The Treatment of Children

by Richard Pitt

There are a number of factors to be considered when treating children. These considerations have both practical and philosophical implications for wider general practice. Successful treatment of children (and adults) has been prophylactic as well as initially curative.

Constitution: An understanding of the constitutional typology of the child is vital for successful treatment.  

Fundamental Miasms: Miasmatic, inherited tendencies are the next most important thing to consider. These constitute 5 main miasms – Psora, Sycosis, Syphilis, Cancer and Tubercular.  

Acquired Miasms: Certain other influences can be defined as a miasm. These are influences, both inherited and/or acquired, that leave a dynamic influence superimposed onto the constitution of the child.

Aetiology: Significant aetiological factors can be of great importance in understanding the remedies that may be needed. These aetiologies may be both physical and psychological and can be inherited and/or acquired.

Acute treatment: Understanding how and when to treat acutely in children is important. Its significance to the underlying constitution also needs to be understood.

The constitution comprises qualities that are both intrinsic to the individual and the imbalances that result from this. It includes the physical characteristics of the body as well as the basic personality of the person. The personality can obviously change as a child develops but in early childhood, it is important to identify the fundamental themes of the child’s personality. In Children, the nature of the constitution is often seen in the body type and in abnormalities of basic developmental evolution. The body type is seen in characteristics such as overall weight, head size, bone size, perspiration, nails and skin. It is also seen in the basic temperament of the child.

Abnormalities of constitutional characteristics are often seen in issues to do with normal development – breastfeeding (nutrition), dentition, walking, talking, sleep, excessive perspiration, skin issues, lymph, and mental and emotional development. Some of these issues may also be influenced by miasmatic and aetiological factors. As a person gets older, some of these constitutional issues become less obvious. The complexity of modern life, and the amount of external input and emotional pressure is creating new “layers” of conditioning in which the basic constitution and temperament of a person are less obvious.

Constitutional factors may often be identified with the psoric miasm, that is, with issues to do with basic nutrition, function and identity. However, inherited characteristics of other miasms will inflect themselves onto the constitution and express themselves through symptons, signs and character.

In theory any remedy can be constitutional to a person. If it is the only remedy a person needs, then that is the person’s constitutional remedy. As homeopathy treats abberations of health or deviations from the norm, then what we are generally treating is what we perceive to be movements away from the norm. However, in practice it could be said that we cannot separate the intrinsic nature of the individual from the symptoms and sensations that express an imbalance. In fact, we include in our analysis characteristic qualities of the person which will not change after the remedy has worked. However, we still use them as indicators.

One theory is that most people may need a mineral based remedy at some point in their treatment. This may be toward the end of treatment, when treating the psoric “layer”, consistent with Hahnemann’s miasmatic theory. This is often seen practically in children as they are going through developmental stages which are very physical, as apposed to stages of emotional development seen later in childhood and also as adults. It is recognized that for some homeopaths, this miasmatic-based theory of prescribing is not applied at all, Hahnemann’s miasmatic theory always being controversial. However, in children, an understanding of constitutional typology, especially pertaining to mineral remedies has proven clinically useful. This is why remedies such as Calcarea carbonica, Calcarea phosophorica, Silica, Graphites, Sulphur, Ferrums, Magnesiums, Kaliums, Natrums, Borax etc., are often seen in children. Some homeopaths have established the idea of their being 3 basic constitutions which they termed Carbonic, Phosphoric and Fluoric, relating to remedies such as Calcarea carbonica, Calcarea phosphorica and Calcarea fluorica. (See Typology in Homeopathy by Leon Vannier). This is a variation on the theme of their being 3 main miasms – Psora, Sycosis, and Syphilis. One difference between them is the phosphoric constitution, which practically is seen as more tubercular than sycotic, but certain parallels can still be drawn.

The significance of miasms and the use of nosodes is perhaps best seen in the treatment of children. Historically, miasmatic theory has fascinated some homeopaths and been ignored by others. This goes all the way back to Hahnemann himself. Richard Grossinger, in his book “Homeopathy, The Great Riddle,” equated miasms with Freud’s work “Civilization and it’s Discontents, as a negative portrayal of the human condition, partly born out of years of frustration in clinical medicine.

