2006 1011 Editorial For The Month of October November 2006

EDITORIAL FOR THE MONTH OF OCTOBER – NOVEMBER 2006
RANDOM NOTES ON PEDIATRIC CASE-TAKING
Pediatric case taking is one of the most difficult aspects of practice for two
reasons:
a) There is hardly any verbal communication between the child and the
physician as child till the age of 3 years does not develop much
communication skills; in such a situation it is some times difficult to
understand the language of the child.
b) It is very difficult to interpret especially the body language or gestures of

the child when they are too young.
I would like to divide this whole process into certain groups:
1. Personal and Family history:
As you know diseases run in families and they have always an imprint of the
same on the child’s health hence it becomes mandatory to find out strong
familial traits, by studying what we call in homoeopathy as Diathesis and
Fundamental miasm. Do not for get to ask family history of common illnesses
like tuberculosis, diabetes, vitiligo, asthma, rheumatism, rheumatoid arthritis or
hemorrhagic disorders in the family.
After completing the family history try and look for the same in the repertory.
Dr. Frederick Schroyens has written Synthesis Repertory, which now runs into
9.1 edition of the Radar programme. In this repertory under the chapter of
GENERALS, you will see the rubrics:
GENERALS – Family history, of – alcoholism

GENERALS – Family history, of – allergies
GENERALS – Family history, of – eczema
GENERALS – Family history, of – asthma
GENERALS – Family history, of – goiter
GENERALS – Family history, of – gonorrhoea
GENERALS – Family history, of – gout
GENERALS – Family history, of – hemiplegia
GENERALS – Family history, of – hepatitis
GENERALS – Family history, of – skin complaints; of
GENERALS – Family history, of – suicidal deaths
GENERALS – Family history, of – tuberculosis
Drugs mentioned in these rubrics are incomplete; the list can be much longer as
practitioner gains maturity in the practice.
2. Past history:
Past history of the child illness shows the present dominating miasm, other than
this if the child has a recurrent episode of the certain illnesses then you should
refer the chapter GENERALS, there is a rubric ‘HISTORY, personal’ where you
will see lots of rubrics like:
GENERALS – HISTORY; personal – Abscesses; of recurrent

GENERALS – HISTORY; personal – Antibiotic; of use of
GENERALS – HISTORY; personal - Birth trauma; of
GENERALS – HISTORY; personal – Bite of animals
GENERALS – HISTORY; personal – Croup; of recurrent
GENERALS – HISTORY; personal – Coryza; of recurrent
GENERALS – HISTORY; personal – Cystitis; of recurrent
GENERALS – HISTORY; personal – Tonsillitis; of recurrent
GENERALS – HISTORY; personal – Eyes – recurrent styes on the; of
Hence these recurrent illnesses are extremely important and integral part of
pediatric case taking.
3. Development:
We should see whether the child’s development is slow or retarded and

questions pertaining to development are most important aspects of case taking.
In repertory look under the chapter of generalities.
GENERALS – Development – arrested

GENERALS – Development – complaints; of
GENERALS – Development – rapid, too
GENERALS – Development – slow
These rubrics have to be used with certain other mental rubrics like:
MIND – DEVELOPMENT of children arrested

MIND – TALKING – slow learning to talk
BACK – WEAKNESS – Lumbar region – learn to walk; children do not
EXTREMITIES – WEAKNESS – lower limb – child late learning to walk
EXTREMITIES – WEAKNESS – ANKLES – children; in – learning to walk
GENERALS – Dwarfishness
GENERALS – WALKING – learning to walk – late
GENERALS – WALKING – learning to walk – late – development of bones;
tardy
4. Dentition:
Questions related to teeth are seen in the chapter of teeth in the repertory, do
not neglect this chapter as rubrics mentioned below gives me tremendous
success.
TEETH – DENTITION – difficult

TEETH – DENTITION – difficult – accompanied by – diarrhea; with
TEETH – DENTITION – difficult – fever
TEETH – DENTITION – difficult – salivation
When there is ‘Dentition – difficult – accompanied by – salivation’ then many

practitioners will think of Mercurius but my favorite remedy is Silicea; or
sometimes ‘Dentition – difficult – accompanied by – worms in children;
complaints of’ then majority of practitioners will think of Cina but my favorite
remedy is Stannum metallicum; or sometimes in the a cases of ‘Dentition –
slow’ then the remedy like Tuberculinum has been extremely useful to me.
Sometimes I also see that during dentition child may get many problems
associated with cough; bladder disturbances like bed-wetting and sleep related
problems like insomnia or frequent waking etc.
5. Vaccination:
As you know the vaccination in India is mandatory with almost all the
educational organizations, this produces for us huge bulk of patients suffering
from immunocompromised situations like recurrent colds, allergic asthma,
recurrent tonsillitis, and atopic eczema. The best place to see in repertory is:
GENERALS – VACCINATION – ailments; after
Or if the individual vaccines which are responsible like after BCG vaccine or
after DPT vaccine then you should see the specific rubrics. Sometimes you get
severe reaction after vaccination then the remedy like Carcinosin is very useful
in practice. Some additional places to be seen in repertory are as follows:
FEVER – vaccination, after

