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Jacqueline Tan/ PG-799

Thesis Presentation By Post Graduate Student 2008


Name: Jacqueline Tan Topic: Homeopathic Management of Aggressive and Defiant Children Offered to The British Institute of Homeopathy, UK
Singapore Faculty of Homeopathy
(Local Examiner: - Dr. Mrs. Deepa Desai)

Jacqueline Tan/ PG-799

Contents
1. Introduction.5 2. Disruptive Behavior Disorders....7 3. Associative Features and Disorders.......11 4. Causes of Oppositional Defiant Disorder and Conduct Disorder......16 5. Neurological Causes..17 6. Psychiatric Assessment..22 7. Treatment of Oppositional Defiant Disorder and Conduct Disorder.22 8. Differential Diagnosis....24 9. Pharmacotherapy..26 10. Prognosis..32 11. Prevention.....32 12. Right Parenting.32 Alternative Management 13. Alternative Treatments.33 14. Bach Flower Remedies.34 15. Ayurveda..35 16. Aromatherapy...38 17. Chinese Medicine.39 18. Meditation....41 19. Reiki.42 20. Mudras.43 21. Hypnotherapy...45 22. Sound and Music Therapy....45 23. Nutrition...46 24. Biochemic Tissue Salts47 Homeopathy 25. What is Homeopathy?............................................................................................48 26. Homeopathy Case-Taking.49 27. Hahnemann and other masters on Mental and Emotional Diseases.51 28. Hahnemann on Nature of Chronic Disease..52 29. Potentisation.59 30. Posology...59 31. Repertorial Analysis61 32. The Three Kingdoms68 33. Homeopathic Efficacy.82 34. Case Studies.83 35. Conclusion......114 36. Bibliography...115

Jacqueline Tan/ PG-799

Acknowledgement Almost three years of Homeopathic studies, culminates to this dissertation which was finally crystallised after many weeks of rumination. For this, I would first like to thank Bhagawan Sri Sathya Sai Baba for initiating me into the healing path, and for being my Source of Inspiration and encouragement. I would also like to thank Dr. Rangachari for his ever constant attention and concern for all the Singapore Faculty of homeopathy students. I would also like to show my gratitude to Dr. Jit K. Aggarwal for teaching me vibrionic healing. Both are good lightworkers of God and great engines for expanding alternative healing knowledge and free service in their countries and beyond. I would also like to thank Dr. Mrs. Deepa Desai for her support and her advice in my dissertation research, as well as other seniors, who have kindly contributed their case studies. Last but not least, I would like to thank my family and loved ones, especially my parents for their unconditional love and for giving me the opportunity to learn and grow independently.

Jacqueline Tan/ PG-799

Abstract Aggression and misbehaviors in children are highly prevalent in todays society. How can bringing up and teaching children in the 21st century be so much more challenging than a few decades ago? Does bombardment of new technology, changing family and economic structure play such a huge role in the hyperactivity and aggression of children today? Or did these disorders simply go unnoticed in children of the years gone by? Cases of disruptive behavioral disorders and mood disorders have often gone unnoticed by parents who choose to think that aggression and misbehaviors in children are temporary, normal growing up phenomenon and do not warrant much notice. Many do not bother going to the allopathic doctors and even if they do, many cases remain improperly diagnosed. Sometimes, parents and caregivers think that mental and emotional cases are beyond the reach of medical help, as at times, symptoms of misbehavior may not be sufficient to be diagnosed as one of the recognized mental disorders. Irrespective of situations, homeopathy offers its benefits in treating with children with the above issues. This dissertation was compiled to provide an easy understanding of the different therapies available for these children and how homeopathy can help. Topics included focus mainly on the symptomatic pictures of Disruptive Behavioral Disorders, namely, Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) in relation to aggression and defiance, and the current medical treatments and interventions available. Associative features and mood disorders such as Bipolar Disorder (BPD) and Attention Deficit Hyperactivity Disorder (ADHD) are also covered in some detail so as to bring about a broader understanding on Disruptive Behaviors. Bipolar Disorder was included as it covers symptoms of depression and mania, and violence. It is imperative that we understand these common behavioural disorders in order to avoid under, over and misdiagnosis of aggressive and defiant children. The highlight of this dissertation lies in the homeopathic approach to management of Disruptive Behavioral Disorders and includes useful homeopathic remedies, which can be taken alongside allopathic remedies for a more rounded response to healing. Homeopathic case studies on aggressive and defiant children were included for justification purposes. Rubric and repertorial analysis of 27 homeopathic remedies that best fits the symptomatic pictures of Conduct Disorder and Oppositional Defiant Disorder with possibility of use in mood disorders and Attention Deficit Hyperactivity Disorder are also added. In addition, other existing allopathic and alternative systems of medicines are also covered for a more rounded perspective.

