These are the “warm-blooded” drugs starting with PULSATILLA which is the most commonly indicated drug in children of this type.
PULSATILLA children are very typical. There are two main types. One is the very small, fine type, with a fine skin, fine hair, unstable circulation, liable to flush up from any emotion very often going pale afterwards; definitely shy, sensitive; always affectionate very easy to handle, and always very responsive.
The other PULSATILLA type, is much fatter with definitely more colour, usually rather darker hair, a little more sluggish in reaction, a little more tendency to weep than to be bright and gay as the smaller, finer type, craving for attention without much response to it, always asking for a little more.
If you get one picture clear you are apt to forget the other. The factor common to both types is their temperature reaction, all PULSATILLA children are sensitive to heat, they flag in hot weather lose their liveliness, lose their sparkle and energy.
They hang about, become either tearful or irritable, and are likely to get digestive upsets. But they are much more liable to be upset a sudden change to cold in a hot spell-that is to say they often get an attack of acute sickness or diarrhoea from being chilled in hot weather.
They tend to get cystitis, or to get earache. Sudden chilling during hot weather causes their troubles. Whilst generally they flag in hot weather, their acute conditions are much more liable to be brought on by chilling. In the same way they are upset by taking ice-cream in hot weather, this factor is quite as common as the ordinary PULSATILLA aggravation from too rich food.
Something one misses a case because of the odd reactions in a feverish attack. The PULSATILLA children get acute colds in the head, acute coryza, and with this they are shivery, and very chilly. With the coryza, there is a certain amount of gastric catarrh, a feeling of nausea, and they may actually vomit.
But, in spite of their chilliness, their sense of blockage in the head is better in the open air and worse in a stuffy room. A PULSATILLA cold always has a bland discharge.
There is sometimes an apparent contradiction they are very apt to get conjunctivitis, and in the PULSATILLA conjunctivitis the eyes are very sensitive to any cold draught, and water profusely in the open air. There is usually marked photophobia with itching of the eyelids, and PULSATILLA children are apt to get styes, affecting the lower rather than the upper lid.
A point that is sometimes a help in PULSATILLA earaches, which are very intense and usually brought on from exposure to cold, is a very violent pain, which spreads all over the side of the face as well as into the throat.
If the condition has gone a little further, there is feeling as of something bursting out of the ear, as if something were pressing right through the ear drum. Another thing is amelioration from cold-their earaches are better from cold applications.
PULSATILLA children are very often tired, edgy and sleepy during the day, and they become more lively as the day goes on, they are liable to get the PULSATILLA nervousness about sunset the ordinary sunset aggravation of PULSATILLA.
They become very lively towards bedtime, are slow in going to sleep, and once asleep tend to get nightmares, night terrors usually some kind of strife dreams-not necessarily being chased by the black dog of PULSATILLA-but always something worrying, terrifying. Most of these PULSATILLA children are afraid of the dark, afraid of being left alone, as one would expect in the shy nervous type of child.
One thing that will almost always produce a night terror in these children is listening to ghost stories in the dark before going to bed; you can be sure that will give a PULSATILLA child a nightmare.
Another useful pointer is that these children are very liable to become giddy from looking up at anything high. The only other drug that I know in which this is so marked is ARGENTUM NITRICUM which has an aggravation from looking down, but it has also an aggravation from looking up, but this is very much more marked in PULSATILLA.
The PULSATILLA child often lies with the hands above the head and this is a useful pointer, although it is by no means constant.
Kali Sulphuricum. [Kali-s]
When considering the hot-blooded child of PULSATILLA type, the next thing to consider is whether it is PULSATILLA or KALI- SULPHURICUM. Kent says that KALI SULPH. is merely an intensified PULSATILLA. I do not think it is.
The KALI SULPH temperature reactions are identical with the PULSATILLA ones, the child is sensitive to heat it flags in the hot weather, cannot stand stuffy atmospheres, is better in the open air, tends to stagnate if keeping still, and is better moving about. It has an aggravation from rich food; and is liable to be upset by sudden changes of weather. But there is a distinct difference.
The KALI SULPH child is much more flabby than the PULSATILLA child, it certainly does not approach the thin fine type of PULSATILLA although it approaches more to the sluggish heavier type of PULSATILLA. Its muscles are flabby, it is easily exhausted by muscular effort. It is more liable to sit about, and has a much more sluggish reaction generally.
There is more obstinacy in the KALI SULPH. type than in the typical PULSATILLA. The PULSATILLA child may be irritable, it may flare up in a temper but it is over; KALI SULPH. is much more liable to be obstinate.
