Books » Diseases of the Respiratory and Digestive system of children by Dr. Fortier Bernoville » DISEASE OF THE DIGESTIVE SYSTEM OF THE FIRST INFANCY

DISEASE OF THE DIGESTIVE SYSTEM OF THE FIRST INFANCY


DISEASE OF THE DIGESTIVE SYSTEM OF THE FIRST INFANCY


We will try in this article to make a brief review of the affections of the digestive apparatus and the troubles of nutrition of children. In order to do that we will have to speak at least in ten chapters about their pathology. But you will see that the number of medicines used for children are very small. We will have to fall back again and again on the same remedies. Among the 7 or 8 columns that we have drawn in our schema we will constantly fall back on Chamomilla, Belladonna etc.

We may say that the homoeopathic treatment of children as regards digestive system, is very simple. Here is our plan of study.

1. First of all some generalities from the point of view of constitution and temperament of the child and from the point of view of the general actions of homoeopathic remedies in children.

2. Then we will study the basic remedies which we will describe in detail always indicating the hereditary taints corresponding to the remedies.

3. Then we will give a list of principal remedies that may be prescribed in the digestive troubles and in the nutritional troubles of the infancy.

Constitution & Temperament.

Let us consider at first a child at birth. If it is quite natural that it carries with it a certain heredity and shows more or less some hereditary taints which will not be quite apparent during its birth but on the contrary these taints will become apparent as the child will grow. If we consider in the light of general homoeopathic philosophy, the child of the first infancy (infants), of the second infancy (pure), the adolescent, the adult with their constitutions, their temperaments, we will see that their hereditary taints become evident only lately.

Even at the birth, the child seems to be healthy in general with a life. It will not show any sign of very ancient hereditary syphilis coming from several generations, or tuberculous or other taints only after many years. This is not naturally exact in habitual pathology as regards here dose in whom we immediately detect clear taints, evident stigmas and also in children born of tuberculous patients. These children are sickly and they cannot live if they are not separated from the familial milieu. And this true as regards the symptoms stamped and more or less recognized by the official school. This will be still more evident when we will study the question of constitution. We may say that the child is born with a vital force which is immense and given during the birth, which will gradually diminish till death or old age.

But if a child has a certain constitution, and if it is possible, during the birth, to foresee what will be its consequences (because it is possible up to a certain point to foresee the diseases from which the child may suffer), which one can do inspite of every-thing, only with great prudence because if the constitution, a Static, is fixed; the temperament the Dynamic, is not fixed. The dynamic behaviour of the patient is completely subject to the vegetative life of the digestive system.

1. The three Osteo-articular constitutions:

Let us then consider rapidly the question of Constitution and Temperament.

The constitutions of children are well studied by Dr. A. Nebel, According to him there are three forms of static constitution: Carbocalcic, Phosphocalcic and Fluorocalcic. He also calls these three constitutions Normocrinic (Carbocalcic, Hypercrinic (Phosphocalcic) and Hypocrinic (Fluorocalcic) according to the endocrinal troubles that may be associated with them, hyper or hypofunction in a general way.

The indications of constitutions of Dr. A. Nebel is very interesting, but it is necessary that we should consider it with care because though it is certainly true from the clinical point of view, yet it is not experimentally proved.

The descriptions of Dr. A. Nebel as it was given to us in his lecture are, that one can distinguish according to the articular laxity the Fluorocalcie whose articular tissues are very lax; the Phosphocalcic has medium laxity of articular tissues and the Carbocalcic has very little laxity. These types correspond to hypophysary troubles.

The three salts of Calcium, specially indicated in children are of the first importance in Homoeopathic therapeutics of children. These three salts help to classify at least clinically the individual patient.

2. Physiological temperament.

It is also necessary to consider here the temperament as studied by Dr. Allendy. You know that the occult writers of the middle ages, the traditionalists, studied with hippocrates the temperaments under the four forms: Lymphatic, Sanguin, Bilious, and Nervous. These terms may actually no more be used from the physiological point of view. They mean nothing precisely. But Dr. Allendy has explained in his book “Les temperaments” that the above classification may again be taken up on a physiological basis. He has described four types: Atonia plastic, Toniplastic, Toniaplastic, Atoniaplastic.

He started from the very fecund idea that to understand any organism, it is necessary to take into account the qualitative element on the one hand and the quantitative on the other: The Tonus and Plasticity.

The child is essentially Atoni-plastic, because it has at the same time the tonus and plasticity. It has tonus only in vitro we may say. It does not use it always in a rapid and clear way. But on the contrary all the diseases from which it suffers are generalised on the whole organism very rapidly. It has no localising tendency.

The Adolescent (young adult) is Toni plastic, because it has at the same time the tonus and the plasticity which it generalises. It does not localise and fixes very little energy on the lesional plan.

In the Adult age, the individual has still the tonus but he begins to localise. He is therefore Toni-aplastic.