Jacqueline Tan/ PG-799

1. Introduction
Violent behaviour in children and juvenile delinquency is a worrying worldwide phenomenon. In the United States, the 1999 Columbine High School massacre where 2 teenagers killed 12 students and a teacher still reverberate in the minds of many when violent youth crimes are concerned. In 2008, the Sunday Telegraph reported that United Kingdom had a one-third increase in violent crimes committed by children and youth. Total offences rose by 21% from 2003 to 222,750 in 2006, with violent crimes and robberies at an even higher rate1. Many were also joining street gangs, which increased an individuals ability to be engaged in crime. United Nations stated that economies in transition saw a 30% increase in juvenile crimes, mostly associated with alcohol or substance abuse2. Even if criminal offence is not an issue, authorities and parents worldwide are finding increasing number of children who are hyperactive, aggressive and violent. For parents who are at their wits, they will often send their children for diagnosis. More often than not, these aggressive and defiant children are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), Disruptive Behavior Disorders or/and Mood Disorders. Disruptive Behavior Disorders and Mood Disorders, have a high co-morbidity with Attention Deficit Hyperactivity Disorder (ADHD). These children are mostly prescribed with allopathic medications which are able to help in many cases, but may come along with its side effects. More can be done medically to arrive at a wholesome and permanent cure for the children and youths who are the future leaders of the world. Violent youths and adolescents often start behaving aggressively as children. Evidences point to an increasing number of children with aggression and defiance, at earlier ages. Onset of aggression in younger children (age 3) is the most significant indicator of delinquency, violence and substance abuse in later years. In 2008, Times reported that England saw a total of 4,000 suspensions in children aged 5 and lower. 310 of the 400 suspension cases of children aged 2 and 3 involved physical attack or threat on another child or the teacher, with behavior ranging from biting, hitting, throwing chairs and shouting abuses at the victim3. The total suspensions age 2-11 came up to more than 45,500, with age 9 making up about a quarter; most cases involve violence or threat of violence. ADHD, for example, is a commonly occurring problem that affects 8-10% of school aged children, although in most cases it starts even prior to schooling4. Not accounting for comorbidity with ADHD, Oppositional Defiant Disorder affects between 2-16% of the children and adolescent population5. Goodwin estimated that serious Conduct Disorder affects 4-5% of the children and youth population6. Another observation was that many individuals 10-25% with CD, ODD, ADHD, Major Depressive Disorder and Dysthmic Disorder have learning disorders. The National Institute of Mental Health estimates that 2040% of the 4,000,000 children in the United States with learning disabilities may be prone to recurrent defiance or malicious conduct and may be diagnosed with ADHD and oppositional defiant disorder (ODD) or conduct disorder7.

Jacqueline Tan/ PG-799

Mood disorders take up another chunk of diseased children, although the numbers may be overlapping with disruptive behavior disorder. Approximately 3% of children and 12% of teenage population have been diagnosed with depression8. Bipolar disorder, a disease that was recently thought to occur in adults, amounted to less than 7% of all childhood mental health disorders9. Visits to the doctors showed that bipolar disorder registered a 40 times increase between 1994 and 2003. Nearly all doctors interviewed believed that bipolar disorder, a severe illness, is overdiagnosed, with Leibenlufts studies at the National Institute of Mental Health, supporting that only 20% of the bipolar disorder children meet the criteria for the disease. Thus, pointing out to the importance of understanding the symptoms during case taking. The symptoms associated with the disruptive behavioral disorder and its associative disorders and the corresponding features are given here for clearer understanding and diagnosis.

