3/06/2011

MINDING THE MIND IN THE CLINIC:

APPROACHING CHILDREN - 12

DR ASHOK MOHANTY

A 6 years old boy was brought to me for severe abdominal pain. The boy was holding his abdomen with both hands. Though the expression of pain can be seen from the face of the boy but he was not at all making any sound. His father told, “We had been to a party two days back and he ate the junk foods against our advice. Since last night he was suffering from this pain and he had passed several loose motions.”

Dr.: (To boy) “Tell me about the pain?”

Boy: “It is not so severe. It is bearable. I am managing it since last night with ease.1 I knew I shouldn’t have eaten so much of that junk food and because of that I am suffering now.”2

Dr.: “Anything else?”

Boy: “No, I am OK.”

Boy’s father: “He has not complained anything on his own. But by seeing his face we could feel that he is having severe pain. When we look at him, he starts doing something like playing with his toys, pencil box etc as if he wants to show that he is not having pain, rather doing his normal routine work.”3

A dose of Opium 30 settled the pain and his stool also became normal.

The following rubrics were taken:

  1. WELL - says he is well - sick; when very & HIGH-SPIRITED
  2. DELIRIUM - blames himself for his folly
  3. ANTICS; playing

Let us understand why Opium says well though he is very sick?

It is because of the high-spiritedness of this remedy.

Opium is very high-spirited which means he keeps his spirit high even during his sufferings. By high spirit we mean that the individual never allow his will power to collapse being in extreme state of suffering. In this state he will always keep his tempo high and keep assuring himself that nothing will happen to him and he will overcome successfully this negative state.

The high-spiritedness of Opium makes him content & quiet, where in he feels that the state he is in, is very-very satisfactory, so he never complains.

In this case the other rubrics are taken as per the version of the boy during sickness corroborates to the central theme of “WELL - says he is well - sick; when very”.

Let me explain those two rubrics one by one.

DELIRIUM - blames himself for his folly

Delirium means a state of temporary extreme excitement marked by restlessness which is sometimes uncontrollable.

Opium is heedless (unmindful) about others suggestions. He hadn’t paid any attention to others advice that he shouldn’t eat so much in the party and ate junk food beyond his capacity. When the pain started then he went into state of excitement and blamed himself why he had taken so much of food (which he felt is a mistake for him).

ANTICS; playing means intentionally doing something which looks like a play but it is meant to attract or divert the attention of the onlooker.

Here the boy starts playing to show his parents that he is not in pain.

Hence Opium doesn’t complain during suffering as he is very high-spirited and feels he can manage the problem.

Let me discuss another case –

A boy of 4 years came to me for ARI (Acute Respiratory Tract Infection). His father told, “Throughout the night he couldn’t sleep for a minute. He was coughing continuously with breathlessness.”

When I asked the boy about his problem, he just smiled. He took the torch from the table and asked me, “Uncle, this is a special type of torch, how to put it on?” I explained him the mode to switch it on. He switched it on and played with it for few minutes.

On enquiring if he has any complaint, he again smiled and didn’t pay any attention to my question and asked me why the ray of the torch is milky which is different from other torches which is generally bit yellowish. I explained it is an LED torch. He asked further questions on the torch and it was continuing.

His father intervened, “Sir, he is like this. He is always interested to know about things and enjoys the process of getting involved about knowing things which gives him immense pleasure. Even though he was coughing very badly in the night he was not bothered about cough but asking us about the person who looks for snakes in the jungles of Africa shown on Animal Planet.”

A dose of Lachesis 30 cured this boy.

The following rubrics were taken:

  1. FRIVOLOUS
  2. CURIOUS
  3. PLAYFUL
  4. AMUSEMENT - desire for

Lachesis individual is very frivolous i.e. non-serious about their problem. For them play is more important as iT amuses them. These types of children live, eat and sleep in play. They always look for amusement in everything which is their disposition. They can’t sit idle for a moment (SITTING - aversion to sit). They are always eager to know about things (Curious) which again amuses them.

Playful means being happy and rejoicing in what you do. They really enjoy the process of knowing about the things and amuse themselves in the process.

So these children doesn’t complain because they don’t take their problems so seriously as they are more interested in play which amuses them.

Another case

A little girl 6 years of age was having very high fever. Her parents brought her to the clinic. It was rush time in the clinic. I could listen to the crying of the girl, “Papa, please don’t show me to the doctor, I will be alright very soon.”

When their turn came, she was reluctant to come inside my chamber. Her mother brought her forcibly while she was crying. Her mother told her, “This doctor is not that doctor who gives injection rather he gives sweet pills.”

I gave her a bottle of globules and assured her that only sweet pills are given here.

Though she stopped crying but the look from her face showed that the fear is still there. She was not looking at my face. Even when I look at her she looks to her parent’s side.

Her mother told, “She is having fever since last three days. Whenever it is very high we give Crocin which subsides the temperature. But after 5-6 hours it again comes.”

Dr.: “What does she do during fever?”

Mother: “She just lies at one place. Her behavior totally changes as if she is not in her own self. She behaves like some other person. She talks a lot which has no meaning. Every 5-10 minutes she changes the topic. She sometimes screams loudly, we think it may be because of pain in the body so we stay with her that time pressing her extremities. She wants us to be with her during the state of fever.”

Dr.: “Why she didn’t want to come here?”

Mother: “She has bitter experiences with other doctor as they always ask for routine blood tests and she fears the injection.”

Just by hearing this question she started sobbing and went to her mother and sat on her lap.

A dose of Stramonium 30 brought down the fever in few minutes. The child was totally normal in three days.

Stramonium child doesn’t complain because they have the fear of doctor as doctor is always associated with injections.

Rubrics taken:

  1. FEAR - doctors
  2. UNCONSCIOUSNESS - fever, during
  3. LOOKED AT, cannot bear to be - evading the look of other persons
  4. LOQUACITY - fever; during

Let me explain the rubric ‘UNCONSCIOUSNESS - fever, during’. The meaning of conscious is awareness of self. Here in this case the child was not aware of self, about her behavior, her parents told that she behaved like a different person during high temperature.

So here the child is not conscious about self and talks continuously changing the subject frequently which is not what she behaves during her normally.

As the child was not looking and evading the look so the others rubrics are taken.

Because of fear stramonium child will never complain about the problem and cling to the person who carries her to the doctor.

8 comments:

  1. Sir very beautifully explain the cases. Thank you sir.

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  2. Dr Sanjay S JadhavMarch 9, 2011 at 4:53 AM

    Its Fundoo explanation. Keep blessing us.

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  3. sir please tells us the differance between FEAR, social position about and FEAR, opinion of others.

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  4. An article on these rubrics will be published soon!

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  5. Short, Simple, Sweet....
    It can't be made simpler than that...
    Excellent!!!!!

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  6. TOO GOOD DIFFERNTIATION OF REMEDIES WHO DOESNT COMPLAINT.. TOO GOOD SIR

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  7. thank u very much boss..........................

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  8. Dr, your explanation as well as detailed analysis with simple samples of the behaviours of the patients is so interesting and conducive to learn a lot definately......

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