A 4 year-old boy comes to my office with his mother. Since he was 6 months old he has suffered from recurrent respiratory infections, mostly bronchitis. He has bronchitis with fever every 2 months. They do not know how high the fever is because they always give antipyretics. However, it is at least 38°C. Each bronchitis is difficult to treat and it usually lasts for 2 weeks. He takes Aerius (antihistaminics) and Sinecod (antitusicum) in the acute stages.
During spells of cough he often vomits (3) and he sometimes suffocates (2) and is cyanotic(1). The mother says that opening a window helps him to breathe. In the past they also used Spiropent (Beta 2 agonist bronchodilator). The cough is usually worse in the morning after waking (1).
He is rather warm-blooded and uncovers himself at night (2). He likes to eat sweets (1), vegetables (2) and cucumbers (3). He can eat the whole cucumber at once. He has had this desire since he started eating solid food. He has an aversion to onions (1), fat (1) and meat (1).
He cannot bear his hair being cut or combed.(3) His mother uses electric hair clipper and he complains that it tugs him. He also refuses to wear glasses or anything else on his head.(3)
Lately he has developed obstinate behaviour (3) and he tends to be angry (2). If he wants something, he gets upset, stamps feet and screams.(3) He often contradicts when his parents want him to do something.(3) When he wants something and he does not get it, he strikes people.(3) I also observed this in my office. He punched his mother several times during the consultation because he soon got bored and wanted to go home. He is often dissatisfied and gets bored very quickly.(2)However, he is not malicious. This behaviour started about half a year ago.
His right eye is short-sighted (½ diopter).
His sleep is restless andhe moves a lot in sleep.(3) He usually sleeps on back (1) or on the right side (1).
9 months ago, he had a period of night enuresis. One year ago, he had a period where his perspiration had sour odour.
His father strong allergy to pollen with obstruction of breathing and has to take antihistaminics every day.
Note: numbers behind the symptoms mean their intensity (underlining). If the number is behind a symptom, it is valid for the particular symptom. If it is behind the whole sentence, it is valid for all symptoms in the sentence.
Analysis of the case:
This is typical of a child with a combination of recurrent acute infections and behavioural problems which we see in our practice very often these days (at least in the western world). The fact that the child has so frequent acute diseases means that his immune system is quite compromised. From the homeopathic point of view, this case is complicated by the fact that this child also has some symptoms on the emotional level. It means that the defence mechanism is too weak to keep the pathology on the physical level only (we consider the mental level and emotional level deeper than the physical). This makes the prognosis somewhat worse and it can mean that the treatment will take more time and more remedies will be needed. The other negative factors for the prognosis are the fact that he has had these recurrent infections since the very early age and genetic dispositions from his father.
From the pathological point of view, the physical disturbance is focused on the respiratory system. Particularly bronchial tubes are affected, which is a relatively deep organ system close to lungs. If such condition is untreated or suppressed by inconvenient treatment, it could lead to lung affections like pneumonia or asthma. There is also another possibility after a suppression – the child’s psychological condition might get worse.
Homeopathy can be very effective in recurrent respiratory infections and immune deficiencies in general, as well as in behavioural problems in children. Regarding the fact the boy’s level of health is relatively high, the prognosis is quite good.