Jacqueline Tan/ PG-799

2. Disruptive Behaviour Disorders


A. What is Oppositional Defiant Disorder? Diagnostic Features of Oppositional Defiant Disorder According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)10, Oppositional Defiant Disorder is defined by a recurrent pattern of negativistic, hostile, disobedient and defiant behavior towards parents or other authorities for a minimum of 6 months11. To qualify for ODD, it must occur more frequently than is observed in children or adolescents of comparable age and developmental level and must significantly affect the functioning academically, socially or occupationally. Diagnosis of ODD is not made if the above behaviors occur due to a Psychotic or Mood Disorder, Conduct Disorder or Antisocial Personality Disorder (in individuals over 18 years of age). For diagnosis of ODD, at least 4 of the 8 symptoms must occur regularly: Losing temper Arguing with adults Actively defying or refusing to comply with adults'/ elders requests or rules Deliberately annoying people Blaming others for his mistakes or misbehavior Being touchy or easily annoyed by others Being angry or resentful Being spiteful or vindictive Expressions of Oppositional Defiant Disorder include: Verbal aggression (as opposed to physical aggression of Conduct Disorder) Persistent stubbornness Resistance to directions Not willing to give in, compromise or negotiate Deliberate or persistent testing of limits ODD children may show inability to engage in play quietly, disrupt the play activity of others and even break toys. They may also like to drag their meal times and fight over food options. Rebellion may arise in terms of personal appearance, hygiene, time schedules. Conflicts frequently arise with parents, teachers or peers. Parent and child tend to bring out the worst in each other when they are in conflict. An important factor to note is that many ODD children do not consider themselves to be defiant or oppositional, but felt that their behaviors were justifiable given the unacceptable claims or situations. Thus, medical practitioners should better understand this as it may present the underlying cause of the disorder (e.g. lack of love, want of attention at home). Age and Gender ODD is usually evident prior to age 8 and not later than early adolescence. ODD is more commonly seen in males who are highly sensitive, difficult being soothed in their preschool years or are highly reactive. After puberty, the numbers seem to be more equalized between males and females.

Jacqueline Tan/ PG-799

Prevalence Oppositional Defiant Disorder is predominantly present in the home during interactions with people that the ODD child knows well. It may not be apparent in the school or community setting, or during clinical examination. Hence family members become important sources of information for the early detection of ODD. Onset Onset is typically gradual, occurring over months or years. ODD symptoms tend to increase with age. ODD is a common antecedent for childhood onset of CD, especially among males. However, many children with ODD do not end up developing CD. Diagnostic Studies Studies must be done to ensure that the disruptive behavior is not due to other causes. Thyroid studies should be conducted to ensure there are no hyperthyroid or hypothyroid conditions. Neurological studies to ascertain that there are no organic brain problems. Psychological testing should be conducted to rule out giftedness, borderline retardation, and anxiety disorders, and assess learning abilities12.

Jacqueline Tan/ PG-799

B. What is Conduct Disorder? Diagnostic Features of Conduct Disorder Conduct Disorder children are also defiant, oppositional and hostile. However, Conduct Disorder is a more serious behavioral problem compared to ODD as Conduct Disorder is defined by a set of persistent behavior that violates the basic rights of others or major age-appropriate societal norms or rules13. To be diagnosed with Conduct Disorder, there needs to be significant malfunctioning on the academic, social or occupational arena; and criteria should not be fulfilled in Antisocial Personality Disorder for individuals aged 18 and above. There also needs to be at least 3 presenting symptoms in the past 12 months and at least 1 symptom in the past 6 months: Aggression to people and animals 1. often bullies, threatens, or intimidates others 2. often initiates physical fights 3. has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun) 4. has been physically cruel to people 5. has been physically cruel to animals 6. has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) 7. has forced someone into sexual activity Deliberate Destruction of property 8. has deliberately engaged in fire setting with the intention of causing serious damage 9. has deliberately destroyed others' property (other than by fire setting e.g. smashing car windows, school vandalism ) Deceitfulness or theft 10. has broken into someone else's house, building, or car 11. often lies or break promises to obtain goods or favors or to avoid debts or obligations (i.e., "cons" others) 12. has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery) Serious violations of rules 13. often stays out at night despite parental prohibitions, begin before age 13 years 14. has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period) 15. often truant from school, beginning before age 13 years. Older children are absent from work without good reason Onset Types Conduct Disorder is differentiated by 3 Onset types:

