MINDING THE MIND IN THE CLINIC

APPROACHING CHILDREN: KREOSOTE

Dr Ashok Mohanty

9810026564

A boy four years old was brought to me for multiple warts on the body. The warts were spread on the abdomen, forearm and right hollow of the knee.

The boy as such had no complaints about the warts. Neither he complained about the warts nor were the warts painful or bleeding, needing some medicine. But the parents were concerned as there were fifteen plus small warts and they are growing day by day.

Because of some prior knowledge about homoeopathy the parents had already consulted a homoeopathic doctor and prescribed remedies like Thuja, Nit Acid, Causticum and Dulcamara to the boy which yielded no result.

I asked the parents to explain everything in detail about the boy.

His father told, “He is naughty boy. He never sits idle at home, always in a move. Even during rest on the bed also he will be doing one or other thing like disturbing his elder brother who is studying on the same bed or pulling the hair of the mother who is taking a nap.

Everyday he will come up with a request for a new item from market. “Papa, bring pasta for me as shown on the TV or Gems surprise Ball with Benten toy inside.” When I bring the same he will tell “now I don’t want this, you bring Mc Cain Smily or MC Donald happy meal toy etc etc.”

I just listen to him and tell I will bring next time, sometime he will listen to it and keeps quiet and keeps on playing but sometimes he becomes very adamant that, “now I want it immediately.”

It might be night 10 O’clock but he will be very obstinate that he needs the same right now which is practically impossible as the market is closed by that time.

Then he will start throwing the items with which he would be playing. No matter how costly the items are, he will throw them outside.

Sometimes I keep my cool but if my mood is not good then I keep hold of him and slap him. But there is no stopping of his nuisance, he stays in the same state of anger and defiance and again throw the items around.

Even after repeated slapping and threatening he will not cool down. He will cry in a very loud tone and look into my eyes and keeps strong eye contact with me. This behavior further angers me and sometimes I beat him a lot but he will not go away from that place and keep on staring at me with defiance.

His mother intervenes and takes him away to the next room. But after few minutes he will again come back in front of me and start sobbing and crying looking at my eyes with defiance. He will not go away till I tell him sorry and take him in my arm and love him and tell lot of things like, “tomorrow I will certainly bring the item you want, please excuse me for my rudeness, I will not repeat the same etc etc.”

I observed the boy sitting on the chair. He was listening to what his father was saying and looking at me. There was no fear on his face as other boys of his age in the clinic do.  Children generally fear doctor first time in a clinical setup because of repeated experience to injection during vaccination. I asked him his name; he didn’t reply and looked to the other side.

From the above information I formed the following rubrics:

OBSTINATE, headstrong - children

CAPRICIOUSNESS - rejecting the things for which he has been longing; when offered, he is

ANGER - throwing things around

DEFIANT

SHRIEKING - children, in

CARRIED - desire to be carried - caressed; and

A dose of Kreosotum 30 was prescribed which cured the warts.

Understand the remedy and differentiating it from the other remedies in the core rubric ‘CARRIED - desire to be carried - caressed; and’

Kreosotum child is very obstinate. Once he made up mind for something he will make sure that he gets it. He is so stubborn that nothing can deter him from fulfilling his need.

Obstinacy can be defined as an unreasonable determination to execute one’s plan. He will not yield to any reason or plea how logical may it be. He goes to any extent to have his own way. He cannot be easily subdued.

This can be differentiated from pertinacity in which the person also holds firmly to his demand or need or purpose or belief, but yields to logical understanding. The person is intelligent enough to understand the situation and yields accordingly but mind you he never lets the demand or purpose permanently. Rather when the situation becomes normal he will again ask for his need to be fulfilled.

Kreosotum child is capricious as well. The state of the child is such that his mind is very changeable and impulsive. He changes his demands very impulsively without taking any heed of the circumstance whether it is possible or not.