Finally the Old has neither the tonus nor the possibility to generalise. His diseases are more or less fixed in time and space. He is atoni-aplastic.

This classification of Allendy is very interesting and very true as regards children.

If we compare the classification of Allendy with that of Claude Sigaud, Digestive, Respiratory, Cerebral and Muscular, we may say that the child is before all a predominantly digestive. In the child who has only a vegetative life, the digestive system naturally plays a role of the first importance. From the pathological point of view as well as from the therapeutic point of view the 4/5th of the affections of the first infancy are related to nutrition, to digestive system and respiratory system i.e. to say to the two important apparatuses of the vegetative life.

3. The Diet.

Because the child is digestive type, there is great importance as regard diet. It would be irrational for a homoeopath to try to cure a child of its vomiting, diarrhoea, anthrepsia, if the Homoeopathic treatment is not followed by good revision of physical hygiene and of the diet of the child. The clinic the hygiene have naturally a step over therapeutics in Homoeopathy as well as in the official treatment. The child is after all a digestive type which can neither walk nor move. The movement, air and sun even, have their place in the question of digestion Therefore it is necessary when you have to treat a child for vomiting or for diarrhoea, that you should begin a good clinic.

4. Rapid and simple action of Homoeopathic remedies.

Inspite of this, the role of Homoeopathy, though very frequently adjuvant in benign cases is however very important for being taken into consideration because it may be the best system of medicine in grave cases. In a child which has digestive troubles of common type, it will be necessary to regularise the diet. When the troubles are serious Homoeopathy steps over diet. The Homoeopathic treatment will then act with some advantages, because the child has no pathological past behind it, because the troubles though serious are not intricated at first as there had not been many diseases that have stepped into one another or succeeded one after the other. There had not been successive morbid metastasis in time and space for which we will not have good results, with our Homoeopathic remedies without a thorough search in the antecedents. When we have to treat an adult we are very often forced to find out the chronological succession of the remedies indicated. As for example a woman is of Natrum muriaticum, then of Sepia, then of Lachesis and finally of Psorinum. In the case of a child we will not have any succession of remedies; there does not exist any pathological past. The child is a new organism. It has come new in the world. Generally we do not find hereditary taints in the child. These taints are there but not in vitro. We must investigate the past in the parents, not in the child. And if you add to these facts the idea that the child is extremely sensitive you will easily understand that Homoeopathy has a definite advantage over the chemotherapic treatment of the official school.

5. The past played by the morbid heredity.

Thus we arrive at the question of morbid heredity in children which leads us to study at first the nosodes from the therapeutic point of view.

The little child has therefore an immense vital force, its hereditary taints are shrouded. The famous hereditary Psora of Hahnemann is a term which suits admirably to children. It is at the end of 4, 5 6, 8 or 10 years and sometimes even later the child will be forced to purge its hereditary taints that it has received. Fortunately its organism will purge them rarely so long as it is a child. The principal means of purge are the eruptive fevers and acute diseases which are special in children: whooping cough, chicken pox, scarlatina, measles etc. The measles is an important infantile disease, which seems to us to be a real collective crisis of the cleansing of entire generation. The measles is an important cleansing disease of tubercular conditions. Scarlatina is related to hereditary psoric, tubercular and syphilitic taints. Similarly the mumps and diphtheria are related to Psoro-tubercular condition, intricated with sycosis and syphilis. The whooping cough is like measles related to tubercular condition. It is great antipsorics of Hahnemann that will be able to prevent them, but in this case there will be a spasmodic element which does not exist in case of measles. In the last case Sulphur will cause rapidly a cutaneous eruption. In whooping cough the most important thing is the localised spasm of the larynx. In this case what becomes of the idea of microbes and specific drugs? The microbe exists and it should not be considered negligible. The germs grow because they have a favourable ground and will play because of its migratory character, the part of sparks that spontaneously spring out of overheated combustibles,. In the actual life, and perhaps since thousands of years that man exist they should necessarily suffer form measles ninety times our to hundred in their childhood. So much so that Psora is so to say, anchored in us in an indefinite manner. Perhaps it had been attracted from the very moment when man began to live in caves or in a house with a roof on it, depriving himself partially of pure open air, of sun and light. Normally when we speak of naturists, about back to the nature, we think of natural food, but none among us will have the idea to live outside like an animal.

But let us not anticipate. What we may say, in reply to the question of heredity-if we admit that its influence does not act only on two or three but on numerous generations-is that the miasms of humanity have fatally left their stamps on the children: tuberculosis, syphilis, gonorrhoea, cancer. Let us not forget other diseases such as Malaria which was for so long a time of the first importance in our countries as well as in the Orient or in other countries having hot climate.

Those which seem to us more important in our region are: The Psora first of all, i.e. to say chronic tuberculinism of Dr. A. Nebel, probably associated with alimentary intoxications. or other.

