNDERSTANDING MIND OF THE CHILDREN: PULSATILLA

By DR ASHOK MOHANTY

Generally, in clinic, children hardly express their suffering for which they are brought and the parents explain them.

Timidity is the main factor for which they hesitate to explain their problem. Children need time, space and affection to open up. It is the ability of the physician to become close to the child as soon as possible by becoming friendly with him.

Another common factor which creates a fear factor in the mind of the child is the fear of injection. This is because of vaccination schedule in the country. The child is exposed to this threat or pain since birth so he always associates injection with all doctors. So we homoeopath should become friendly with him by showing sweet globules, rather we should give some globules to taste so that his fear vanishes and he feels at ease that there is no injection available with this doctor.

To understand the mental state of children is very easy if you don’t stay prejudiced about small details of the parent’s complaints. Observe the child’s behavior and gesture in the clinic and then link the complaints of the parent, this may guide you to the right remedy.

Let me explain you a case, so that it will be easy to understand the mental state of the child:

A boy, 7 years old, was brought to me by his father for enuresis, acute cold and involuntary passing of stool at the school.

Boy’s father: “He had been passing urine at night on the bed since last one year. We take all precautions like waking up twice in the night to pass urine, not allowing him to drink liquids after 8 PM but without fail he passes urine every night. We are really embarrassed as we cannot visit any of our guests and stay there at night because of this boy. Sometimes, I admonish him in the morning but nothing good happens. In the school before someday he told his class teacher to go to washroom as he had urgent urge for stool but she didn’t allow. Then he passed stool in his pant. After that incident everyday he dirties his pant and come home. When we ask why he doesn’t ask his teacher to allow him to go to washroom he replies that he controls the urge as the madam will not allow and the stool passes involuntarily. Even we told his madam to allow him. She agreed, but he hesitates to ask for stool and tries to control and ultimately the stool is passed involuntarily.”

I looked towards the boy; he was sitting on the chair very calmly, looking downward. In spite of repeated asking to tell something about him, he didn’t reply to may query. Tears rolled from his eyes and he looked into my face.

Dr: “Why don’t you ask your class teacher madam about your natural call?”

Boy: “She is not so good.” (oks bruh vPNh ughaA)

Further he didn’t reply to any of my queries.

His father added, “He is mama’s boy. He always wants to stay with her. I become bit angry sometime and admonish him when he doesn’t do things in a right way. That may be the reason he stays with his mother always. But he loves when I take him out for shopping or dining out. He always says to change the section in the school as he does not like the class teacher madam, but it is not possible at the middle of the session.”

In this case, you have to associate the symptoms of the child with parent’s explanation.

The child is very timid and generally hesitates to talk to new persons. The timidity increases further if the child is admonished for any of his mistakes. He then totally stops communicating. But because of fear he may reply you the bare minimum may be through gesture. At home also he is close to Mummy as she understands him and his father always reacts angrily for pretty mistakes.

A dose of Pulsatilla 30 cured the case in a month-time. The child stopped passing urine in the bed and never dirties his pant at school with involuntary stool. Now he asks madam to go to washroom and stopped telling to change the section.

The main feeling of the child in this case is, “HANDLE ME WITH CARE”.

The child is very-very soft and always needs that everybody should behave with him lovingly. Any rude behavior from anybody makes him timid and withdraws him from the person. He feels her madam to talk to him affectionately and not rudely as she didn’t allow him to go to washroom. He does not stay with his father much because he behaves angrily. At the same time he is a mama’s boy because she never tells anything rude to him and always showers affection & love to him.

We have a rubric in Pulsatilla “CARRIED - desire to be carried - caressed; and”. The meaning of this rubric is “handle me with care and love”. Whenever somebody behaves rudely with Pulsatilla then he becomes very timid & closes himself. He then communicates with them bare minimum. (ANSWERING - monosyllables; in) Monosyllables mean expressing the feeling in one or two or minimum-most words. Even sometimes they become so timid that they just communicate by nodding the head. (ANSWERING - nodding; by)

Let me tell you another case of fever which was prolonging for a period over one year. The child was four years old. Once it was detected as typhoid fever and he was given treatment for the same several times. But the fever used to recur every two months.

The child used to be totally normal till 102⁰F, playing and doing day to day activities but when the temperature rises beyond that he used to lie dull in the bed as if there is no energy left in his body and want his mother or father to be at his bed side, softly touching his body. Sometimes he used to sleep in similar state. After giving antipyretic when the temperature recedes then again he starts playing.