Jacqueline Tan/ PG-799

1. Childhood-Onset Type: onset of at least 1 criterion characteristic of Conduct Disorder prior to age 10 years. There is more physical aggression, disturbed peer relationships, and possibility of co-morbid ADHD. 2. Adolescent-Onset Type: absence of any criteria of Conduct Disorder prior to age 10 years. There is less physical aggression and more normative peer relationships. 3. Unspecified-Onset: age at onset is unknown Severity of Conduct Disorder There are 3 main levels of severity: 1. Mild Symptoms are few in excess of those required to make diagnosis; Conduct Disorder that cause minor harm to others e.g. lying, truancy, staying out after dark without permission 2. Moderate - Number of conduct problems and severity is between "mild" and "severe" e.g. stealing without confronting a victim, vandalism 3. Severe - Many conduct problems in excess of those required to make diagnosis; Conduct problems that cause considerable harm to others e.g. forced sex, physical cruelty, use of weapon, stealing while confronting victim, breaking and entering Age and Gender Features Conduct Disorder is more prevalent in males. Symptoms of the disorder tend to vary according to age, typically with the milder symptoms appearing first. However, there are cases where individuals engage in the more detrimental acts at an early age. Males with conduct disorder tend to have a more confrontational approach compared to females. Males with CD tend to exhibit fighting, stealing, vandalism, and school discipline problems compared to females who tend to lie, play truant, engage in substance abuse and prostitution. Prevalence Conduct disorder appears to be higher in urban than rural areas. CD seems to exist in 110% of child population. Course Conduct disorder can start occurring at preschool years, with the first significant symptoms appearing from middle childhood through middle adolescence, with rare onset after age 16. In majority of individuals, CD would have remitted by adulthood, particularly those with adolescent onset and those with fewer and milder symptoms. However, those with early onset have higher risk for Antisocial Personality Disorder and Substance-related Disorder in adulthood. Disruptive Behavior Disorder Not Otherwise Specified This disorder is used for characterizing cases with conduct or oppositional defiant behavior and sufficient significant clinical impairment, but do not meet the full criterias of ODD and CD.

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3. Associated Features and Disorders14


Associative features and disorders vary with age and severity of ODD and CD. It is necessary to treat any co-occurring disorders, diseases or substance abuse because they can cause or worsen irritability or defiance if left untreated. A. Pre-School Years ODD and CD children in their preschool years often show signs of being easily irritated, are hypersensitive to external stimuli and are difficult to be soothed. B. School Years: Associated Features and Disorders of ODD and CD 1. Low self-esteem (CD has additional projected image of toughness) 2. Over inflated self-esteem 3. Poor frustration tolerance 4. Irritability 5. Mood lability 6. Lower than average verbal IQ and reading skills 7. Learning or communication disorder 8. Anxiety disorder 9. Mood disorder 10. Psychotic disorder 11. Substance-related disorders of drugs, tobacco, alcohol; indiscriminate use 12. ADHD C. Associated Features and Disorder of CD 1. Little empathy or concern for the feeling, wishes, well-being of others 2. Misperceive intentions of others as being more hostile and threatening, they then respond with aggression that they think is justified 3. Callous, lack guilt or remorse. Expressed remorse may not be genuine 4. Inform on companions; blame others for their own misdeeds 5. Temper outbursts 6. Recklessness and risk-taking acts. Accident rates are higher in CD than non CD 7. Early onset of sexual behavior 8. Suicide ideation, attempted and completed suicides at a higher rate than normal

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D. Understanding associated Attention Deficit Hyperactivity Disorder ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity in children and is higher in intensity and more detrimental than it is for children of similar developmental stages; with impairments in at least 2 environments such as at home, school or work. These symptoms should be present before the age of 7. Approximately half of children with ADHD have either ODD or CD. The rates of ADHD children with these ODD or CD is higher than those with other mental disorders; with higher incidence in the 2 sub-types marked by hyperactivity-impulsivity.15 Thus, it is important for us to understand the symptoms covering ADHD so that we can identify it as a separate disorder during diagnosis. The symptoms of ADHD are as follows:

Inattention 1. Failure to pay close attention to details or make careless mistakes in tasks 2. Work is disorganized, careless, done without thought; individuals have difficulty keeping their attention in activities and find it difficult to persist until completion 3. As if the individuals mind is elsewhere, he is not hearing or listening to others requests and instructions 4. Often move from one activity to another without completion; frequent shifts in conversations 5. Failure to complete task is due to inattention and not other reasons like defiance 6. Strong dislike or aversion towards tasks that require self-application, more mental effort, higher concentration or organizational skills 7. Materials required for task are often scattered, lost, carelessly handled or damaged 8. Easily distracted by stimuli such as noises or events that are ignored by others 9. Forgetful in daily activities Hyperactivity 1. Fidgeting or squirming in ones seat 2. Not seated when expected to do so 3. Inappropriate and excessive climbing or running 4. Difficulty engaging in activities quietly 5. As if always on the go or propelled by a motor 6. Talking excessively 7. Fidget with objects, tap their hands, shake their legs or feet excessively 8. Restlessness 9. Impulsive: impatient, difficulty delaying response, awaiting ones turn; prone to accidents and is reckless 10. Interrupt, intrude others, initiate talks, touch things, grab objects inappropriately; make a fool Hence, ADHD can be classified into 3 subtypes: (1) predominantly inattentive, (2) predominantly hyperactive-impulsive, (3) combined type.

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E. Understanding associated Mood Disorders


Mood Disorders itself is a major topic and it covers all types of depression and mania. Since Bipolar Disorder covers symptomatic picture of both depression and mania, and majority of children with Bipolar Disorder exhibit aggressive and violent behaviors, Bipolar Disorder shall be used as a reference. Depression Depression in children must be differentiated from the usual feeling of sadness. It is only when depression affects the family, school and social life of the child, does it warrant the diagnosis. Depression in children has similar symptoms when compared to adults (Table below). Additional symptoms include: (1) being fearful, anxious, tense; (2) repeated rejection or lack of interaction with peers; (3) weak academic performance; (4) restless with inability to concentrate or boredom; (5) repeated shouting or complaining; (6) physical complaints without medical cause like headache or stomachache16. Mania Mania is characterized by severe irritability with prolonged temper outbursts. Symptoms of aggression is a reason for the great need of psychiatric hospitalizations in manic children. Mania in children is often misinterpreted as ADHD. ADHD is sometimes the first manifestation of mania. Elevated mood, flight of thoughts, decreased sleep and hypersexuality(in children who have not been abused or witnessed adult sexual behavior) and grandiosity are the best symptoms to differentiate mania and ADHD. Bullying may be an age specific symptom of grandiosity, but precaution has to be taken for correct diagnosis17. Symptoms of Major Depressive Episode, Manic, Mixed, Hypomania Episodes18 Major Depressive Episode Experience of 5 or more symptoms that persist nearly every day for 2 weeks 1. Irritability e.g. angry outburst, frustration, blame others, exaggerated response to minor incidents, persistent anger. Agitation (inability to sit still, pacing, hand wringing, pull or rub skin, clothing etc.) 2. Sadness/depressed/ hopelessness 3. Disinterest in activities which were previously of interest 4. Decreased appetite or failure to make weight gain/ increased appetite/ Crave sweets or carbohydrate 5. Changes in Sleep pattern e.g. Insomnia/ Hypersomnia 6. Decreased energy, tiredness, fatigue / Manic Episode Abnormally or persistent elevated mood that last for at least a week 1. inflated self grandiosity 2. decreased need for sleep 3. talkative, pressured need to talk 4. flight of ideas or subjective experience that thoughts are racing 5. distractability 6. increased goal directed activity or psychomotor agitation 7. excessive involvement of pleasurable activities that may have painful consequences Mixed Episode Symptoms of both manic and a Major Depressive Episode to occur everyday for at least 1 week 13

Jacqueline Tan/ PG-799

Slowed physical and mental activities Hypomania and muteness 1. elevated mood or irritability for at least 7. Sense of worthlessness or guilt 4 days 8. Impaired ability to think, concentrate or 2. include at least 3-4 symptoms of mania make decisions episode 9. Suicide ideation Possible: body aches