The Syphilis of which the role is well-known, has surely influence on numerous generations.

The Gonorrhoea, which seems to us very important, though its influence is impossible to prove by the Homoeopathic school that it may hereditary influence the sycotic temperament in children and in adults. But from multiple facts collected from our experience we are inclined to believe that sycosis plays an important part and it is the cause of different troubles.

Finally malaria and all other possible intoxications b y alcohol, meat etc.

For each of these entities we must think of the possibility of human temperamental deviations even though there is no necessity of transmission of germs in children.

The hereditary taints in the child are not evident. They are always veiled. It is only during the second infancy these taints are revealed by means of all sorts of possible affections: eruptive fever, cutaneous troubles, spasmodic troubles and many other diseases that are not possible to enumerate here.

The treatment of the troubles of the digestive apparatus and of nutrition of the first infancy.

1. General therapeutic considerations.

How should we treat the child from Homoeopathic point of view when we compare the Homoeopathic treatment of the child with that of the adult? In children we may take into account the question of heredity and use of Nosodes. But precisely because these hereditary taints are more or less dormant, that become evident later on, and precisely because they should reveal themselves very lately, it becomes necessary that we should not treat the child in a brutal manner with nosodes.

In a general way, we may say that the great antipsorics of Hahnemann, that remedies from plants and minerals are more advantageously used in children than the remedies from the animal kingdom. You will find none of the remedies from animal kingdom on our chart because their actions are very complex. In any case these very rare remedies from the animal kingdom should be used with great care and often in relatively low potency.

As for example we should not treat brutally the child with Tuberculins of Serum of marmoreck, not because of the chance of aggravation in adult (a child generally tolerates better the Homoeopathic medicines), but because we will not get clear and favourable results. The effects of the great classic remedies are generally favourable. Some nosodes, Bacillinum, Medorrhinum

Luesinum may be indicated more often than the habitual tuberculins. On the contrary for a prenatal treatment we may act on the pregnant mother deeply and energetically with all the nosodes specially by T.K., T.R., Luesinum. When the woman is pregnant you may treat her directly for three months for her nausea and vomiting or for her sympathetic troubles. It is only towards the fourth month and up to the end you will treat almost exclusively the child by using alternately Thuja, Natrum Sulphuricum on the one hand and T. R., Medorrhinum or Luesinum on the other hand. This kind of treatment seems to act marvellously as prenatal treatment according to our personal experience.

2. Some Rules Of Prescription We are now going to study the most important basic remedies that are used in children. A clinical classification will follow later on which will serve us as the basis of the study of our homoeopathic remedies in different cases.

Let us give at first some rules of prescription for the treatment of children.

We have just said that the child has no pathological past There is no medicinal aggravation in children. This fact surprises those who come new in Homoeopathy and they are also surprised to see how easy it is to treat the child with homoeopathic medicines. One faces difficulty when one begins to do Homoeopathy with Sulphur, Lycopodium and other such remedies that have centrifugal action. These remedies may in some cases cause aggravation of eczema and liver troubles. In children everything goes well. It is generally easy to select a remedy and the organism of the child responds rapidly. It is curious to note that in children the nature seems to be at our disposal. Subjective symptoms are very much necessary in Homoeopathic treatment but in the case of a child and animals it is different. Here the objective symptoms are more important and they are the real keys that will help us to arrive rapidly to the simillimum.

On this question we may automatically make a justified remark to some of the unicists for whom homoeopathy is valuable only in subjective symptoms. They think that the objective symptoms are less important, while some homoeopaths like Dr. A. Nebel have tried to enrich the Homoeopathic pathogenesis with the fruits of their clinical researches with all the indications that one may find on the tongue, on the lips and on the face. These facts have been described but it is a mistake because numerous objective symptoms have been indicated by Hahnemann himself in his pathogenesis specially in case of a child.

Rules of Posology.

In case of a child use the high dilutions only with care inspite of the fact that the child easily tolerates them because, it is preferable to give the remedies that do not act for a long time. If you apply a very high dilution you will be forced to wait for 3, 4, or 5 months before repeating the medicine according to the general principle of homoeopathy, or you will not be able to use any other remedy and you will not be able to ascertain which of the remedies will have been effective. Or again their action may be very fleeting and you will have the risk to take time. In a child it is necessary to act soon. You should not wait for curing the vomiting of a child or cholera infantile. You should not, like some unicists, turn over the pages of a book for two hours for finding out the good remedy and thus risk the aggravation of the disease. I, however believe that fewer remedies are required for children than for the adult. Generally the cases are simple because there is no pathological past, or if you like the child has his past before it. It is, as it will show the signs of hereditary taints in the form of eruptive fevers or other affections. The affections will appear in their time. They should not be called in earlier with a misunderstood treatment, neither they should be “choked” in their appearances by forcing the eruption to get in i.e. suppressed.

