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:

Flat no. 190, Sector - 9, Pocket - 2, Dwarka, New Delhi New DelhiNew New

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.

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