Selection of symptoms:
From all the available symptoms of the case I chose these to be the most characteristic:
- desire for cucumbers (3)
- desire for vegetables (2)
- sensitive scalp, aversion to have hair cut or combed, cannot wear glasses (3)
- obstinate (3)
- anger with striking (2)
- disposition to contradict (2)
- dissatisfaction (2)
- restless sleep (3)
- myopia of the right eye (2)
Relevant rubrics from the repertory: (using The Essential Synthesis repertory)
GENERALS – FOOD and DRINKS – cucumbers – desire
GENERALS – FOOD and DRINKS – vegetables – desire
HEAD – SENSITIVENESS – Scalp, of
HEAD – SENSITIVENESS – brushing of hair; to
HEAD – TOUCH – agg. – External head
MIND – OBSTINATE (- children)
MIND – ANGER (- children; in)
MIND – STRIKING
MIND – CONTRADICTION – disposition to contradict
MIND – DISCONTENTED
SLEEP – RESTLESS
VISION – MYOPIA
GENERALS – HISTORY; personal – bronchitis; of recurrent
Differential diagnosis of the most probable remedies:
Belladonna can be very irritable and even violent, with striking or biting, pulling other’s hair, etc. It has complaints from having hair cut but mainly because the remedy is sensitive to cold draft and shortening of the hair makes the head more susceptible to it. Belladonna is worse from touch in general. It can have restless sleep, although it is not a keynote. It has desire for vegetables. However, the remedy does not have any real keynote in the case.
Nux-vomica is an angry remedy and can hit in anger. Is it very sensitive to external impressions, including touch. It can have restless sleep, but it cannot be confirmed otherwise.
Chamomilla is one of the main remedies for children with behavioural problems. It covers anger with aggressive elements like striking, kicking or throwing things. It belongs to the main remedies for dissatisfied and obstinate children. It has a strong aversion to be touched in general, but not particularly on the head. We can even find sour perspiration in this remedy in the Materia medica, but as this is an older symptom which is not present at the moment, I am not taking it into consideration. Chamomilla has restless sleep. Irritability and anger are essence of this remedy.
Cinamaritimais very similar to Chamomilla in many respects. It covers the obstinacy, anger with striking and aversion to be touched as keynotes. It also has a strong sensitiveness of the scalp. Children who need Cina cannot have their hair combed or cut.6 It belongs to the main remedies for behavioural problems in children, it is very dissatisfied and covers restless sleep. Like Chamomilla, this remedy also has sour smell of the body, although not as a keynote.
Tuberculinum is a remedy we should think of when we see a combination of irritability and respiratory complaints (especially in recurrent respiratory infections). It is one of the most important remedies for irritable children where the anger has an aggressive form and destructiveness. This child is not destructive, he does not break or throw things in anger. Tuberculinum covers striking during anger. It has a strong aversion to be touched in general and we can find a confirmation for sensitivity of scalp in Phatak’s Materia Medica. Tuberculinum is never satisfied. It has restless sleep.
AntimoniumCrudum covers a peculiar keynote in the case – desire for cucumbers. It is the only remedy that has this symptom as a keynote in the Materia medica.3It belongs to the main remedies for behavioural problems in children. Children who need this remedy can behave somewhat similar to Chamomilla. They are irritable, dissatisfied, peevish, and have strong aversion to be looked at and touched. However, children who need Antimonium crudum are not aggressive and do not attack or strike.
From the above discussed remedies Chamomilla, Cina, and Tuberculinum seem to be the most similar to this case. All three remedies are dissatisfied, angry and all are able to strike when irritated. They all can be capricious. The difference is, that in Chamomilla children the primary characteristic is malice. They are over-reactive and their expressions of anger are malicious. Cina is rather capricious, they can strike or be aggressive, but it all comes from the capricious element of not feeling comfortable in almost any situation. Tuberculinum’s main themes are boredom and destructivity. They cannot endure being bored and in their anger, there is always some kind of destructivity.
The symptom which is decisive in this case is the sensitivity of head to touch or any kind of other discomfort (glasses, etc…). This symptom can be confirmed best in Cina, for example in G. Vithoulkas’ Materia Medica Viva. During my observation of the child’s anger, I could not see any malicious element. The contradiction and striking seemed to come rather from inner boredom of the child so this makes Chamomilla and Tuberculinum less probable. If we look in the rubric Mind-contradiction-disposition to contradict-children, in, we can find only one remedy there – Cina.1This remedy interesting is that it can be found in the rubric Chest-inflammation-Bronchial tubes-children,in in the second degree.