A. The Basic Remedies: These are the great antipsorics of Hahnemann of which the list is somewhat revised but on the whole it is exact.

You will be astonished of the following fact: If you consider these remedies you will find that more than half a dozen of these remedies should never be used in children.

Graphites for example is very rarely a remedy of a child. It will begin to be indicated in the 2nd infancy. It is not absolutely a constitutional remedy.

Causticum will be indicated only in the 2nd infancy, in children who have partial paralysis, strabism, or other troubles like retention of urine, incontinence of urine or some manifestations having a peculiar mental symptom: the fear of darkness. But it is not generally indicated in an infant.

Similarly a child may become a Thuya child after vaccination but some time must elaps before the picture, which the British homoeopath Dr. Burnett has so clearly described to us. It is only after vaccination during the second infancy the child may have warts, brittle nails and other symptoms of Thuya.

Lachesis, Ignatia, Nux vomica, all these remedies of endocrinal imbalance are also to be considered later on . A girl who in her first infancy will require Chamomilla or Belladonna will be come a patient of Ignatia only at puberty. Dr. Nebel sometimes uses Lachesis in children before puberty when they are related to Sulphur.

Natrum sulphuricum, a remedy of hydrogenoids in particular will be indicated only in the second infancy, in asthmatic children who have the attacks during the second infancy. Asthma of a child is generally amenable to Phosphorus and Natrum muriaticum.

Many other ground remedies which are suitable to the adolescents, adults or to the second infancy are not indicated in infants.

The remedies of infants are very simple and less numerous.

First of all the three Calcareas: Calcarea carbonica, Calcarea phosphorica and Calcarea fluorica.

We have said just now that the so fecund and so useful description of Dr. A. Nebel from the clinical point of view of the osteo–articular constitutions should be supported by an experimental basis by quantitative and comparative researches of Calcium Carbonate, Calcium Phosphate and Fluoride of Calcium in the skeleton of numerous individuals of all ages. We know already that in the bones, there is 2/3 of Calcium phosphate for 20/100 of Calcium carbonate and a very small quantity of Fluoride of calcium. This fact shows that while the Carbonica are more numerous, the qualitative question is more important than the quantitative in the bone tissues that always contain these three Calcium salts.

Inspite of the above fact, it is necessary to make quantitative researches and to have physiological criteria. This is not yet done.

It is also necessary, on the basis of the antagonism of Silicate and of Calcium,specially Calcarea carbonica, to find out what is the quantity of Silicate contained in the periarticular tissues because it is said that in the Fluro-calcis, there is a great laxity of the articulations in relation to that laxity if for examples there is greater trouble of Silicate metabolism in Fluorocalcics.

Whatever it may be, we may call the age of the infants with Dr. Thooris, the age of Calcium and if the child is before all a digestive, we must try to understand how much the question of mineralisation and bones are physiologically related to the digestive system.

We see then that from the therapeutical point of view the three Calcareas are of the first importance in children. After the Calciums comes Silicea and later on Sulphur and Arsenic.

We therefore find at the basis of Homoeopathic treatment of children, acting as the best of the remedies among the habitual important remedies of morbid temperaments, the minerals that form the human organism and Arsenic, which though not a mineral, is at the basis of the constitutions. With them we may add Phosphorus but from another point of view it is only of secondary importance.

Really speaking Phosphorus has very good action in children of all ages but it is a dangerous remedy because in actual life, most of the children whom we treat are oxygenoid tubercular. They may soon suffer from ganglionary or respiratory lesions and in such cases Phosphorus should be used with great care up to the age of 18 to 20. However, there is one exception, in the case of infantile asthma which “responds” to Phosphorus 30.

Let us then leave aside Phosphorus in case of digestive troubles of children. Let us study at first the five remedies that we have already mentioned. Then we will study Lycopodium, Sepia, Thuya and other remedies that are less important: Natrum muriaticum & Iodium though they are secondary to those which we have placed on the top of our schema.

Let us first of all study comparatively the three Calcarea: Calcarea carbonica, Calcarea phosphorica and Calcarea fluorica of which the first two are more important from the clinical point of view.

Calcarea carbonica. It corresponds to all digestive and nutritional troubles of the infants at the beginning of the second infancy. The child suffers from troubles caused by milk which it does not digest. At the end of the 2nd infancy there may be rachitism or some manifestations of nutrition. Nutritional troubles are of the first importance in this remedy. If from the very birth, the child has a big head, protruded frontal eminence you will immediately think of a heredo- syphilitic child. Calcarea carbonica is a very important remedy of some heredo-syphilitic children. It acts also on Fluorocalcics of A. Nebel and Calcarea carbonica which is considered as a constitutional remedy of Carbocalcics should not be confounded here. The child cannot digest well the milk and may vomit it in curdled form; it may have acidity, sour stool. It does not like fat ands milk with too much fat is not digested by it. Calcarea carbonica perfectly suits these children.