GENERALS – convulsions – vaccination, after
GENERALS – SEPTICEMIA; blood poisoning – smallpox vaccination, after
6. Nursing:
A nursing infant needs to be observed very closely how they suck the nipple,
from which breast (look for this in the repertory under generalities-side), how
fast (look in mind hurry eating or drinking), whether they smile after sucking
(look in the repertory under mind, cheerful eating after) or whether they go to
sleep while sucking (look in the repertory under sleep, sleepiness eating after)
or whether they sweat during nursing (look in the repertory under perspiration
eating during or after).
Additionally you will see in the chapter of GENERALS, the following rubrics:
GENERALS – NURSING, Suckling aggravates

GENERALS – NURSLINGS
The rubric ‘Nurslings’ should be used in those children who are nursing their
mothers. All the milk related problems are extremely important for the child,
which you can study under the chapter ‘Food and Drinks’.
GENERALS – FOOD AND DRINKS – Milk – agg. – Mother’s

(Here the important remedies are Sanicula or Valeriana)
GENERALS – FOOD AND DRINKS – Milk – aversion – mother’s milk

(Here the important remedies Calcarea-Sil, Silicea, and Cina)
GENERALS – FOOD AND DRINKS – Milk – aversion – mother’s milk – child

refuses
(Here the important remedies are Calcarea phos, Acetic acid, and Mercurius
Sol)
CHEST – MILK - absent – milk in mother
7. Family and Relationship with others:
In this context you should observe carefully how the child interact with each and
every member of the family? How is the bonding with the mother or father? How
calm is the child in the hands of the mother or grandmother? When does the
child smile? When does the child weep? When does the child become fearful?
And in whose presence? Or in whose absence?
Also one must observe what behavior is present in the school or when the child
is playing; is the child very friendly with other children’s while playing?? Is the
child timid with other children? Is the child having separation anxiety from
parents while left in the park or garden for playing? All these area should be
probed quite deeply.
Then you should also see whether the child is interested in going to school?
You can also probe into which are the favorite subjects of the child and which
are not e.g. good in maths or poor in language!!!!
Then you should know about the child’s attitude towards animal; fascination for
animals; fascination for birds; fascination for insects; fascination for butterflies.
So it is very important area to look at that how does the child react with the
animal kingdom.
8. Games and hobbies:
What is the child’s most favorite toy; how does the child play? In whose
company the child plays the most? Does he play all the time? Does he stop
playing if he looses the game? All these aspects are important.
Is the child fascinated by cars or boat or computer or electronics; how does he

preserve the toy; how does he share the toy; all these things are very important
to understand.
I have made many editions of the rubrics PLAYING or HOBBIES in the chapter
of MIND in SYNTHESIS REPERTORY that is extremely useful in the practice.
9. Non-verbal symptoms or observation of the child:
How does the child sit; how does the child stand; how does he walk; what
clothes he wears; whether he wants a cap or he wants a coat; he wears a shoe
or he does not wear a shoe; his behavior; his gestures; his body language; the
colour of the hair; the colour of the eyes; the discoloration of the tongue; the
shape of the abdomen; and also discharges which are coming from the various
parts of the body like stool, urine, perspiration etc.
I have discussed all these in my third edition of my latest book on ‘CLINICAL

OBSERVATION ON CHILDREN’ in great detail.
I would also like you to include the blood chemistry report and all the X-ray
findings; as non-verbal symptoms.
The observation of the parents of the child is also very important aspect of the
pediatric case taking because some symptoms we cannot see like perspiration
in the night during sleep; a physician cannot see, it will always be the mother
who will answer this to you or in what position the child sleeps in the night; it is
only the mother who can observe this.
Hence it is very important when you cannot find out certain non-verbal
symptoms then you have to ask the parents to observe in that direction and
then report back to you. Sometimes the surgical pathologies can be directly
seen in the repertory when the chief complaint of the child is for example like
appendicitis, intestinal obstruction, peritonitis, prolapse of the rectum, tonsillitis,
etc.; all these are mentioned in the Synthesis repertory.
My friends in conclusion what I meant to say is that all these things which I have
just mentioned have really helped me to understand the child, it will help you
also. I will strongly recommend you to start using repertory, look for the rubrics,
study the remedies and I am sure that success will be on your lap.
Thank you.

2006 1011 Editorial For The Month of October November 2006

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2006 1011 Editorial For The Month of October November 2006

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EDITORIAL FOR THE MONTH OF OCTOBER – NOVEMBER 2006

RANDOM NOTES ON PEDIATRIC CASE-TAKING

b) It is very difficult to interpret especially the body language or gestures of

I would like to divide this whole process into certain groups:

1. Personal and Family history:

GENERALS – Family history, of – alcoholism

GENERALS – HISTORY; personal – Abscesses; of recurrent

We should see whether the child’s development is slow or retarded and

GENERALS – Development – arrested

MIND – DEVELOPMENT of children arrested

TEETH – DENTITION – difficult

When there is ‘Dentition – difficult – accompanied by – salivation’ then many

FEVER – vaccination, after

GENERALS – NURSING, Suckling aggravates

GENERALS – FOOD AND DRINKS – Milk – agg. – Mother’s

GENERALS – FOOD AND DRINKS – Milk – aversion – mother’s milk

GENERALS – FOOD AND DRINKS – Milk – aversion – mother’s milk – child

CHEST – MILK - absent – milk in mother

7. Family and Relationship with others:

8. Games and hobbies:

Is the child fascinated by cars or boat or computer or electronics; how does he

I have discussed all these in my third edition of my latest book on ‘CLINICAL

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