Kreosotum child has a deadly combination of three mental rubrics i.e.,

OBSTINATE, headstrong - children

CAPRICIOUSNESS - rejecting the things for which he has been longing; when offered, he is

DEFIANT

This can be best explained as a child who is very whimsical and erratic, changes his demands very frequently even though it is given to him and doesn’t understand the difficulty or the reasonable problem of others and sticks to his demand strongly. When admonish he becomes defiant and even dares to look into the eyes of the guardian.

Only caressing brings normalcy to Kreosotum child. The person who has slapped or admonished him has to caresses him with lot of affection then only the Kreosotum child becomes normal.

Let’s differentiate the other two remedies present in the rubric ‘CARRIED - desire to be carried - caressed; and’:

Aconite needs caressing when he feels that the situation is frightening to him. He feels now he cannot come out of the situation on his own. He communicates to the person who can help him to come out of the state which is death like frightening to him.

For example, a child who is constipated calls her mother from the toiled several times, “Mother the stool is not coming out, it is paining a lot.” But when the mother assures her that, “Daughter, just hold on, give a little pressure from the abdomen, the stool will certainly come out, please bear the pain for a few moment and you will see the stool will pass out and you will feel relieved.”

The child holds on by getting assured by the soft words of the mother and bears the pain and continues to exert pressure and ultimately the stool passes out.

We have the following set of rubrics for Aconite for the above expression:

FEAR - suffering, of

COMMUNICATIVE

LIGHT - desire for

PERSEVERANCE

CARRIED - desire to be carried - caressed; and

Pulsatilla child needs tons and tons of affection. She feels she is the only child who should be loved and caressed.

She is very selfish and is very jealous if the parents love others in the family especially her other siblings. She feels that others should love her and she will love others as per her need.

We have a rubric in Pulsatilla i.e. AFFECTION - absorbs. This means that you give any amount of affection to Pulsatilla it will absorb immediately as it has lots & lots of need for love and affection. So Pulsatilla child always needs to be carried and caressed with love and for love.

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6 DAYS CLASSROOM TRAINING

AUDE SAPERE HOMOEO ACADEMY (asha) Organizes
6 DAYS CLASSROOM TRAINING (Only 10 students in one batch)

Venue:

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Dates :

Beginner Level : 7 to 12 November 2011

Advance Level : 14 to 19 November 2011

BEGINNER LEVEL – Intern/BHMS/MD having no experience in practical knowledge of application of rubrics in Mind section of Repertory

ADVANCE LEVEL – BHMS/MD having at least three years clinical experience in practical knowledge of application of rubrics in Mind section of Repertory

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SYLLABI FOR CLASSROOM TRAINING PROGRAM, LEVEL - I

Beginner Level – I : 5 - 10 Sept 2011

Understanding Mind

Why only Mind

Principle of Prescribing

Case Understanding

Case Management

Explanation of Rubrics in Mind section of repertory and their common versions:

ANGER, ANGUISH, ANXIETY, IRRITABILITY, DELIRIUM, DESPAIR, FEAR, GRIEF, SADNESS, HELPLESSNESS; feeling of, JEALOUSY, ENVY, MAGNETIZED, MOANING, RELIGIOUS – affections

In-depth Study of Remedies:

Arsenic Alb

Bryonia

Lachesis

Natrum-mur

Phosphorus

Sepia

Staphysagria

Advance Level – I : 12 to 17 Sept 2011

Mental State and Totality

Managing Failure Cases

Posology

Explanation of Rubrics and their metaphorical meanings with common versions:

ABSORBED, ANARCHIST, CLOSING EYES - amel., CONTEMPTUOUS, CURSING, DECEITFUL, sly, DELIRIUM TREMENS, DICTATORIAL, EMBITTERED, exasperated, ENNUI, tedium, ESCAPE, attempts to, ESTRANGED, QUIET; wants to be, FLATTERING

Understanding Remedies in totality:

Anarcardium Orientale

Arnica Montana

Crocus Sativus

Dulcamara

Ferrum Metallicum

Cimicifuga Racemosa

Graphites

STUDY OF RUBRICS

MINDING THE MIND IN THE CLINIC:

APPROACHING CHILDREN - 12

DR ASHOK MOHANTY

A 6 years old boy was brought to me for severe abdominal pain. The boy was holding his abdomen with both hands. Though the expression of pain can be seen from the face of the boy but he was not at all making any sound. His father told, “We had been to a party two days back and he ate the junk foods against our advice. Since last night he was suffering from this pain and he had passed several loose motions.”