Later on in the second infancy Calcarea carbonica will evolve towards rachitism and avitaminosis. We will have then the typical child of Calcarea carbonica: big, fat, soft, chilly, slow, indolent, always aggravated by cold, who walks late. If it is forced to walk earlier it will become bow-legged and it may have all the troubles or rickets. Thorax becomes shallow, big belly open fontanelles, perspiration on the head. It suffers from obesity. It becomes a prize baby.

One important characteristic of the child is that it desires indigestible food, chalk, charcoal etc. It seems that it desires indigestible food, chalk, charcoal etc. It seems that the child receives from the nature the indication about his troubles of Calcium metabolism, and it tries to fight against its rachitism by products which are not food. Thus it may have great desire for eggs, salt, sugar, and certain condiments. He may not have appetite.

Silicea. In opposition to Calcarea carbonica it is rather a lean child,small with a big head and a big belly. It has also sweat of the head; difficult closing of the fontanelles with early lymphatic ganglions. The ganglions of Calcarea carbonica are soft but the ganglions of Silicea are hard and small and mobile, rolling under fingers or they may suppurate. The child of Silicea may have extraganglionary boils, fistulas, cutaneous boils, respiratory boils and chronic otitis etc.

Silicea has also sour eructations like Calcarea carbonica. The child may have diarrhoea but more often constipation. It has troubles after vaccination. Very often the child who will be suitable to Thuya and will have warts towards the age of 10, will require at first Silicea.

Silicea is a remedy of the troubles of growths and athrepsia. Calcarea carbonica suits rather to rickets. Silicea may grow to become lean; Calcarea carbonica will grow towards obesity.

Calcarea phosphorica has a retracted boat like chest, the opposite of Calcarea carbonica. Calcarea phosphorica child will suffer often from colic with every trial with new food. It has diarrhoea from fruits, from fruit juices. Calcarea phosphorica is tubercular and chronic tubercular which cause in it a desire for exciting foods, either alcohol or meat. Calcarea phosphorica has rather the desire for pork, and salted meat. It is a remedy of Phosphocalcic child either pure or mixed with marked hereditary tubercular condition.

In Calcarea phosphorica, like Calcarea carbonica and Silicea the fontanelles close late and the child evolves towards anemia of the muscles. Its tissues are soft. Really speaking Calcarea phosphorica is not a remedy of rickets.

Calcarea fluorica. In Calcarea fluorica there exists a great laxity of articulations. The articulations are very lax but the glands are very hard, as hard as stones. The bad elastic tissues are seen on the surface of the veins. The child will have varicose veins in adult age. The rachitism of Calcarea fluorica is related to Syphilitic heredity (with deformations of bones like curvature of the femur, of the tibia etc.). Heredo-syphilis is marked specially on the sense organs. The child will have in the very early age, suppurations of the eye lids, blepharitis, otitis etc.

Some Homoeopaths use Luesinum as a rule with Calcarea fluorica and Aurum metallicum specially in children who suffer form otitis and during dentition. Teething is particularly difficult in Calcarea fluorica because the child has not enough place in his maxilla, so that the teeth may grow easily. The teeth grow obliquely. You may see all the signs of syphilitic heredity on the teeth, for example dented teeth, the gingival palate etc. Calcarea fluorica corresponds to this picture.

After these four very important constitutional remedies are to be studied. We will speak at first of Iodum and Natrum muriaticum. They will be required somewhat late, generally at the end of the first infancy or during the second infancy.

Natrum muriaticum. It is a remedy of the troubles of growth of children who remain lean for a longtime, who do not develop well or who remain a cretin.

As regards cretinism, the child who is very slow to develop is also suitable to Silicea, to Natrum Muriaticum or specially to Baryta carbonica. In such cases we should think of a very ancient syphilis which has attacked the endocrines specially the hypophisary. Baryta carbonica will be the specific remedy of heredo-syphilitic, Silicea of the heredo-tubercular and Natrum muriaticum 200 being the constitutional remedy for fixing the salts of Calcium and to help the child to gain weight.

We must compare Natrum muriaticum with Serum de Quinton or with Aqua Marina. In some patients lower triturations of Natrum muriaticum are necessary. It is Arnulphy, a famous homoeopath of Nice, who first proved the value of this remedy. Arnulphy worked with Quinton. Our colleague Jarricot of Lyon continued the use of Serum de Quinton. Unfortunately, I believe that actually this remedy is very rarely used. However, it is a valuable arm in many cases of athrepsia or of nutritional troubles of the infants.

Iodium. It is to be given in cases of marasmus or to children suffering from indurated glands with troubles of nutrition. The child eats well but becomes lean and evolves rapidly towards tuberculosis. But this remedy is more interesting in the second infancy.

Thuya. It is equally useful in the 2 nd infancy for troubles relating to sycosis and vaccination.

