MINDING THE MIND IN THE CLINIC: APPROACHING CHILDREN: IGNATIA

A girl of 15years came to me for treatment of leukoderma, which she had been suffering since last 6-7years.

She sat in front of me, his mother sitting on the next stool.

I asked her about the problem, she didn’t reply anything.

She was looking into my eyes but did not utter a single word. I repeated the question several times but she didn’t say a word. Her mother intervened to say about her problem.

I told her not to say anything, let her daughter speak about the problem herself.

Fifteen minutes passed but she was not telling anything. She was looking very blank and straight into my eyes.

Her mother started crying and told me, “Why are you torturing her? She won’t speak about her problem. She even didn’t want to come. We somehow managed her to bring to you for medicine. She even does not want to take medicine. She is in a shock because of the problem which is persisting since so many years.”

I told her mother to stop talking and asked the girl, “What is the main problem? If you didn’t speak I won’t give you medicine.”

After this two drops of tear came out from her corner of eyes but she wiped it with her index finger.

After five minutes she told, “What to tell, can’t you see these spots spreading all over the neck and hands. How a person does feels if she has this type of disease spread all over the body. I can’t go to anybody’s house; everybody looks at me as if I am untouchable. I avoid other students in school also. I told mummy before coming here, there is no point in taking medicine as it cannot be cured and I have lost all hope and faith that it can be cured.”

I asked, “Then why you came for medicine?”

She reported, “See my mummy, she is crying, she is deeply worried about my disease. I am not so stupid; I have to think about her also. She insisted to come to you so I agreed.”

I asked, “What is the impact of this disease on your life?”

She didn’t reply and looked down, tears rolling from eyes continuously and she was wiping it with her hanky.

By seeing her weeping, her mother again started crying and pleaded me not to ask her further.

Her mother explained, “Since last 7years she is suffering from this problem. Initially she was not so serious about it, but after her eighth class she used to ask about it, “When it will be cured?

She is taking medicine since last 7years without even 1% relief rather the spots are increasing, spreading to her neck and face.

Since last 1-2years her behavior is completely changed. She does not want to participate in any entertainment or curricular activities1

If you just tell her, ‘you should do things this way’, that makes her very low and she stops talking to all of us.2&3

Then she does all conflicting works (contrary). If you tell her to get up in the morning she will not get up in the morning, further, she will sleep till noon. If you threaten her that when father comes from office we will complain, she will reply, “What he can do, maximum he can beat me, let him do that, but I am not going to get up now.” 4&5

If she is doing a painting & you appreciate that, then she will immediately spoil that.6

Tell her, “if you expose yourself to sun then the spots may increase”, she will do just the opposite. She will go out for marketing in the sun.

Sometimes, if we want to go for some marriage party she will not get herself dressed. Seeing her younger sister dressed she becomes resentful. I observed, she does horrible things like sprinkling ink on her younger sister’s dress. She will then behave as if she is not well and insist on not going to party.7&8

I took the following Rubrics:

1. AMUSEMENT - aversion to

2. ADMONITION - agg. - kindly; even,

3. DELUSIONS - insulted, he is

4. DEFIANT

5. AUDACITY,

6. IMBECILITY – negativism

7. JEALOUSY,

8. FEIGNING - sick; to be

A dose of Ignatia 30 was given. This case was followed up for two years with only one dose of Ignatia 200 in between and then she is totally spot-free since last three years.

The condition in which patient does not want to take any treatment in a chronic case feeling that there is no point in continuing medicine as it is not going to be cured is DISCONCERTED.

IGNATIA CHILD:

The observation about Ignatia child is that they keep on playing till the body gives up.

DEFIANT

This child is very rude and harsh to the mother.

RUDENESS

Why?

It is because she wants the company of the mother as per his requirement.

What is there in it to get angry upon the mother?

When she leaves her alone.

She wants the company of the mother and doesn’t allow her to go anywhere. She becomes very rude if she leaves her for some time.

Suppose if she is in the toilet, she would stand outside and keep shouting for her to come out.

CARRIED - desire to be carried

If the mother goes out for shopping without telling the child (which she has to do as the child would not allow her to go out without him) and in between the child comes to know that the mother is not at home, she gets very irritated and doesn’t listen to anybody. When the mother comes back she gets angry on her by abusing shouting, beating pulling her hair and asks why she went without her, why she didn’t take her along?