Dr.: (To boy) “Tell me about the pain?”

Boy: “It is not so severe. It is bearable. I am managing it since last night with ease.¹ I knew I shouldn’t have eaten so much of that junk food and because of that I am suffering now.”²

Dr.: “Anything else?”

Boy: “No, I am OK.”

Boy’s father: “He has not complained anything on his own. But by seeing his face we could feel that he is having severe pain. When we look at him, he starts doing something like playing with his toys, pencil box etc as if he wants to show that he is not having pain, rather doing his normal routine work.”³

A dose of Opium 30 settled the pain and his stool also became normal.

The following rubrics were taken:

1. WELL - says he is well - sick; when very & HIGH-SPIRITED
2. DELIRIUM - blames himself for his folly
3. ANTICS; playing

Let us understand why Opium says well though he is very sick?

It is because of the high-spiritedness of this remedy.

Opium is very high-spirited which means he keeps his spirit high even during his sufferings. By high spirit we mean that the individual never allow his will power to collapse being in extreme state of suffering. In this state he will always keep his tempo high and keep assuring himself that nothing will happen to him and he will overcome successfully this negative state.

The high-spiritedness of Opium makes him content & quiet, where in he feels that the state he is in, is very-very satisfactory, so he never complains.

In this case the other rubrics are taken as per the version of the boy during sickness corroborates to the central theme of “WELL - says he is well - sick; when very”.

Let me explain those two rubrics one by one.

DELIRIUM - blames himself for his folly

Delirium means a state of temporary extreme excitement marked by restlessness which is sometimes uncontrollable.

Opium is heedless (unmindful) about others suggestions. He hadn’t paid any attention to others advice that he shouldn’t eat so much in the party and ate junk food beyond his capacity. When the pain started then he went into state of excitement and blamed himself why he had taken so much of food (which he felt is a mistake for him).

ANTICS; playing means intentionally doing something which looks like a play but it is meant to attract or divert the attention of the onlooker.

Here the boy starts playing to show his parents that he is not in pain.

Hence Opium doesn’t complain during suffering as he is very high-spirited and feels he can manage the problem.

Let me discuss another case –

A boy of 4 years came to me for ARI (Acute Respiratory Tract Infection). His father told, “Throughout the night he couldn’t sleep for a minute. He was coughing continuously with breathlessness.”

When I asked the boy about his problem, he just smiled. He took the torch from the table and asked me, “Uncle, this is a special type of torch, how to put it on?” I explained him the mode to switch it on. He switched it on and played with it for few minutes.

On enquiring if he has any complaint, he again smiled and didn’t pay any attention to my question and asked me why the ray of the torch is milky which is different from other torches which is generally bit yellowish. I explained it is an LED torch. He asked further questions on the torch and it was continuing.

His father intervened, “Sir, he is like this. He is always interested to know about things and enjoys the process of getting involved about knowing things which gives him immense pleasure. Even though he was coughing very badly in the night he was not bothered about cough but asking us about the person who looks for snakes in the jungles of Africa shown on Animal Planet.”

A dose of Lachesis 30 cured this boy.

The following rubrics were taken:

1. FRIVOLOUS
2. CURIOUS
3. PLAYFUL
4. AMUSEMENT - desire for

Lachesis individual is very frivolous i.e. non-serious about their problem. For them play is more important as iT amuses them. These types of children live, eat and sleep in play. They always look for amusement in everything which is their disposition. They can’t sit idle for a moment (SITTING - aversion to sit). They are always eager to know about things (Curious) which again amuses them.