Sulphur. A child may soon require Sulphur. Sulphur is generally called the king of antipsorics. For Hahnemann Calcarea carbonica was the king of Antipsorics. He considered the value of heredity because the more one is a Homoeopath the more he gives importance to heredity from the pathological and therapeutic point of view. We shall not hesitate to go back in search of syphilis to several generations and not two or three generations only as some homoeopaths teach. But Sulphur has as well as Calcarea carbonica, a deep action on hereditary taints.

In the symptoms that indicate the primordial agent of hereditary force in Calcarea carbonica, we should note one very important symptom, the mydriasis. It is a child suitable to Calcarea carbonica. In acute case Chamomilla or Belladonna is necessary.

Sulphur will therefore be necessary to drain out, in a brutal manner, all the possible toxins. It is with Sulphur we will begin the treatment of measles, whooping cough and most of the infantile diseases.

Sulphur is inconvenient only, as explained by P. Chavanon, in children who have easy suppurative tendency. We will help the nature to play the part of fire, and the condition of the child will ameliorate at the cost of a possible otitis or any other suppuration that may become dangerous. A single dose of Sulphur given prematurely to a child who has the maximum suppurative tendency, will improve the general condition, but will aggravate the local conditions. There is therefore antagonism between general and local interest of the organism.

Sulphur is an important remedy and should be used in lower or medium dilutions and should be very rarely repeated.

The important indications of Sulphur, though it does not enter in the present study, is the incontinence of urine. With Calcarea carbonica, Sulphur is of the first importance in incontinence of urine in children. It is with Sulphur 200 followed by Plantago 6 and Equisetum 30 we will have frequent and regular success in the treatment of bed wetting in children.

We will besides find cramp rings almost always in the iris of these children and hereditary syphilis.

Lycopodium. It is a remedy of children of all ages.

I have Lycopodium in our schema immediately after Calcarea and Sulphur because there are digestive troubles which are related either to cutaneous sphere (Sulphur) or to the liver (Lycopodium).

The principal indication of Lycopodium is loss of appetite in all ages.

There is hardly a child in whom we cannot bring back the appetite. I have never failed even in a single case. Anorexia called nervous or mental seems to us in reality to be of hepatic origin because we cure it by liver remedies. It is here, where homoeopathy is really interesting because here we have to make a particular mental gymnastic. The officials at first make a pathogenesis and they gather a group of symptoms. The difficulty is that there is often a great distance between diagnosis and therapeutics. There is often an abyss to cross. One may not always cross over this difficulty. In homoeopathy we have always some landmark in our reasoning. From symptoms to therapeutics from therapeutics to clinic our mind shuttles many times and we constantly the confirmation by touch-stone treatment. We may bring back the appetite of infants or of children of the 2nd infancy or of girls at the time of puberty who keep themselves closed in a room, who like solitude. Their condition is cured with Sepia. When puberty will make them hypertensive of the portal veins and when there is pelvic and liver congestion, we will bring back their appetite. But it is rather with Lycopodium we will be able to bring back their appetite., We will cure the mental type of anorexia of the first or of the second infancy. We therefore think that we are right to think that if everytime we cure them with remedies like Lycopodium or by other remedies of hepatic insufficiency, that the anorexia which is called mental is in reality of hepatic origin or perhaps hepatopancreatic origin. It may exist with some mental troubles, but it is before all glandular and is often related to more or less ancient hereditary syphilis.

We will cure marvellously some nervous anorexias with Lycopodium in children who are soon satisfied who leave always half of their milk.

Lycopodium will also be useful in cyclic vomiting with Senna.

B. Functional remedies of different syndromes of nutrition.

Now we come to the properly called homoeopathic remedies. Let us examine some syndromes of nutrition from the clinical point of view.

1. Athrepsia, congenital weakness, anemia.

2. Troubles of growth, rickets and its satellite troubles.

3. All the liver troubles with Lycopodium, from mental anorexia to acetonomy.

4. Vomiting, diarrhoea, dyspepsia, infantile cholera, dysentery, enterocolitis and constipation, are the most important syndromes. Then we will broach rapidly colics, constipations and we will say something on erythema which is related to digestive troubles.

1. Athrepsia, congenital weakness, anemia.

These diseases are classic in children who are brought up with artificial milk or with food that does not contain sufficient vitamins. We have no homoeopathic remedy like fruit vitamins and we will also give orange juice or juices of other fruits. We will however follow the principles of naturists and will give one or two drops daily while the official school will apply quantity of acid fruit juice daily. We will thus avoid the troubles of demineralisation.

But when we have children suffering from marasmus, who are mere skeletons without flesh and who rapidly proceeds towards death we will think of Silicea (30 or even 200); Natrum muriaticum, Iodium, the basic remedies and in the Materia medica we will find some more important remedies: Abrotanum, Arsenicum iodatum, which are very important in pre-tubercular or tubercular children who become emaciated very rapidly. They should be used in the 3rd dilution or in triturations. In other cases Calcarea silicata in chilly children. Ferrum metallicum and Pulsatilla will be indicated in anemic children (anemia of children for want of air). In such cases quantity of milk should be diminished and food with assimilable iron should be used. In such cases we may use Ferrum metallicum 30. Pulsatilla is an excellent drainer of tubercular patients. Children suffering from marasmus are more or less tubercular.