Also the PULSATILLA children are shy, but the KALI SULPH. children tend much more to have a lack of confidence in themselves-it is not shyness. They are lazy, they dislike work and there is not the keenness and interest of the PULSATILLA children.
The KALI SULPH children are not bright they get tired out by mental exertion, whereas the PULSATILLA children are very often bright and sharp and do quite well at school.
There is a certain similarity in that they are both nervous, both afraid of the dark, are very easily frightened, easily startled at strange noises, strange surroundings.
The typical KALI SULPH child tends to be more sickly than the typical PULSATILLA child. The PULSATILLA child may not be strong, but the KALI SULPH. child tends to have less colour and if flushed it is much more a circumscribed flush on the cheeks rather than the variable circulation of the PULSATILLA.
Another thing that indicates KALI SULPH rather than PULSATILLA is that nearly all KALI SULPH children have a yellow-coated tongue, particularly the root of the tongue although the coating may spread right over.
Another point which helps is that there is a slight difference in the type of discharges. The typical PULSATILLA discharge is a thick, creamy, non-irritating discharge. The typical discharge in KALI SULPH. is a much more watery, more stringy, yellowish discharge.
As far as liability to actual acute illness is concerned, PULSATILLA is more often needed for acute gastric catarrh, acute gastritis, acute colic and diarrhoea; but if the gastritis has gone on to a jaundice in a PULSATILLA child the indications are more for KALI SULPH than for PULSATILLA.
With a PULSATILLA type of child who has caught cold and developed bronchitis which has gone on to a broncho-pneumonia with the ordinary PULSATILLA indications, that is to say, aggravated from stuffy room, relief from air, sense of suffocation possibly a loss of voice, very dry mouth without much thirst, with a yellowish, watery sputum and probably patches of consolidation at the left base-left base more commonly-the response is better from KALI SULPH than from PULSATILLA.
With a PULSATILLA child who has whooping cough with a lot of rattling in the chest, and the ordinary PULSATILLA modalities, KALI SULPH. does more good than PULSATILLA.
That is perhaps what kent means by saying KALI SULPH is PULSATILLA intensified-in these acute conditions the symptoms are very similar and yet the more severe the condition the more definite are the indications for KALI SULPH.
It is sometimes useful to remember that the heavy PULSATILLA child is liable to go on SULPHUR whilst the finer PULSATILLA child is much more liable to become chilly and go on to SILICEA or PHOSPHORUS.
I usually give PULSATILLA in low potency in chronic cases. They are mostly sensitive children, and where you are dealing with the sensitive type you do not want a high potency. When dealing with bovine types I go high, but in a sensitive type like PULSATILLA they blossom on a 30 potency. PHOSPHORUS is exactly the same, PHOSPHORUS children respond beautifully to lower potencies.
I have found very good results from ANTIMONIUM CRUDUM 12, repeated three times a day for two days, in impetigo. With CALC CARB or GRAPHITES I would give a high potency every time-a 200, or higher, as one is dealing with an insensitive type.
From the point of view of children, there are two definite SULPHUR types. Much the commonest is a fairly well-nourished, well-grown child, always with a definitely big head. They are usually fairly heavy in build and rather awkward and clumsy in their movements.
They are apt to very coarse, strong hair, and always a fairly high colour. Their skin tends to be roughish, it will roughen in a cold wind, and they sweat easily. They tend to have rather red extremities, red hands and very often red feet. They always have the red lips, very often red ears, and they easily run to redness of the margins of the lids.
That is one of the exceptions to the coarse hair, because that type of SULPHUR child very often has poorly developed eyelashes; they have had repeated attacks of blepharitis they have crusty eruptions about the eyelids which they have picked and scratched and consequently the eyelashes tend to be undeveloped or poor.
The other SULPHUR type which is usually thin, with a fairly big head but rather spindly legs, very often with a biggish abdomen, rather poorly development chest, very often not so much colour, tending to be paler, with a definitely rougher skin.
They type has a drier, coarser skin, with a very marked tendency for the skin to split, to crack on exposure, and the child is rather more miserable generally. The child looks more seedy, has less vitality, is more easily tired and always stands badly.
The heavier SULPHUR type have much more bite about them, they tend to be quarrelsome, impatient rather critical, fault-finding discontented, very often generally dissatisfied; are apt to feel they are not getting a fair deal, often feel they are being under-estimated.