Playful means being happy and rejoicing in what you do. They really enjoy the process of knowing about the things and amuse themselves in the process.

So these children doesn’t complain because they don’t take their problems so seriously as they are more interested in play which amuses them.

Another case

A little girl 6 years of age was having very high fever. Her parents brought her to the clinic. It was rush time in the clinic. I could listen to the crying of the girl, “Papa, please don’t show me to the doctor, I will be alright very soon.”

When their turn came, she was reluctant to come inside my chamber. Her mother brought her forcibly while she was crying. Her mother told her, “This doctor is not that doctor who gives injection rather he gives sweet pills.”

I gave her a bottle of globules and assured her that only sweet pills are given here.

Though she stopped crying but the look from her face showed that the fear is still there. She was not looking at my face. Even when I look at her she looks to her parent’s side.

Her mother told, “She is having fever since last three days. Whenever it is very high we give Crocin which subsides the temperature. But after 5-6 hours it again comes.”

Dr.: “What does she do during fever?”

Mother: “She just lies at one place. Her behavior totally changes as if she is not in her own self. She behaves like some other person. She talks a lot which has no meaning. Every 5-10 minutes she changes the topic. She sometimes screams loudly, we think it may be because of pain in the body so we stay with her that time pressing her extremities. She wants us to be with her during the state of fever.”

Dr.: “Why she didn’t want to come here?”

Mother: “She has bitter experiences with other doctor as they always ask for routine blood tests and she fears the injection.”

Just by hearing this question she started sobbing and went to her mother and sat on her lap.

A dose of Stramonium 30 brought down the fever in few minutes. The child was totally normal in three days.

Stramonium child doesn’t complain because they have the fear of doctor as doctor is always associated with injections.

Rubrics taken:

1. FEAR - doctors
2. UNCONSCIOUSNESS - fever, during
3. LOOKED AT, cannot bear to be - evading the look of other persons
4. LOQUACITY - fever; during

Let me explain the rubric ‘UNCONSCIOUSNESS - fever, during’. The meaning of conscious is awareness of self. Here in this case the child was not aware of self, about her behavior, her parents told that she behaved like a different person during high temperature.

So here the child is not conscious about self and talks continuously changing the subject frequently which is not what she behaves during her normally.

As the child was not looking and evading the look so the others rubrics are taken.

Because of fear stramonium child will never complain about the problem and cling to the person who carries her to the doctor.

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MINDING THE MIND IN THE CLINIC:

APPROACHING CHILDREN - 11
By DR ASHOK MOHANTY

A boy of 9 years old came to me for the treatment of multiple warts on his scalp. The warts were very hard and while combing, the upper hard crusts sometimes fall off. Other than this there were no problem the boy was facing. The parents were concerned as it started with one small pimple like eruption on the scalp but within one year there are at least 6-7 big warts.

Dr.: “Do you face any problem due to this eruption?”

Boy: “No, they don’t trouble me at all. I take care while combing.”

Dr.: “Any other problem?”

Boy: (Smiling) “No, I am OK.”

His father added, “He never complains of anything regarding these eruptions. He is so sincere that he takes care that everything is very much organized at his end so that we are not troubled as he has a younger naughty sister and we are much preoccupied with her all the time. Even he sometimes helps us to manage her sister’s routine so that we are not troubled.”

Dr.: “Any other problem does he have?” (To parents)

Father: “No, he doesn’t complain of anything else also. He is so intelligent that he manages everything on his own. He does homework on his own and helps his sister to do hers. At this age also he is so understanding and caring that even if there is a problem situation for us he helps us by giving some suggestions. Even during minor ailments like cough & cold he will never lie down and complain like her sister, rather he helps his mother during local shopping of vegetable and groceries. Whenever his mother is sick he will help her in domestic works.