2. Rickets, troubles of growth.

In rickets we have spoken of Calcarea carbonica, Silicea, Lycopodium, afterwards Natrum muriaticum & Abrotanum. We should also think of Baryta carbonica which is the best remedy of cretinism of children who cannot speak well, who walk late, who are intellectually late. Baryta carbonica is one of the principal remedies in retarded children. We should also think of Luesinum and Hepato-Luesinum. The latter seems very often more active.

Sulphur iodatum may be indicated in emaciation of children , in oxygenoid children of tubercular constitution. Dr. Parteneau has given a prescription having a reconsitituting power which is very useful in children. Here is the formula.

Sulphur 6

Iodium 6

Calcarea phos }

Calcarea carb } IX

Calcarea flour }

It is a good medicinal combination which will help the emaciated child to take up weight. It seems that the lower dilutions of Iodium and Sulphur are necessary and Natrum muriaticum 200 will also be necessary to fix the salts of Calcium Oleum jecoris aselli (codliver oil), may be given in homoeopathy may be given according to the official doses, but it may cause digestive troubles.

Thus we come to the question of Vitamins.

We should also think of Organotherapy in all cases of the troubles of growth. We must not forget that syphilis is the basic factor of endocrinal troubles, next comes tuberculosis.

In children of tubercular constitution Arsenicum iodatum helps the child to take up weight and Kali iodatum in syphilitic child.

Aurum metallicum may be added to the list.

3. Anorexia and hepatic troubles: In Anorexia the important basic remedy is Lycopodium but it should often be followed by remedies directly acting on nausea and vomiting such as Ipeca and Antimonium crudum, according as the tongue is clean or covered with while patch.

In anorexia of children I generally give Lycopodium 30 one dose every 10 days, Calcarea phos 6, sometimes Arsenicum album and sometimes Silicea according to the symptoms.

If there is vomiting Ipecac is indicated.

When there is acetonemic vomiting Belladonna, Senna, Causticum, Lycopodium.

In these cases Lecithin may be given in gross doses. Lecithin has sometimes good actions.

On the whole with a few remedies Anorexia may be cured.

Sepia may be given in the second infancy when the child eats and digest only what is defended to it. Hard cheese, vinaigre, salted food (like Phosphorus & Natrum muriaticum). Sepia will be indicated in children of Iodium type who desires to remain alone.

Really speaking Sepia is a remedy of Anorexia of girls of 14, 15 or 16 years of ages, who have arrived at the age of puberty, who isolate themselves and say eating is a taxation to them. We can cure them easily with Sepia 200 & Nux vomica 30 followed by Luesinum. If the cure is delayed Luesinum should be used alternately with Lycopodium.

4. Vomiting and Diarrhoea.

In vomiting and diarrhoea and diarrhoea I will place Aethusa cynapium on the top of the list. But Dr. Renard has convinced me about the great value of Ipeca in infants. Let Dr. Renard speak.

Dr. Renard-Ipeca is indicated not only in the vomiting of infants but also in diarrhoea of infants. There are children who have alternate diarrhoea and constipation. The stools may be green; the colour of the stool may be normal when passed but becomes green afterwards. Ipeca should be given not in dilution but in mother tincture, one drop with hot water, sometimes 2 drops a dose four times a day.

Dr. Bernoville- We may then say that it is a marvellous remedy but it should be used in the required doses.

Generally when you have to treat mechanical troubles i.e. materially palpable such as digestive troubles, lower dilutions even the mother tincture should be used. For sympathetic troubles and mental troubles the high dilutions are required as for example you may use Ipeca 30 or 200 in asthma. If you want to cure the fit of whooping-cough use Ipeca 6 or 30.

Aethusa cynapium -Aethusa cynapium and Antimonium crudum are also two interesting remedies. The second is to be given in vomiting of children having a white washed tongue, and temperament like that of a Calcarea carbonica child.

Aethusa cynapium is a very important remedy. It is a remedy of the Ombellifera family and like all other remedies of this family it has spasms with all its troubles; sudden vomiting immediately after sucking or taking milk; vomiting of big clots of milk. It is a very faithful remedy. Generally it is given in the 6th dilution.

You see that generally the homoeopathic therapeutics is easy in children. The remedies are less numerous and easy to handle.

In cyclic vomiting Iris versicolor, Mercurius dulcis, and Senna give good results. The vomiting may be acetonemic when Senna will give good result.

In diarrhoea there are many remedies easy to handle. These remedies are of vegetable and mineral origin. The minerals seem to act slowly but deeply while the vegetables act very rapidly specially in acute cases.

