Treating a child during acute respiratory illness like viral pneumonia with high grade fever is a challenge for homeopathy. High grade fever can induce febrile convulsions and also lead to delirious states in a child. Case taking in a child requires special skills, often the portrait of the disease can only be completed with the help of the history received from parents and via observation of the patient.
The prescription should be based on the characteristic symptoms which are the expressions of the disease state of susceptibility. In a paediatric patient, the state of susceptibility is high until there is evidence of immunosuppression or suppressive treatment or any congenital illness or irreversible diseases. In a high state of susceptibility, the most characteristic symptoms are projected. The physician should keenly observe these manifestations for prescribing the simillimum.
Case History
This is 6- year-old male child suffering from respiratory infection. The patient presented with complaints of fever, cold and cough, vomiting since 3 days, recorded temperature ranging from 100F to 103F. He also had sleeplessness along with other general symptoms like loss of appetite and weakness.
Cough worse after eating followed by vomiting. So patient was avoiding eating with fear of vomiting. Craving for cold food and drinks but that aggravates R.S complaints. Thirstless3+.
Sleeps – on abdomen3+. Weight- 16.8 kg. Thermally -Hot patient.
Kali carb 200 prescribed on OPD basis without any relief So patient was admitted.
Mental characteristiscs:
Contradiction intolerant2+ He expects others to talk politely to him. If ordered to do something he gets annoyed. Intelligent child and very good at his studies. Mature in talking. He is also very obstinate about the type of game he wants to play. He doesn’t allow younger cousin at his house as she dictates her wish to play a game which he is not liking. Parents said that he has tendency to catch cold every 15 days and it requires bronchodilators and antibiotics.
| 21-7-22 | ||
| Hemoglobin | 14.1g/dl | |
| RBC | 5.09 million/cumm | |
| WBC | 13000/cumm | In age group of 6 years to 15 years
WBC normal range 4800 to 10800. |
| Neutrophils | 74% | |
| Lymphocyte | 13 % L | |
| Absolute Neutrophils | 9620/cmm H | |
| Absolute Eosinophils | 780/cmm H | |
| Absolute Monocytes | 910/cmm H | |
| Dengue NS1 Antigen | Negative | |
| Dengue IGM | Negative | |
| Malaria parasite antigen | Negative | |
| CRP | 10.4mg/L |
X ray Chest PA view 22/7/2022
Visualized lung fields show increased vascular markings with patchy haziness Bilaterally. Suggestive of Viral Pneumonia HRCT is suggested for further evaluation if clinically indicated.
On Examination-
Pulse -90 /min
Temp- 98.0 F (11.00 PM) on arrival (Parents gave anti pyretic before their house)
R.S – Generalised wheeze and scattered Crepts more at LLZ.
DIAGNOSIS:- VIRAL PNEUMONIA with Secondary Bacterial Infection.
CLASSIFICATION OF THE DISEASE: ACUTE INDIVIDUAL DISEASE WITH FULLY DEVELOPED SYMPTOMS
Acute Disease totality:
- Mind-Dullness -heat during
- Stomach –Thirstless-heat during
- Stomach –Vomiting Cough during
- Extremities –Pain – fever during agg.
Chronic Constitutional Totality:
- Obstinate in Children
- Restlessness in children
- Contradiction, intolerant of children
- Precocity in children
- Cold take, tendency to
- Extremity Pain Fever during.
- Repeated tendency to get cold and coryza.
TUBERCULINUM CHILD
Tuberculinum: They are very mature for their age, active, intelligent and irritable especially if they do not receive things they desire. Usually playful, restless, wants to change the position, desires travelling and constant change in life and wants to do different things. Heedless and reckless.
Remedy Selection:
Tuberculinum 10 M Single Dose
Different Methods of prescribing
Acute medicines are used to treat the illness
Constitutional medicines are used
Intercurrent remedy or Anti-miasmatic remedy
Intercurrent remedy followed by constitutional
Pathological remedies
Tissue remedies or organ specific remedies
In this case the constitutional remedy covers the miasmatic depth and helps in the case management.