A dose of Pulsatilla 30 cured the child and the fever never recurred.

We have a rubric “Torpor” which means lifelessness. In this the person feels that the disease has drained away all his energy and he cannot even move his limbs, which force him to lie down on the bed.

The other rubric is “Clinging to mother” ( Complete Repertory) which means during the sickness the person will need motherly affection and will ask somebody who is very close i.e. like mother to be near him so that he can adapt to the state of disease and will come out of torpor to become healthy.

These two rubrics guided me to prescribe Pulsatilla.

In a nutshell, Pulsatilla child is very-very lovely, always showers affection on others even to the extent of physically caressing & kissing. (AFFECTIONATE - kisses and caresses children) She feels that everybody should reciprocate the same and love her & caress her equally. (CARRIED - desire to be carried - caressed; and) She becomes upset if does not get that reciprocation. But she does not behave rudely with others. She will just sit in one place and weeps in such a manner where other person can observe him. The motive is that she needs attention & love that time to come out of this situation. (CONSOLATION - amel.) A little love, affection and caressing showered on her, makes her lively and she is again full of love and affection, playing with other children. She will avoid to be with people who behave rudely because she has a desire to be carried slowly and smoothly.( CARRIED - desire to be carried – slowly).

UNDERSTANDING MIND OF THE CHILDREN

MINDING THE MIND IN THE CLINIC: APPROACHING CHILDREN: IGNATIA

A girl of 15years came to me for treatment of leukoderma, which she had been suffering since last 6-7years.

She sat in front of me, his mother sitting on the next stool.

I asked her about the problem, she didn’t reply anything.

She was looking into my eyes but did not utter a single word. I repeated the question several times but she didn’t say a word. Her mother intervened to say about her problem.

I told her not to say anything, let her daughter speak about the problem herself.

Fifteen minutes passed but she was not telling anything. She was looking very blank and straight into my eyes.

Her mother started crying and told me, “Why are you torturing her? She won’t speak about her problem. She even didn’t want to come. We somehow managed her to bring to you for medicine. She even does not want to take medicine. She is in a shock because of the problem which is persisting since so many years.”

I told her mother to stop talking and asked the girl, “What is the main problem? If you didn’t speak I won’t give you medicine.”

After this two drops of tear came out from her corner of eyes but she wiped it with her index finger.

After five minutes she told, “What to tell, can’t you see these spots spreading all over the neck and hands. How a person does feels if she has this type of disease spread all over the body. I can’t go to anybody’s house; everybody looks at me as if I am untouchable. I avoid other students in school also. I told mummy before coming here, there is no point in taking medicine as it cannot be cured and I have lost all hope and faith that it can be cured.”

I asked, “Then why you came for medicine?”

She reported, “See my mummy, she is crying, she is deeply worried about my disease. I am not so stupid; I have to think about her also. She insisted to come to you so I agreed.”

I asked, “What is the impact of this disease on your life?”

She didn’t reply and looked down, tears rolling from eyes continuously and she was wiping it with her hanky.

By seeing her weeping, her mother again started crying and pleaded me not to ask her further.

Her mother explained, “Since last 7years she is suffering from this problem. Initially she was not so serious about it, but after her eighth class she used to ask about it, “When it will be cured?

She is taking medicine since last 7years without even 1% relief rather the spots are increasing, spreading to her neck and face.

Since last 1-2years her behavior is completely changed. She does not want to participate in any entertainment or curricular activities1

If you just tell her, ‘you should do things this way’, that makes her very low and she stops talking to all of us.2&3

Then she does all conflicting works (contrary). If you tell her to get up in the morning she will not get up in the morning, further, she will sleep till noon. If you threaten her that when father comes from office we will complain, she will reply, “What he can do, maximum he can beat me, let him do that, but I am not going to get up now.” 4&5

If she is doing a painting & you appreciate that, then she will immediately spoil that.6

Tell her, “if you expose yourself to sun then the spots may increase”, she will do just the opposite. She will go out for marketing in the sun.

Sometimes, if we want to go for some marriage party she will not get herself dressed. Seeing her younger sister dressed she becomes resentful. I observed, she does horrible things like sprinkling ink on her younger sister’s dress. She will then behave as if she is not well and insist on not going to party.7&8

I took the following Rubrics:

1. AMUSEMENT - aversion to

2. ADMONITION - agg. - kindly; even,

3. DELUSIONS - insulted, he is

4. DEFIANT

5. AUDACITY,

6. IMBECILITY – negativism

7. JEALOUSY,

8. FEIGNING - sick; to be

A dose of Ignatia 30 was given. This case was followed up for two years with only one dose of Ignatia 200 in between and then she is totally spot-free since last three years.