Bipolar Disorder Bipolar Disorder was virtually believed to be non-existent in children until a revolution in child psychiatry in the late 20th century. Bipolar disorder in children and adolescents is a more severe illness than that in older teenagers and adults. Many children with Bipolar remains undiagnosed, which is serious as the longer the bipolar disorder remains untreated, the worse is the long term prognosis such as the high suicide rate, with as much as 10-15% of bipolar patients committed suicide19. Bipolar I Disorder Involves: 1. One or more manic or mixed episodes 2. Often have had one or more Major Depressive Episodes 3. Recurrence is indicated if there is a change in the polarity of the episode (e.g. Major Depressive Disorder episode to Manic or Mixed episode) or an interval between episodes of 2 months without manic symptoms Other specifications: Longitudinal Course Specifiers (with or without interepisode recovery); With Seasonal Pattern; Rapid cycling is often manifested in children prior to or soon after puberty. Bipolar II Disorder Involves: 1. 1 or more Major Depressive Episode with at least 1 hypomania episodes 2. Presence of Manic or Mixed Episode In Bipolar I and II Disorders, there must be significant impairment in functioning at work, home or school setting. The symptoms should also not be better accounted for by Substance Abuse Disorder, general medical conditions or other Mood Disorders such as Schizoaffective Disorder and are not superimposed on Schizophrenia, Delusional Disorder, Psychotic Disorder20. Children and adolescents show a higher percentage of mixed symptoms, with simultaneous expression of depression and mania or rapidly changing moods. Instead of euphoria, children more commonly exhibit intense emotion lability and irritability. The Bipolar Child, a successful book published by the psychiatrist Demitri Papolos and his wife, Janice, in 1999, noted that one striking symptom present was the craving for excessive carbohydrate21. 14

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Bipolar children are mostly males. A long term study shows that one-third of the children with the less severe Bipolar II, often switches to the more severe Bipolar I as they age. However, there are also children who seem to have recovered after they become adults, although a person who has had a manic episode has a higher probability of having another. Differential Diagnosis In late adolescents, bipolar disorder is often mistaken for schizophrenia and conduct disorder; while for younger children ADHD has been difficult to differentiate from bipolar disorder, with high rate of coexistence between the two which tend to decrease with increasing age. Children with ADHD tend to develop bipolar disorder between 11 and 12 years old, often showing depressive symptoms first. For youths with major depression, about a third develops mania/bipolar disorder. The manic rating scale by Fristad, Weller and Weller can help differentiate manic and hyperactive children.22

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4. Causes of Oppositional Defiant Disorder and Conduct Disorder


Till now, there is no one definite cause, but possible contributing causes23 are:

The childs innate personality and behavior such as children with history of difficult infant temperament The family and parents poor relationship dynamics with the child such as a nonloving relationship, not giving the child sufficient attention and time Permissive parenting style, lack of boundaries and structure in the childs daily life Unhealthy environmental conditions such as family instability Genetic Component Biological brain injuries or damage; chemical imbalance in the brain Childs awareness that throwing tantrums will get him what he wants

Risk Factors for Oppositional Defiant Disorder and Conduct Disorder Since Disruptive Behavioral Disorders are complex, several risk factors may lead to the development of ODD24:

At least one parent or sibling with a history of mental disorders: ADHD, Oppositional Disorder or Conduct Disorder, Anti-social Personality Disorder, Substance-related or Mood Disorder (e.g. depression) A mother who smokes during pregnancy Being a victim or witness of abuse or neglect Harsh, inconsistent or ineffective parenting. Some cultures and families do not allow room for individual differences. Some parents misunderstand average or increased developmental oppositions as the childrens defiance. Ineffective parenting may lead to a power struggle, setting the backdrop for oppositional defiant disorder25. Lack of supervision Poor relationship with at least one parent e.g. lack of love and concern. Sometimes, disruptive behavior is learnt as a way for gaining adult attention. Family instability such as marital discord, divorce, multiple moves (military moves, changing schools or child care providers frequently), financial problems, poor relationship with siblings Exposure to violence such as watching violent programmes, playing video or computer games, growing up in a violent neighborhood Peer rejection or delinquent association Substance abuse by parent or child e.g. alcohol, drug Early institutional living Large family size

Causes of ADHD26 Hereditary: At least 2 genes have been associated with ADHD Brain structure Brain chemicals neurotransmitters Learning disabilities

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Medical conditions (hyper or hypothyroidism; food intolerances or allergies such as milk, nuts, eggs, shellfish, wheat and soya; pets, mold, dust mites, artificial food, sweeteners and preservatives, caffeine and tobacco smoke) and mental health conditions (like ODD and CD) Tourettes syndrome A mother who takes alcohol and drug during pregnancy. Cellphone usage during pregnancy also increase hyperactivity, inattention and other behavioral problems27 Lead and other toxic poisoning

Risk Factors for Bipolar Disorder Anticipation hypothesis genes become more concentrated over generations, bringing stronger and faster onset of illness over the generations Assortive mating hypothesis couples with Bipolar Disorder tend to be attracted to each other, resulting in greater concentration of genetic offload to descendents

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5. Neurological Causes: Brain abnormalities