1. IRRITABILITY - contradiction - slightest; at

2. ABUSIVE

3. STRIKING

ANOTHER CASE OF IGNATIA

A two years child was brought to me for the treatment of headache, cold and coughs. The mother said, “Doctor, the child is very irritated, since morning he has not eaten anything, doesn’t allow her to go anywhere. He wants me to be around her all the time.”

Q – Does he asks only you (mother) to be with him or anybody can sit near him?

A – No, he wants only me.

Q – How are you managing your work?

A – I leave him when he gets busy in some game.

Q – How he behaves when he doesn’t find you?

A – He starts searching for me. Or if he sees me he leaves the game and starts weeping. Sometime when I have to finish my work then I give him to his father forcefully.

Q – What is he doing since morning?

A – In the morning when the headache was at the peak he was lying very quietly as if he has no energy. When headache became less he wants that he should be left alone and let him play. But I have to be around him. He stays very irritable. On the slightest contradiction he gets annoyed. He doesn’t like to listen any negative comment on his work. Then he gets annoyed.

IRRITABILITY - pain, during

CARRIED - desire to be carried

PLAYFUL

DISCONCERTED (it is a feeling inside the patient that he can not do any thing against the disease now and just let him be in that state)

IRRITABILITY - contradiction - slightest; at

The other symptoms of

Ignatia child:

If anybody and anything interrupts in between, he starts shouting at the person or the thing. Suppose, he is riding a tricycle, and the wheels gets struck in the furniture. He will apply force on the cycle so that he can free it from the obstruction but when he fails to do it he starts kicking it and shouting very loudly. When mother advises him that instead of shouting he should have tried to take out the cycle, he would reply that why have you kept the furniture here? Can’t you put it somewhere else?

The mother would say that he wants me to be around all the time but does not like if I ask him not to do this and that. He likes to be left alone and gets irritated if some other child would touch his toy. He likes that we should listen and follow his instructions but doesn’t want to listen to my instruction.

This child would not listen to the advice given kindly to him for his well being. Instead he would start behaving more abnormally (he would go out of control). At that moment if he gets a slap on his face he would get milder. She told me in the morning when the fever was high that time he was lying very calmly as if he has no energy left. But after some time when the fever came down he started playing again. When fever is high he takes no interest in anything.

INTERRUPTION - agg.; mental symptoms

ANGER - contradiction; from

ADMONITION - agg. - kindly; even

INDIFFERENCE, apathy - chill, during

The nature of the child is that the person who cares for him or gives attention to him his behavior towards him is very rude. But he is very nice towards the person who has the tough attitude towards him.

CONTRARY

Ignatia child do not play for amusement. Ignatia is the only drug in playfulness which do not do it for amusement. It is really strange. Then why does she play. She plays different game. Ignatia is a moralist. She does her work perfectly without giving any body a chance to point finger towards her. At the same time she expects reciprocation from others. If she does not get it then she starts playing the game. She will sit in a corner, refuse to eat and show as if she is not well so that everybody should realize her importance. She even goes to the extent of spoiling the mood of whole family because of this problem.

EMBITTERED, exasperated

She feels it is her right to get the due reciprocation, if denied or neglected she will openly resist others without thinking of the consequence

DEFIANT

In a nutshell Ignatia child is very righteous. She always tries to do things in a right way. She gives proper respect to others. She does all her works in such a way that no body should tell her that it is not done in a proper way.

If she is pointed out then she behaves very rudely.

I have observed that Ignatia child when admonished will go away from that place with out crying and sit in a corner of the room and weep without getting noticed. If the parents go to her and try to console her so that she should be normal, she would tell them to leave her alone. She would become normal on her own and then come back to the daily normal routine.

Here the differentiation can be done with Pulsatilla, where the child will always look to the parents so that they come and console her and love her so that she become normal soon where as Ignatia takes her own time to become normal and if somebody consoles her she may become more aggressive.

IGNATIA : CONSOLATION AGGRAVATES

PULSATILLA : CONSOLATION AMELIORATES

By Dr Ashok Mohanty, Mob.:9810026564