The condition in which patient does not want to take any treatment in a chronic case feeling that there is no point in continuing medicine as it is not going to be cured is DISCONCERTED.

IGNATIA CHILD:

The observation about Ignatia child is that they keep on playing till the body gives up.

DEFIANT

This child is very rude and harsh to the mother.

RUDENESS

Why?

It is because she wants the company of the mother as per his requirement.

What is there in it to get angry upon the mother?

When she leaves her alone.

She wants the company of the mother and doesn’t allow her to go anywhere. She becomes very rude if she leaves her for some time.

Suppose if she is in the toilet, she would stand outside and keep shouting for her to come out.

CARRIED - desire to be carried

If the mother goes out for shopping without telling the child (which she has to do as the child would not allow her to go out without him) and in between the child comes to know that the mother is not at home, she gets very irritated and doesn’t listen to anybody. When the mother comes back she gets angry on her by abusing shouting, beating pulling her hair and asks why she went without her, why she didn’t take her along?

1. IRRITABILITY - contradiction - slightest; at

2. ABUSIVE

3. STRIKING

ANOTHER CASE OF IGNATIA

A two years child was brought to me for the treatment of headache, cold and coughs. The mother said, “Doctor, the child is very irritated, since morning he has not eaten anything, doesn’t allow her to go anywhere. He wants me to be around her all the time.”

Q – Does he asks only you (mother) to be with him or anybody can sit near him?

A – No, he wants only me.

Q – How are you managing your work?

A – I leave him when he gets busy in some game.

Q – How he behaves when he doesn’t find you?

A – He starts searching for me. Or if he sees me he leaves the game and starts weeping. Sometime when I have to finish my work then I give him to his father forcefully.

Q – What is he doing since morning?

A – In the morning when the headache was at the peak he was lying very quietly as if he has no energy. When headache became less he wants that he should be left alone and let him play. But I have to be around him. He stays very irritable. On the slightest contradiction he gets annoyed. He doesn’t like to listen any negative comment on his work. Then he gets annoyed.

IRRITABILITY - pain, during

CARRIED - desire to be carried

PLAYFUL

DISCONCERTED (it is a feeling inside the patient that he can not do any thing against the disease now and just let him be in that state)

IRRITABILITY - contradiction - slightest; at

The other symptoms of

Ignatia child:

If anybody and anything interrupts in between, he starts shouting at the person or the thing. Suppose, he is riding a tricycle, and the wheels gets struck in the furniture. He will apply force on the cycle so that he can free it from the obstruction but when he fails to do it he starts kicking it and shouting very loudly. When mother advises him that instead of shouting he should have tried to take out the cycle, he would reply that why have you kept the furniture here? Can’t you put it somewhere else?

The mother would say that he wants me to be around all the time but does not like if I ask him not to do this and that. He likes to be left alone and gets irritated if some other child would touch his toy. He likes that we should listen and follow his instructions but doesn’t want to listen to my instruction.

This child would not listen to the advice given kindly to him for his well being. Instead he would start behaving more abnormally (he would go out of control). At that moment if he gets a slap on his face he would get milder. She told me in the morning when the fever was high that time he was lying very calmly as if he has no energy left. But after some time when the fever came down he started playing again. When fever is high he takes no interest in anything.

INTERRUPTION - agg.; mental symptoms

ANGER - contradiction; from

ADMONITION - agg. - kindly; even

INDIFFERENCE, apathy - chill, during

The nature of the child is that the person who cares for him or gives attention to him his behavior towards him is very rude. But he is very nice towards the person who has the tough attitude towards him.

CONTRARY

Ignatia child do not play for amusement. Ignatia is the only drug in playfulness which do not do it for amusement. It is really strange. Then why does she play. She plays different game. Ignatia is a moralist. She does her work perfectly without giving any body a chance to point finger towards her. At the same time she expects reciprocation from others. If she does not get it then she starts playing the game. She will sit in a corner, refuse to eat and show as if she is not well so that everybody should realize her importance. She even goes to the extent of spoiling the mood of whole family because of this problem.