He is very caring and loves her sister like we do. At the same time he also loves if we appreciate his works and love him, rather each time he does some good work at home or school he looks at us in such a way that we hug him and appreciate him for the good work done.”

There was no acute condition associated with the problem so no further complaints.

A dose of Carcinosin 30 reduced the size of the warts and in few months they fell down.

Rubrics taken for repertorization of the above case:
TIDY
CARES, full of - others, about
INTELLIGENT
DUTY - too much sense of duty
AFFECTATION
CARESSED; being - wants to be caressed
AFFECTION; loves

In the above case the remedy was selected by taking into consideration the information given by the parents as there were no acute conditions of the boy. The main information given by them was, “the child never troubles them”.

Let us now understand in detail this piece of information which is quite often told to us by parents accompanying the child with varied complaints.

Why a child doesn’t trouble the parent, may it be in acute condition or in a chronic illness?

In the above case it was because of the rubric, “CARES, full of - others, about”. As the child cares about his parents he doesn’t want to trouble them.

Carcinosin child is very intelligent as well as affectionate. He loves affection very much rather he always has a deep craving for affection from others (AFFECTION; loves, CARESSED; being - wants to be caressed).

He is very tidy which means not only in appearance but also in behavior and manner it is very difficult to find a fault in this child. He will go to school in time and keep his bag & books in proper place, do his home work on his own. As he is very intelligent there is no need to remind him about any of his work or duty. He is very duty conscious. He feels it is his duty to help his parents and his younger sibling also. But the only thing carcinosin wants that in return he should be given lot of affection.
Cocculus Indicus child is also in the rubric “CARES, full of - others, about”. But unlike Carcinosin’s intelligence it is more so because of his recognition. Cocculus Indicus recognizes his need to care for others as a mother nurses his child. Cocculus Indicus wants nothing in return. That’s the reason it is there in the rubric, “RESPONSIBILITY - taking responsibility too seriously”.

While doing a duty a person expects some remuneration either in terms of money or honor or love or appreciation etc but when a person is responsible for something he feels it is his own and does the same without expecting anything.

We have another remedy Pulsatilla in this rubric which also doesn’t complain during sickness. Pulsatilla child always has a need for love and affection. When he is with his parents he never complain for anything because he feels if he irritates them, they may abandon him. He don’t want to leave the bed of love which he is in, so to be in that state he never complains for minor ailments. (BED - remain in bed; desires to)

Let me share with you another case of one of my colleague. He rang me telling that his son who is 7 years old, is coughing very badly since last one week. He tried many medicines but there was no relief. When I asked him,” What he is doing now?” He replied, “He is just lying on the bed and telling nothing. Even if he is coughing badly, when we ask him about any problem, he just keeps quiet and tells us that ‘I am OK.’ His mother told me, last time when he had this type of violent cough we were forced to take him to hospital and he was admitted for few days and given lot of medications. May be to avoid that he always tells that I am OK?

A dose of Hyoscyamus 30 cured the cough.

Hyoscyamus does not complain about his problem because he feels his complain will initiate the process of taking him to the hospital where he will again be troubled like the previous time. The doctor there may give him medicines or injections which would be very painful for him. He wants to escape that situation hence he doesn’t complain.

Rubrics:
WELL - says he is well - sick; when very
FEAR - injury - being injured; of
INDIFFERENCE, apathy - complain; does not

From the above cases we can infer that though the parents tell about their non-complain nature of children but the cause behind the non-complain may vary as we have seen in the case of Carcinosin, Cocculus, Pulsatilla and Hyoscyamus. While taking a case please take utmost care to understand the reason why the remedy is present in the rubric, don’t just prescribe the remedy because of its presence in the rubric.

In the next issue we will discuss few other remedies where the parents express similar non complaining nature of this child like Opium, Strammonium, Arsenic alb, Lachesis etc.