And I have seen quite a number of Chamomilla babies who were teething, with acutely inflamed gums, who did develop convulsions. So evidently you have got an explosive nervous system in the Chamomilla child, and you have to be a little chary about letting it go too far.
“What potency do you give to a teething child ?”.
Teething children do quite well on low potency. A few doses usually stops all the disturbance, 12 or 30, two hourly, in the average case. But where you have a violent attack, give possibly every half-hour until they quiet down.
There is one other condition for which you commonly need Chamomilla, and that is the acute otitis in children. It is a frightfully painful condition, and in most of these acute otitis cases the child doesnt want to be touched, and it is intensely irritable, very often yells with the pain; and if you get a history that has been brought on from exposure to cold, I think Chamomilla is one of your greatest standbys in the small child, particularly if you have got the one-sided flush with it. I should think when I was in general practice I cleared more acute otitis in small children with Chamomilla than with any other single drug.
And you can clear it up quite well without any puncture of the drum or anything of that sort; the whole thing simply subsides. But you have got to have the Chamomilla make-up as well as the otitis, otherwise Chamomilla does not work. In other works, their nervous system has to be all the fret, and they have got o be irritable and touchy, otherwise Chamomilla does not do it. In other words, you get the Pulsatilla from the same cause, exposure to cold, again with otitis media, and one- sided flush; but it is a Pulsatilla child, not a Chamomilla one, and Chamomilla wont do it any good. I think they are the two commonest drugs-at least they were in the practice I was doing.
Again in CINA you can practically duplicate the symptoms on the notes, and yet it is and entirely different patient one is dealing with.
No. 6.
WELL, we have got to try and finish this to-day, because we dont meet again, and I think thee are still four of these drugs to get through so I will try and cut them as short as possible. I will try and give you the salient features of them without any unnecessary padding.
I think last day we finished up with Chamomilla, and the next one is CINA which is a very interesting comparison with Chamomilla because I think you will agree that most people start with a dose of Chamomilla and if it doesnt work they give a dose of Cina, and it isnt a very scientific way of proceeding, and I think it is better to have a clear idea of what Cina is like and where the difficulties arise.
I think the outstanding mental distinction between the Chamomilla child and the Cina child is that in Cina you have got a degree of obstinacy that you never meet with in the Chamomilla. The Chamomilla kid is always unstable; the Cina child can be as obstinate as a mule. I think that is the main mental distinction.
Then there are various other points which are a help. I think the first one is that in Chamomilla you are likely to get an irregular flushing-flushing of one cheek and pallor of the other. You may get the whole face red, but you are more likely to get the irregular distribution. In the Cina child you much more commonly get a circumscribed red patch on the cheeks, and very often a noticeable pallor about the mouth, the mouth and nose.
Then I think the next thing about them is-I mean the next distinguishing thing about them-is that both dislike to be handled, they both resent interference, but in the Chamomilla it is much more mental resentment, whereas the Cina child is definitely tender to touch.
You will very often find that you get the same description of the two, that they will yell when you handle them, but you find that once you get over the preliminary discomfort of handling in the Cina children they are quite peaceful, they allow you to carry them about, it will quiet them down; whereas in the Chamomilla they are wanting distraction all the time, if you stop walking about with them they are likely to strike at you, they are always wanting to be doing something new. You do not get that reaction in the Cina. But the Cina kid will want you to go on carrying it; in other words, the steady, passive motion does soothe them down.
Then there is another distinguishing point in Cina which you do not get in Chamomilla; the Cina children are very apt to be sick, and so are the Chamomilla ones, but you will commonly find that in the Cina children, after they have vomited, and almost immediately after, they are hungry. And you will very often find the Cina children are crying out for more food immediately after a meal. And in the Cina child you are very likely to get a story of nightmares, night terrors, if the child has had a late meal.
Then, another thing that will help you when you are distinguishing between Chamomilla and Cina is in their diarrhoeic upsets. They both get diarrhoea. The typical Chamomilla green stool is noticeably absent in Cina. The typical Cina stool is a white stool-a very white, watery stool.
And there is one constant characteristic about the Cina child, both in its digestive upsets and ordinarily too, and that is that it gets relief from pressure on the abdomen; if it has got a colic it will turn over on to its tummy. If it is being carried about while it has a colic it will turn over the nurses arm so as to get pressure on its tummy; if it is restless at night, again it turns over on to the abdomen and is at peace.
Then as far as their temperature reactions. The Cina kids are always chilly; they are sensitive to any draughts of air, and they are very liable to get irregular muscular twitchings, particularly after any excitement, and very often you will notice it particularly in the muscles of the face.
Then in the slightly older children there is another mental characteristic of the Cina child, and that is that they are frightfully touchy, they have got a complete inability to see a joke of any kind, particularly if it refers to themselves.
Then there is another thing that is worth remembering about the Cina children, and that is that they all have a hyperaesthesia of the head, the head is sensitive to jarring, and they have a hyperaesthesia of the scalp. So that if you are ever wanting to soothe down a Cina child dont go and stroke its hair, otherwise you will know that you have got a Cina kid.
Then there is one other point about them which I have noticed quite frequently, and that is that they have a most inordinate habit of yawning; they yawn, and yawn, and yawn, as if they would dislocate their jaws. And I have seen several of these Cina children now who have been brought to me with a definite history of acidosis, which I always tend to link up with their yawning tendency.
Then there are two other points which always make me think of the possibility of a childs being Cina. One is that with their intestinal upsets they become very restless, very liable to get meningeal irritation, with constant agitation of their head, rubbing it into the pillow, and without definite meningitis they tend to develop a squint-an internal squint.
And the other point which always makes me think of the possibility of Cina is that all these Cina kids appear to develop an irritation of the nose, it is red, itchy, and they pick at it-and that is quite apart from getting thread worms or anything of the kind. If I get a yawning child coming in and picking its nose I always explore the possibility of its being a Cina, and very often it is. So you see there are pretty definite distinguishing points between Cina and Chamomilla, and you shouldnt have to try one and then the other.
Then the real reason why I put MAG. CARB. in after Cina was in connection with the diarrhoeic attacks. Mag. carb. and Cina are the two most commonly indicated drugs for diarrhoeic attacks accompanied by these peculiarly white stools. And apart from the Mag. carb. is an interesting drug in kids.
The ordinary Mag. carb. child is a sensitive, nervous type of child, and as a rule one comes across them either as very young children or round about ten years of age. And I think the most outstanding feature of the Mag. carb. children is their lack of stamina. They have got-some of them are quite well nourished-but they have got very poor muscular power. You know you handle an ordinary healthy child, the muscles are quite firm; whereas the Mag. carb. child has got soft, flabby muscles, and any physical exertion tires them out.
You will get exactly the same sort of mental reaction. The older child at school gets mentally tired out; it will come home with a violent neuralgic headache. And the neuralgic headaches of the Mag. carb. school child are pretty definite; they are pretty violent pains, maybe any part of the head, and they tend to come on at night. They are accompanied by very marked sleeplessness, the child cant get to sleep at all, and strangely enough they are better if the child is up and going about.