Criteria for follow up:
1.Fever 2. Appetite 3.Sleep 4. Thirst 5. Nausea 6. Vomiting
| 21/7/22
4 PM |
Vomiting- One Episode but child was Dull.
O/E – R.S-Crepts ++ in LUL and LLZ Pulse – 114/min |
Rx
Kali Carb 200 1st Dilution every 2 hrly. |
| 22/7/22
8 AM |
Temp – 101.6F
Cough –SQ- |
Admitted on 22nd July 2022
started with IV Fluid Isolyte P over 12 hrs to avoid dehydration. Kali Carb 200 1st Dilution every 2 hrly. |
| 22/7/22
10.00 AM |
Temp -103.7F
Cough < eating while Cold air agg Probable cause- feet getting cold |
Observation on SL |
| 22/7/22
4.00 PM |
Case restudied
Dullness fever during Thirslessness fever during Cough two paroxysm Cough short bouts Cough eating agg Cough lying down agg Temp -104 F |
Changed the medicine
Rx Tub 10 M (1P) given
|
| 6.00 PM | Temp – 102.9F | Rx
Tub 10 M 1st dil ½ hourly |
| 11.00 PM | Temp – 103F | Rx
Tub 10 M 1st dil ½ hourly |
| 23/7/22
4 PM |
Cough ->>>-
Dullness->>- Appetite is increased. |
Rx
TUB 10 M 1st dilution every ½ hourly |
| 24/7/22
|
Cough ->>>- Fever >>>
Dullness->>- No Vomiting |
Rx
TUB 10 M Ist dilution every 30 mins to 45 mins. |
| Investigations | 24-7-22 |
| Hemoglobin | 12.4g/dl |
| RBC | 4.40million/cumm |
| WBC | 11100/cumm |
| Neutrophils | 68% |
| Lymphocyte | 25% |
| Absolute Neutrophils | 7500/cumm |
| Absolute Eosinophils | 222/cumm |
| Absolute Monocytes | 555/cumm |
| 25/7/22
|
Cough ->>-, No Fever last 24 hrs.
Overall patient is better. No Nausea and no vomiting. R.S – O/E– No Crepts |
Rx
TUB 10 M 1st dilution every 2 hrly |
| 01-08-22 | |
| Hb | 13.1 |
| RBC | 4.67 million/cumm |
| WBC | 10950/Cumm
WBC count reduced from 13000 to 10950 |
| Neutrophils | 43.7 |
| Lymphocyte | 49.3 |
| Absolute Neutrophils | 4785/ cumm |
| Absolute Eosinophils | 110/cumm |
| Absolute Monocytes | 624/cumm |
Follow after 1 week of discharge
Patient is over all much better, No fever, No Cold and No cough
Rx: Tub 10 M first dilution alternate nights for 10 days
Follow up after 2 weeks of discharge
Patient is much better
Rx: SL 200 4 pills 4 times a day x 15 days.
CONCLUSIONS AND LEARNING:
- Childhood respiratory illnesses like pneumonia, LRTI, bronchiolitis can be treated.
- It often begins with viral infection of the lungs due to seasonal change but it can be secondarily infected as confirmed after high WBC count.
- Disease often travels from general to particular known as localization of the disease.
- Dilution technique of prescription delivers immediate relief.
- In this case anti miasmatic remedy was used as the constitutional remedy.
- Team work and acute case management is the most important aspect to provide cure.
- Relevance of temperature monitoring and temperature graph for understanding remedy’s response.
Acknowledgement:
We thank Dr Mohanbhai Patel, Chairman, The Homoeopathic Education Society (Smt. Chandaben Mohanbhai Patel Homoeopathic College),
Shri Nayan Patel, Vice Chairman, The Homoeopathic Education Society (Smt. Chandaben Mohanbhai Patel Homoeopathic College),
Dr Asmita Parikh; General Secretary, The Homoeopathic Education Society (Smt. Chandaben Mohanbhai Patel Homoeopathic College) and Dr Parizad Damania- Principal, Smt. Chandaben Mohanbhai Patel Homoeopathic College for the encouragement, support and hospital infrastructure.
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