However, from an experiential point of view, understanding miasms and the appropriate use of nosodes has been shown to be extremely important to deal with inherited miasmatic qualities. It can fairly be said that many cures would be impossible without knowing the prevalent miasm and the use of nosodes. Whereas, in some cases, one can meander to cure with somewhat similar remedies, when a nosode is needed, it is the only key that will open the door. 

As children develop, there is often an attempt to throw off miasmatic influences, revealing itself in a series of diseases and also emotional states. As in any case, a remedy – be it constitutional or nosode – is needed when that cannot happen on its own, when the vital force is somewhat stuck. It is seen as a fixed chronic state, even if symptoms are episodic or have a latent influence. It is not, however, always necessary to give a nosode to deal with the miasmatic state. The correct constitutional/chronic remedy may be enough. The significant fact though is that if the primary expression of the miasm is not dealt with, or is suppressed, then more serious, chronic “secondary” states of the miasm may be expressed as the child develops.

Childhood diseases such as measles, mumps, chicken pox and rubella are acute expressions of underlying chronic miasms (psora). Their prevention through vaccination may be leading to deeper, degenerative miasmatic disease, not to mention the actual effect of the vaccine itself.

There are 5 main chronic miasms and nosodes used in homeopathy.

Psora – Psorinum: Sycosis – Medorrhinum: Syphilis – Syphilinum: Tubercular – Tuberculinum: Cancer – Carcinosin

Clinically, the most common nosodes used in children are Tuberculinum, Medorrhinum, Carcinosin, Syphilinum and Psorinum, in that order (roughly).  

This may seem strange, to see Psorinum last, but in early life, the child is generally throwing off the other miasms first. Also, often the constitutional remedy – Calc carbonica, Graphites, Silica, Sulphur etc will take care of the fundamental miasm of psora. The first three nosodes can be very difficult to distinguish in children. They share many characteristic symptoms including:

Hyperactivity – aggression, restlessness, learning and behavioral disturbances.

Mental precocity.

Severe acute expressions of chronic disease – Asthma, Arthritis, skin disorders, sinus, ear and chest diseases, inflammatory states in general

Fears: Contagion, animals, dark, etc.

Anxieties: anticipation, morbid anxieties about many things.

Oversensitivity, both physically and emotionally

Strong family history of physical diseases and/or social dysfunction.

The key to prescribing a nosode is to recognize how extreme the expression is of the symptoms. One of the distinctions between a nosode and other more constitutional symptoms is the extreme nature of the expression. The miasm is forcing its way out, leading to the intensity in expression. It is an abnormal reaction to the status quo, to what is; it is extreme, excessive, perverted as opposed to merely a reaction to a fixed chronic state.

Distinguishing between the nosodes and miasms is important and sometimes challenging.

Each miasm has a theme or essential quality to it. This can help distinguish the miasm:

Cancer: Conflict between oppression and expression, or prolonged oppression with sudden, periodic, intense expression.

Tubercular: The quest is to escape oppression. The feeling is one of suffocation and the need for freedom. They don’t allow themselves to become oppressed but if they can’t escape, they feel more physically suffocated and still seek to escape in whichever way they can. They want to feel free.

Sycotic: Expression for the heck of it. They don’t care, they just want to do what they want to do. If oppressed, they become aggressive, rude, defiant and in your face.

Carcinosin has more inflammatory states with no particular pathology attached. Mentally, it is more controlled with explosive outbursts. A family history of domination is more prevalent. Often they are softer and milder than the other two, not so much manic behavior. A strong family history of cancer can be important.

Tuberculinum has more chest conditions - pneumonia and asthma, but the cough is often dry, chronic in the winter and comes on with change of weather to cold, the first signs of winter. Mentally, they are often hyperactive, racing around, dissatisfied, and cannot be contained, (the others may have this also, but here the sheer restlessness dominates). They can be aggressive, but not so often as cruel and malicious as Medorrhinum. The family history of TB is a strong indication (also for Carcinosin). 