They are lazy, but it is often very difficult to say whether it is real laziness or lack of stamina, because they do get tired out on exertion. They have a great dislike of interference, they think they know how to do thing, they know what they want to do, and strongly resent their parents butting in, they think would make a better show of it if they were left alone.
The thin SULPHUR type, are much more inclined to be miserable, low spirited. They have much less vitality much less bite about them. There is the same sort of resentment of outside interference, though it shows itself differently. These thin SULPHUR children are liable to weep, and any attempt to comfort them is apt to annoy them, and they will turn on you.
These thin SULPHUR children have even less stamina than the fat ones, they are more easily exhausted and, like all SULPHUR patients, they cannot stand for any length of time. They stand badly in the ordinary instance, and if they are kept standing they go to pieces.
There is one outstanding characteristic of all SULPHUR patients, whether children or adults, and that the is they have a large appetite-it does not matter whether they are fat or thin and their appetite is well-defined in its likes and dislikes.
All SULPHUR patients have a desire for something with definite taste; they like highly seasoned, spiced foods, and they have a very marked desire for sweets.
Occasionally a SULPHUR patient will crave salt, but it is not really a salt craving, it is much more something with a taste. Another point about SULPHUR children is that they have an almost perverted desire for out-of-the-ordinary food, the unusual dish that the average child dislikes, the SULPHUR child eat with relish.
Another constant feature in both children and adults is that they are always very sluggish after meals, they get heavy and sleepy, they want to lie about and are irritable when disturbed.
One very useful pointer about SULPHUR children is that they are liable to get digestive upsets from milk. The small SULPHUR baby very often gets sickness, and may get diarrhoea and vomiting from milk, and this marked aggravation is often overlooked.
The next thing that is constant to all SULPHUR patients is the skin irritation. Most SULPHUR patient have irritation of the skin somewhere, and it is characteristic. it is very much worse from warmth of any kind; warm room, warm bed, warm sun, warm clothing, all start up the SULPHUR irritation.
When the irritation is present they get definite comfort, and sometimes a peculiar sensation of pleasure, from scratching and occasionally the scratching does relieve the irritation. It always tends to be much more troublesome at night, quite apart from being hot.
When they are about, active and occupied during the day the irritation does not worry them much, but when they are at rest in the evening or at night the irritation tends to become much worse, and much more worrying.
SULPHUR has every skin eruption known to the dermatologist. The point that distinguishes it as a SULPHUR eruption is the reaction to temperature, and the fact that it always irritates. it is an intense irritation that they cannot leave alone; they describe it in various ways- itching, feeling of animals crawling over the skin, sensation of stinging nettles, any description that fits an intense irritation of the skin.
In addition to the general irritability these children tend to get very marked irritation of all the orifices-nose, ears, mouth, urethra, anus-any orifice tends to be congested, red, hot and itchy.
In all acute or chronic conditions they tend to have a red- coated tongue, with very red tip, and very often a red margin running along the sides, not unlike a RHUS TOX. tongue. Most of these SULPHUR patient have a dry mouth, a hot mouth, and they are thirsty. This applies more in acute conditions than in chronic.
Another point which is sometimes helpful in the SULPHUR type children. SULPHUR patient are always aggravated by heat, but one is apt to forget that SULPHUR patients have unstable heat mechanism; they are very liable – certainly in feverish conditions – to waves of heat and also waves of chilliness
Very often they get extremely hot, break out into a sweat and become shivery-very much the type of condition associated with MERCURIUS. Covered up they get hot and very uncomfortable; but when uncovered they feel a draught on the skin and are immediately chilly. But do not overlook SULPHUR because the child does not want to be uncovered all the time.
Another constant in the SULPHUR patient, no matter what the condition whether it is a skin eruption, or a child with rheumatism, or a child with a tummy upset, no matter what condition. It is aggravated by bathing. And SULPHUR children nearly always look dirty.
Some children may at first sight appear to be not unlike CALCAREA children, that is to say, they are heavy, with big heads, are rather pale with a tendency to flush, have rather big bellies, and are clumsy; but they have not the CALCAREA chilliness, they are hot-blooded, and have a very marked tendency to the development of blackheads all across the forehead.
These children are nearly all SULPHUR cases. They have rather paler lips than the average SULPHUR child but, particularly with blackheads scattered over the forehead, always consider the possibility of the child being a SULPHUR type.
