The third group is headed by GRAPHITES. This group is associated with children who have definite skin eruptions. Almost any of the other drugs already mentioned may be required for skin eruptions, for instance, CARBO VEG. Children have a very obstinate eczema of the scalp CALCAREA children have eczema of the scalp, CAUSTICUM children have a lot of skin eruptions.
There may also be a very obstinate eczema of the scalp with SEPIA indications. But the GRAPHITES group is the one to think of when a child has a definite skin history. There is a tendency when treating children with an irritant skin to give a dose of SULPHUR, and there have been many cases where that dose of SULPHUR has done harm and I am chary of starting with SULPHUR in these children with skin trouble.
The typical GRAPHITES child is fat and heavy. It is usually pale, always chilly, and nearly always constipated. In the majority of instances with obstinate constipation in a small child the abdomen is enlarged, a factor so constant that one does not stress it.
GRAPHITES children are always timid. They are rather miserable, and have a complete lack of assurance. The slightly older children hesitate over what they are going to reply to any questions put to them; the school report states that they are indefinite – there is the same hesitation here; and most of these GRAPHITES children are lazy; they have an aversion to work.
There is a queer contradiction in the GRAPHITES children. With the uncertainty and hesitation, laziness and general physical sluggishness, there is always an element of anxiety in the children. They always tend to look on the hopeless side of things; if they are going to a new school, they dread it. They are always looking for trouble.
The next thing about the GRAPHITES children is that, associated with their pallor, under any stress at all flush up – they have a definitely unstable circulation. And under stress, when they are excited, with this flushing up there is a tendency to troublesome but not very profuse epistaxis, which comes on under excitement that is the diagnostic point.
A constant feature of the GRAPHITES children, which at once distinguishes them from the CALCAREA children who look not unlike them, is that instead of the soft, sweaty CALCAREA skin, they have a harsh dry skin which tends to crack, particularly on exposure to cold. If these GRAPHITES children have been playing in water in cold weather they come in with their hands chapped and bleeding.
Associated with the dry harsh skin, are the GRAPHITES skin eruptions, and the type of eruption is constant no matter where it is. Cracked fingers which tend to bleed also ooze a sticky thick yellow serous discharge.
The same kind of condition arises in any of the folds in GRAPHITES types, the back of the ear, canthus of the eye, angles of the mouth the groins, bends of the elbows, round the wrists and particularly about the anus; in this site are found deep painful fissures oozing a thin, sticky, yellowish discharge.
As the discharge dries it forms thick crusts which pile up as secretion of matter continues beneath; and the crusts come off to reveal the same kind of gluey yellowish discharge, very often streaked with blood.
In my experience children suffering from asthma who have a history of skin troubles are not helped by GRAPHITES. These cases of suppressed skin troubles which develop asthma are extremely difficult and I have found that GRAPHITES fails altogether. Many other remedies have been successful such as PSORINUM, ANTIMONIUM CRUDUM, NATRUM MUR., SULPHUR., THUJA has helped quite frequently, and with no other lead it would be wise to start with THUJA.
That can be linked to one or two other typical GRAPHITES symptoms in children. They are liable to get a very persistent purulent nasal discharge, a chronic otitis with a perforation of the drum and again the same kind of yellowish excoriating discharge, with an irritating eczema of the external ear whenever the discharge runs over.
Associated with the purulent nasal discharge, many of these GRAPHITES children have marked hypertrophy of the tonsils, with offensive secretion in them, and as a result they often complain of difficulty in swallowing.
They often suffer with a chronic blepharitis and their lids are completely stuck in the morning with the same sort of gluey discharge; dried discharge adheres to the edges of the lids.
In spite of apparent fatness, they are flabby, and there is general muscular weakness. They are very easily exhausted; are sensitive to motion of any kind; and stand travelling very badly. There is a history of rheumatic pains, particularly affecting the neck and the lower extremities.