Medorrhinum also has chest conditions – especially asthma – often coming after suppression of other infections – ear and sinus being common. There is often more fluid and wetness involved – yellow-green discharges, burst eardrums, etc. Recurrent and intense ear infections may often require Medorhinum. Other inflammatory states such as acute arthritis, pylonephritis, UTI’s, salpingitis, chronic eczema and and other skin conditions such as warts, moles and psoriasis may need this remedy.

A family history of Gonorrhea, Chlamydia, Herpes, genital or other warts, alcoholism, violence etc. may also indicate Medorrhinum.

Mentally, they can be unpredictable, with extreme moods, vacillating emotional states between introverted sensitivity and extroverted precocity, often leading to abnormal socialization problems (violence, mania, learning disorders etc.). Tuberculinum may show similar extremes but is often less unpredictable and vacillating in moods.

Acquired miasms relate to factors that may be defined as a miasmatic influence, in being a dynamic influence (memory) that has been either inherited or acquired. This may include a history of drug abuse in the family – heroin, cocaine, alcohol, cannabis and other factors such as radiation, allopathic medication, accidental poisonings, mercury, vaccinations, or NBWS certain diseases e.g. childhood diseases, meningitis, mononucleosis, etc. Often, the constitutional remedy or nosode will take care of these things. Occasionally, a remedy that relates to the specific influence may be needed.

Aetiology can be an important factor in determining the appropriate remedy. Aetiology or causative factors may be both acquired or inherited and may be physical or emotional.

Inherited emotional aetiology from the parents can be an important factor to consider in prescribing. Dysfunctional, unresolved dynamics in either parent that is expressed in the case taking may need to be used as part of the child’s case. The remedy found may often be based on a combination of the description of both the parent’s and the child’s symptoms. The child may be expressing the compensated symptoms of the unresolved parental situation. Other important aetiological factors may be issues in the pregnancy, both emotional and physical of the mother, birth trauma, early experiences – breast feeding, bonding issues, emotional experiences as a young child that could not be integrated – violence, sexual abuse, separation from mother, shock, fright, and also physical situations such as head injury, exposure to toxins, vaccinations (acutely), etc.

Here, when there is a clear emotional aetiology – certain plant-based remedies are often needed, ex. Stramonium, Belladonna, Hyoscyamus, Aconite, Helleborus, Arnica, Hypericum and Pulsatilla etc. When the problem relates to bonding problems with the mother then remedies such as Saccharum album, Lac humanum and Lac caninum etc., may be needed. Also, certain mineral remedies may be needed, e.g. Natrum muriaticum, Magnesium carbonicum and muriaticum, Calcarea carbonica, Phosphorous, Silica, Sulphur, Kali’s, Ferrum’s etc. Often mineral remedies are needed when the compensation manifests clearly on the physical level as well as the emotional, whereas with plant remedies, the problem may be limited to the emotional level.

Understanding the relevance of acute treatment in children can be important in maintaining the process of constitutional prescribing in children. There is a theory that the constitutional remedy should also work in acute cases if it is really the correct constitutional remedy. However, in practice, that does not work frequently. For example, if a child who has frequent ear infections gets another infection, in spite of good constitutional care (it can happen), the ear infection can be treated acutely without problems to the underlying case and may need a different remedy to the constitutional one given. This is also the case in episodic acute states like Influenza. However, noting the type of acute symptoms can also help in assessing the underlying miasmatic and constitutional remedy needed.  

The following is one interesting case of my colleague in San Francisco, Lyn Farrugia in which the child did very well on a homeopathic remedy:

8 year old boy:

The mother brings her son for the following conditions: daily vomiting, explosive anger, lack of self-confidence and fearful nature. The child has had multiple health problems throughout his life. He had meconium aspiration at birth and was treated with antibiotics for one week in the hospital. He has had chronic nasal congestion. He was found to have Gastro Esophogeal Reflux (GER). During the pregnancy the mother had nausea and retching for the entire 9 months. The birth was quick and easy.