EMBITTERED, exasperated

She feels it is her right to get the due reciprocation, if denied or neglected she will openly resist others without thinking of the consequence

DEFIANT

In a nutshell Ignatia child is very righteous. She always tries to do things in a right way. She gives proper respect to others. She does all her works in such a way that no body should tell her that it is not done in a proper way.

If she is pointed out then she behaves very rudely.

I have observed that Ignatia child when admonished will go away from that place with out crying and sit in a corner of the room and weep without getting noticed. If the parents go to her and try to console her so that she should be normal, she would tell them to leave her alone. She would become normal on her own and then come back to the daily normal routine.

Here the differentiation can be done with Pulsatilla, where the child will always look to the parents so that they come and console her and love her so that she become normal soon where as Ignatia takes her own time to become normal and if somebody consoles her she may become more aggressive.

IGNATIA : CONSOLATION AGGRAVATES

PULSATILLA : CONSOLATION AMELIORATES

By Dr Ashok Mohanty, Mob.:9810026564

MINDING THE MIND IN THE CLINIC : APPROACHING CHILDRENS

BY DR ASHOK MOHANTY

EDITOR 'AUDE SAPERE'

I interact with many doctors who have querries, “How to take the mental state of an infant or child who hardly or never speak?

In my daily practice I see around 10-15 infants/children by understanding their mental state during sickness.

Let us find the possibilities of deciphering their mental state by common and uncommon behavior of these children during sickness in the clinic.

In case of infants/children we get symptoms from the following sources.

1. From the infant/child himself, if they can speak and willing to do so.

2. By observing their acts and behavior inside the clinic.

3. From the parents, if the child is sleeping or he/she is not willing to talk.

4. In case of not acute condition like Enuresis, Forgetfulness, Loss of Appetite sometimes the child doesn’t complain but you have to take the symptoms of the child in healthy condition.

5. Mind you, never take parental concern into account while prescribing in case of child, sometimes parents show more concern than the child. You have to evaluate the symptoms after seeing the child and take symptoms accordingly into merit.

6. Some children are slow to react so don’t be impatient. Repeat your question till the child understands. Never get irritated with the child.

7. Try to be friendly with the child.

8. Never look into the eyes of a child when he enters into the clinic if you find the child is nervous or having fear over his face.

9. Give some time to the child to be familiar with you and other clinic staff.

10. Take into account everything the child does inside the clinic like touching items kept on table, stamping the feet, his gestures and other acts.

Let’s discuss some cases of children where you can find medicines just by observing the child when he enters the clinic.

Case I

A small boy of four years age was brought by his parents for treatment of recurrent bronchial infection. As soon as their turn came his father came inside. His mother was behind him but the child was not entering inside the chamber. He was holding the two sides of the door with both hands and resisting his mother not to come inside. His father who was already inside told, “Sir, whenever he goes to somebody’s place first time, he does like this.”

He was still struggling with his mother not to enter. His father further told, “We are giving allopathic treatment since two weeks, but when we stop the antibiotics the problem recurs. Initially when we visited the previous doctor our child behaved same way as here but after two or three visits he became normal and even takes injection without crying and any hesitation. Regarding his behaviour, her mother added he becomes very stubborn during the episode of cough. If he wants something he will make all the efforts to get that and you have to provide the same. Nobody can make him understand that time.”

The child was still standing on the door struggling with the mother not to come inside. Her mother told him, “Let’s show to the doctor then we can eat panipuri (water balls) while going back in the market. You are such a nice son, nobody on this earth can match you.” She was telling all good things and praising him. After sometime he agreed to come inside.

There was nothing, which I could have asked further as he was reluctant to give any information. From the above conversation and observation I took the following rubrics:

1. FEAR - room, on entering

2. FEAR - strangers, of

3. PERTINACITY

4. FLATTERED - desire to be - gives everything, when flattered

A dose of Lycopodium 30 was given which brought down the cough and breathlessness in 12hrs time. The case was followed up till six months with no recurrence.

His stubbornness reduced to some extent, so as his mingling with new people for which he used to have some fear earlier.

Here in this case the child didn’t want to enter the room because of the fear of stranger and new people inside the room. He didn’t have the confidence to face them. Hence, he became stubborn not to enter the room. His mother’s pampering to great extent made him to come inside.

What is Pertinacity?

Holding firmly to some purpose, belief, or action, often stubbornly or obstinately.

Hard to get rid of; unyielding; persistent

What is Obstinacy?

Unreasonably determined to have one’s own way, stubborn, resisting remedy or treatment.

How do we differentiate between the two?