Another contradiction sometimes met with in SULPHUR children is that they have disturbed areas of heat; they have hot heads and cold hands, or hot hands and cold feet; or hot feet and cold head – very often cold, damp heads-local disturbances of heat and cold as well as general disturbances of heat and cold. A child with cold does not automatically rule out SULPHUR because the child does not put its feet out of bed.
Typical of SULPHUR subjects is sluggishness. They are better for exertion; better when they are stimulated and better when they are moving about. Some SULPHUR patients can be very lethargic, dull, uninteresting people but if they are stimulated in the proper kind of society they wake up; they clever; and you would not recognize them as the same beings.
It is the same with SULPHUR children; badly handled they are dull heavy, cross, irritable; and properly handled they can be bright interesting, quite friendly, and very often clever. Some of the SULPHUR children have a most astonishing command of languages.
A fairly constant characteristic of all SULPHUR children is constipation. This majority of SULPHUR children suffer in some degree from constipation and very often it is quite severe. Associated with that is an enlarged abdomen, frequent enlargement of the liver, abnormal appetite, sleepiness after meals and a very definite tendency to attacks of colic.
The above applies more to the heavier SULPHUR type, the thinner type is more liable to get attacks of ordinary SULPHUR modalities, that is to say, diarrhoea tending to come on early in the morning any time after four a.m. and the stool is always offensive.
The other constant SULPHUR characteristic is an offensive odour. Discharges, eruptions, perspiration all are malodorous, and the SULPHUR child is very difficult to get clean and wholesome.
Another feature often met with in SULPHUR child is that they are often heavy and lethargic and sleepy during the day, and very sleepless at night; also they are liable to get most terrifying nightmares. These are most constant in character, but the child is always being frightened, very commonly being terrified of fire or something of that sort.
Another point shich occasionally occurs in a SULPHUR child. It is quite lively in the evening, slow getting to sleep gets off to sleep, and wakes up soon after in fits of laughter. It is odd symptom, and always in SULPHUR children. Also they get a hungry period about 11 a.m, and all SULPHUR children are liable to be seedy, headachy irritable and tired out if they have to wait for their meals.
Nearly all the actual acute diseases from which they suffer are associated with some skin irritation. SULPHUR is commonly indicated in acute styes with intense irritation of the lid margins, the lids are very hot and burning, aggravated by heat, and particularly aggravated by bathing – they smart and sting if an eye bath is used.
There are commonly indications for SULPHUR in chronic nasal discharges; in these children with a nasal discharge there is always the same SULPHUR offensiveness. The discharge is always excoriating, there is a redness about the nose, with intense irritation, the children tending to pick at it until it is raw and bleeding.
SULPHUR children often get chronic tonsillitis, a deeply injected throat, very swollen, feeling very hot, with very offensive breath. And most SULPHUR children with tonsillitis tend to get masses of glands in the neck- more than ordinary tonsillar gland enlargement and it tends to spread, and involve particularly the submaxillary glands. The tonsillitis is accompanied by irregular heat and cold, shivering attacks, sweaty attacks and thirst for cold water.
There are indications for SULPHUR in chronic conditions, chronic ear discharge, with the SULPHUR characteristics the excoriating, offensive discharge, redness about the external ear, intense irritation; the aggravation of any pain from hot applications, particularly hot fomentations.
Chest conditions is SULPHUR children vary from a mild bronchitis to an acute pneumonia; and again certain features are constant. A tendency to waves of heat and sweat very often occasional shivers, very often burning extremities, and a very definite heavy smell about the child.
There is one constant feature that runs through all SULPHUR chest conditions, it is a very marked sensitiveness to lack oxygen-they cannot stand a stuffy atmosphere, they want plenty of air, and yet they are chilly in draughts. The disturbance is more commonly on the left side of the chest than on the right, but it is too slight a difference to be of much importance.
SULPHUR is one of the most commonly indicated drugs in jaundice of children-acute catarrhal jaundice-particularly with the marked intolerance that SULPHUR has to milk in its acute conditions, intense skin irritation, feeling of burning heat on the surface very often with attacks of colic, frequently with attacks of diarrhoea. A SULPHUR diarrhoea produces an excoriating discharge, redness and rawness about the buttocks, intense irritation, scratching.
The thin type of SULPHUR patient often suffers from acute rheumatic conditions with the usual characteristics-irregular sweats, feeling of heat, thirst, red tip of the tongue. The actual painful condition is worse from heat, it is rather more comfortable from cold, it is very much better from movement, although it is painful when starting to move; and there is liable to be a red blush of the affected joint. There may also be a history of the attack having been precipitated by bathing, either sea-bathing or swimming.