In infantile cholera we should chose from among Veratrum album, Antimonium crudum, Cuprum, and Camphora.

Veratrum and Camphora are more important in infantile cholera where there is the danger of collapse of the heart; the child becomes ice-cold, cyanotic, having cold sweat on the forehead during and after stool.

Camphora has the pinched nose, the face is cold. The stage of collapse.

I repeat again here Veratrum is more important, then comes Cuprum and Camphora. Antimonium crudum is indicated in more benign cases.

These remedies are also of the first importance in Asiatic cholera. In France this disease is now absent. Homoeopathy has taken its root in countries where there is an epidemic of this terrible disease. In Brasil, Homoeopathy has obtained the official consideration since the epidemic of yellow fever in which Homoeopathy was so much successful so that it is recognised by the official authorities.

These remedies act in infantile cholera as well as in Asiatic cholera.

Chamomilla, Podophyllum and China may be compared and all the three act well when the stool is clear yellow.

Chamomilla has the stool like that of rotten egg mixed as if with chopped spinach. Diarrhoea during dentition like that of Podophyllum, specially indicated in diarrhoea in the summer or during hot climate. The child has tendency to prolapsus of the anus.

China is to be used when there is great dehydration with diarrhoea.

Mercurius solubilis and Mercurius corrosivus have greenish stools but those of the first is mixed with mucous, aggravation during night. The mouth of the patient is humid with thirst, the tongue is swollen, having imprint of the teeth.

Mercurius corrosivus has stomatitis and tenesmus of the abdomen or of the rectum. There may be ulceration and terrible pains.

Argentum nitricum, Ipeca and Aconite have green stools. Ipeca has stools like chopped spinach.

Aconite is an excellent remedy when the child has green stools with agitation, anxiety and great thirst.

Argentum nitricum has also greenish stools. Abuse of sweets. Stools becomes green rapidly. Stools, immediately after suckling.

Ipeca has green stools, sometimes glairy, sometimes mixed with blood. Cramping pain around the navel region.

Belladonna may also be indicated in green stools with spasmodic constriction of the anus. The important character is aggravation by the least contact. The child does not like that one touches his belly.

Magnesia carbonica and Rheum, with Calcarea carbonica are the three remedies of sour smelling stool in children.

Aethusa. We have already studied this remedy.

Kreosotum is indicated in children who have dental troubles. Caries of teeth which become black and crumbles.

Kali bichromicum is to be compared with Mercurius solubilis and especially in dysentery (Ipeca, Kali bichromicum, Arsenicum, Mercurius corrosivus, are specially used in bacillary dysentery).

Capsicum is useful in muco-membranous enterocolitis, with much burning sensation, false membranes in stools.

Colics. In colics of infants Chamomilla is the remedy of angry children who should be always carried, who have dental troubles like that of Belladonna and Mercurius solubilis.

Belladonna has fever and throbbing pains; Chamomilla is irritable and capricious; Mercurius solubilis has aggravation at night and in the heat of the bed.

China has diarrhoea with much flatus in the abdomen.

Colocynth has amelioration by doubling forward or by drawing the legs on the abdomen.

Veratrum album h as great abdominal pain; infantile cholera. Magnesia phosphorica has the same modality like that of Colocynth.

Dioscoria also is to be thought of (when there is amelioration by bending backwards).

Constipation: In constipation the remedies are very easy to apply. We will apply Calcarea, Lycopodium, Natrum muriaticum followed by Bryonia and Taraxacum two very important remedies.

Bryonia when the child has no desire of stools. When the stools are brown and large in quantity.

Taraxacum when the constipation is of hepatic origin. It acts better in 3x. It has map-like tongue. Natrum muriaticum has also somewhat similar tongue.

Graphites is interesting in fat children having tendency to obesity and chilliness.

Opium is interesting in constipation without desire. It is to be given in the 30 th potency like Bryonia. Stools are hard and like small balls.

Magnesia muriaticum is a related to Natrum muriaticum as regards dry stools, which comes out in crumbs.

Alumina is a remedy of constipation without desire. The patient is constipated even when the stools are soft. It is also useful in cutaneous troubles and erythema.

Cutaneous troubles and erythema. Chamomilla and Belladonna are useful in erythema with extreme hypersensitive skin specially during dentition. In Belladonna there is the classic triade; redness, heat and pain.

Rhus toxicodendron and Causticum should be given if there are vesicles (small vesicles Rhus tox, large vesicles Causticum). In pemphigus Rhus toxicodendron and Causticum may be useful.

When there is hereditary taints Luecimum or Hepato-Luecimum and sometimes Lycopodium or other ground remedies are to be used.

In cases of traumatism or reddish skin aggravated or caused by: too much tight dresses Arnica is to be used.

We should also treat local infections by external application Calendula or Calendula ointment, or dying powder such as talcum.