In pertinacity, there is strong reason behind his action (better known to the individual)

In obstinacy, he just wants to do it without any sufficient cause behind that.

Let me give one example each to make these two rubrics more clear.

The child is crying at night to have hot popcorns, which can’t be available at that time. You tell him that it can not be obtained at that time; he doesn’t listen and presses more for the same. He then stops talking with the parents and eating his normal food. This is obstinacy.

The child wanted to buy a toy aeroplane in the market. You told him, “I will give it tomorrow as I am not having enough money today.” Tomorrow he will ask for the same. You somehow manage to postpone the buy for next day. Next day he again asks the same. You told, “No, now I can’t buy that.” The child will not leave you till you buy the same. He will never forget the same. This is Pertinacity.

In obstinacy there is more emotional reaction to a stimulus, the child closes down himself and does not participate in any activity and stays indifferent, but in Pertinacity there is more action involved where the child will by any means makes tremendous effort to complete the task in hand for which he had made up his mind.

Case II

One of our colleague’s daughter suffered from very high fever which couldn’t be brought down in spite of changing different remedies in different potencies. We tried individually but there was no relief. The fever was continuing since two weeks.

We thought to take the case together.

Her temperature used to rise very high up to 1040F. She used to lie down or read that time. On asking during that period she tells, “I am OK.” On further questioning she tells, “I don’t feel any pain now. I sometimes feel the need to relax. But I am totally OK and comfortable. Don’t worry about me.”

When her father asks, “You have so high temperature, is there pain or any anxiety or something else?”

She replied, “Papa, don’t worry nothing is going to happen with me. I am more perturbed by your and other doctor’s queries than the disease. I don’t feel good when all of you ask and meet me to select medicine, repeatedly ask the same questions.”

She further added, “Papa I am totally comfortable and I am sure nothing is going to happen to me, please let me relax.” Further she told her mother to tell her father that she doesn’t want to take medicine.”

The following rubrics were taken:

1. WELL - says he is well - sick; when very

2. IRRITABILITY - questioned, when

3. REFUSING - medicine; to take the

8. REST - desire for

A dose of Arnica 30 brought down the fever and she was followed up with no recurrence.

Arnica child doesn’t wan anybody to come near him as any touch be it mental or physical hurts him during the process of recovery so he tells other that he is well.

In the above case the rubric which was guiding to the state of the girl was ‘WELL - says he is well - sick; when very’.

There are different reasons for which, in spite of the sickness the patient tells that he/she is well.

Let us discuss another case of this rubric to find out why they tell OK during sickness.

Case III

A boy of six years was brought to me for skin eruptions with severe itching resembling scabies.

Doctor: “How are you?”

Patient: “fBd gSA (I am alright).”

Doctor: “Once you are alright then why you came for medicine?”

Patient: “Papa brought me here.”

Doctor: “You don’t have any problem.”

Patient: “No, I am OK.”

His father told, “He tells the same way always and plays with his cricket bat and ball. When the itching is more he leaves the game and keeps on itching. If the itching doesn’t subside then he applies coconut oil on them.”

Doctor: “Why you apply coconut oil?”

Patient: “It gives me soothing effect. I feel better after applying oil.”

I took following rubrics:

1. WELL - says he is well - sick; when very

2. PLAYFUL

3. LIGHT - desire for

A dose of Belladona 30 cured the skin eruption and itching.

Belladonna child says well as he wants to play and does not want others to disturb him by taking him to doctor or wasting his play time by giving medicine etc.

Case IV

A boy of 10years age was brought to me by his parents for complete loss of appetite. Some time he complains of pain in the hepatic area.

His mother told, “Since last seven years he is having the same problem and taking treatment continuously either from Ayurvedic or Allopathic doctor.

I asked him, “How do you manage the pain?”

He replied, “I just sit down or lie down during the pain. When the pain reduces I start playing.”

His mother told, “He always plays. Even sometimes during pain also he plays on the bed by throwing the ball to the wall or to the sides of the bed. He never bothers others about his pain. Let it be any severity, he just lie down and never disturb others. He is very sober and nobody from neighbors or from school complained about him. He sometimes fights with his sister momentarily if she disturbs him in his activity or changes the channel of the TV which he used to see regularly.”

I took the following rubrics:

1. PLAYFUL

2. CARES, full of - others, about

3. ANGER - interruption; from

4. MILDNESS

A dose of Cocculus 30 settled the case.

Cocculus Ind. Child plays a very contented play, never disturbing anybody in any condition.