This child presented with vomiting, which occurs most days, after food. When he was a baby he constantly vomited his mother’s milk. His vomiting was described by his mother as being exclusively regurgitant occurring either during or immediately after meals. Typically he appears quite comfortable during and after the vomiting and immediately resumes normal activity. Since very young he has had malodorous and loose stool.

At eighteen months he was very small for his age and at age 3 he was in the 5th percentile for height and the 10th percentile for weight. He was diagnosed with Giardia at eighteen months and was given several rounds of Flagyl. There was some improvement but he continued to vomit every day. At age 3 1/2 he was given an endoscopy, and polyps were found in the stomach. Eosinophilic cells were found on the polyps. One of the nodular lesions was found to be in the prepyloric antrum. This nodular lesion, measuring one centimeter in diameter had the potential to obstruct the gastric outflow. The polyps were not removed. At this point he was given Lycopodium by another homeopath with very slight improvement. From age 3 until age 8 he continued to vomit anywhere between once a week to every day after eating a meal. He had another endoscopy two years later and no polyps were found. However, the vomiting continued in spite of this.

He snores a lot, and grinds teeth in his sleep. He always breathes through his mouth.

His adult teeth have come in very sideways and crooked. He did not start teething until 9 months old. His jaw was very small. He used to have eczema behind his ears, and cradle cap. He still has the cradle cap. When younger he would wake up soaked with perspiration at night.  

He hates competitive things; he is not very social. He has very little confidence. At age 4 he was still wetting and soiling himself. He has needed consistent routines in his life. He has been very particular about his clothing and how it feels to him. It has to be comfortable; he dislikes seams. He has a fear of noises, of clowns and parades.

He has a fear of new food, especially new textures. He has an explosive temper, can kick, bite, hit and throw things. He recently bit another child at school. He would bite out of any emotion, intense love, frustration and anger. He would often have outbursts of anger. He has always been irritable on waking.

His parents used to fight a lot. This would make him angry. When his parents fought, he would tie himself in ropes, and also tie up his dolls. He would get very sad, fearful and nervous when his parents fought. His mother said that he would want to keep the peace. At age 4 they moved to Costa Rica. He was so angry when they moved to Costa Rica that he would not speak to anybody apart from his family for six months. His father had a crack problem, and was having hallucinations and serious problems due to the drugs. The father then left for a while, and after one year they all returned to the United States. 

Food - He desires pizza, lasagna, spaghetti, lemonade and chips. He has an aversion to fat on meat.

His mother had a history of nephritis. She had hepatitis A at age 21. His father has asthma and drug addictions. His maternal grandmother has hypertension.  

He had recently been retested for Giardia which was found to be positive. He has been consistently vomiting at least once a day. He continues to be small for his age. His paediatrician thought this was due to a malabsorption problem.

He had previously been given Veratrum Album, Calcarea carbonica, Tuberclinum, Pulsatilla, Lycopodium and Ipecac by other homeopaths.

The remedy chosen was Magnesium carbonicum. There is clear emotional etiology in the case with the degree of anger and violence in the family, between his parents and his extreme sensitivity to hearing and seeing angry disputes. He would tie himself up in these situations. This alone makes one consider Magnesium remedies. The digestive symptoms are also characteristic. It’s as if he’s refusing to take the necessary nourishment of life; he’s angry about being here. Kent first discussed the use of Magnesium carbonicum in children in orphanages who failed to thrive and would emaciate away. (Kent attributed this to the moral stigma of children being born out of wedlock, being taken away to orphanages from mother’s who didn’t want them or couldn’t take care of them. More likely is the fact that from conception the message these children were getting was “You are not wanted.” This would be enough to make these children not want to live). This child, in this case, is here but physically he’s struggling to develop and he can’t deal with things emotionally or physically. His mother also had nausea and retching the whole pregnancy and he has continued with extreme physical symptoms. Magnesium carbonicum followed by Medorrhinum cured his condition.