Frontal Lobes The frontal lobes are necessary for organizing, impulse control, attention and inhibiting responses to stimulation. The prefrontal part of the lobes is responsible for the interaction of thought, emotions and behaviour28. The motor cortex controls the body movements, while the left frontal lobe is important for speech. Dr. Jeste and Dr. Meeks recent research found that medial pre-frontal cortex is activated when altruistic behavior is called for29. They also suggested that for making moral decisions, certain brain areas are utilized: the rational (the dorsolateral prefrontal cortex brain region that is also used in sustained attention and memory), emotional/social (medial pre-frontal cortex), and conflict awareness (the anterior cingulated cortex, also associated with intuition)30. Studies have shown that children and adolescent with frontal lobe and prefrontal cortex injuries, lesions and impairments often suffer long-term undesirable modifications in their behaviors, especially that towards Conduct Disorder, followed by impulsive, uncontrollable behaviors31. Individuals with prefrontal functional deficit such as lower neuronal density, abnormal phosphate and glucose metabolism tend to exhibit aggressive and impulsive behavior. Research by Neuroscientist Jean Decety and colleagues confirmed that aggressive adolescents did not activate the brain areas involved in moral and social reasoning (the paracingulate cortex and temporoparietal junction) compared to their control group32. Temporal Lobes Temporal lobes are important for hearing and memory. Since the temporal lobes are linked to the limbic system, the temporal lobes seem to be related to emotions such as anger, fear, lust and jealousy. Jeste and Meeks observed that the neurobiology of wisdom involves a balance between the newest brain regions such as the pre-frontal cortex, and the more primitive brain regions, which is the limbic system. Diagram 1: The Lobes of the Human Brain

www.med

Diagram 2 FRONTAL LOBE

TEMPORAL LOBE

Source: www.psykologi.uio.no

Source: www.medem.com

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Limbic System The limbic system (Diagram 2.) connects emotions with thoughts and perceptions. Dr. Mrs. Charanjit Ghooi stated that feelings like empathy, humility, regret, pride, covetousness and moral discrimination are the products of a developed limbic system which regulates mans behavior within a boundary and prevent it from being overly rational and emotional. Abhigail Marsh, Ph.D and colleagues found out that there was less amygdala activity in youths with disruptive behaviors (ODD and CD) and callous, unemotional characteristics than their control group, when they were tested for empathy33. The same youths also had less communication between the amygdala and the ventromedial frontal cortex. Decety added that the amygdala and ventral striatum (which responds to feeling rewarded) were intensely activated in aggressive adolescent boys in non-empathetic situations when they watched pain being inflicted on others, which suggested that they took pleasure in others sufferings. ADHD versus Disruptive Behaviors Marsh also evidenced that ADHD and callous, unemotional characteristics have different biological background, although these individuals share the same impulsive and irresponsible behavior. ADHD tests show smaller basal ganglia (nerve clusters involved in routine behaviors) and reduced frontal lobe activity in ADHD34. Katya Rubia, Ph.D and colleagues cited in their research that inhibition mediating pre-frontal regions seem reduced in ADHD, whereas the posterior temporal-parietal region seemed dysfunctional in conduct disorder35. Diagram 2

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Neurotransmitter Findings36 Oppositional Defiant Disorder and Conduct Disorder have been associated with improper functioning of special chemicals in the brain called neurotransmitters. Neurotransmitters aid brain nerve cells in proper communication with each other. Serotonin, norepinephrine and dopamine are neurotransmitters related to emotions and behaviors. When these chemicals are imbalanced or not functioning well, communication and relay of information within the brain may become hampered, leading to behavioral symptoms. Studies show that monoamine neurotransmitter abnormalities have been indicated in aggressive, defiant and antisocial individuals. Serotonin is responsible for sending signal to an individual to avoid harm. Serotonin dysfunction causes a lack of capacity for behavioral inhibition and hence leads to episodic aggression. The main metabolite of Serotonin, 5-Hydroxyindoleacetic acid (5-HIAA), appeared low in adults with early onset alcoholism and violent suicidal behavior (Steiner and Wilson, 1999). Adolescents with conduct disorder also have a low platelet serotonin count (Unis and Cook, 1997). In addition, 5-HIAA and homovanillic acid is also observed to be inversely related to aggression in a group of ODD boys (Van Goozen et al, 1999). Stoff et. al (1989) reported unbalanced platelet monoamine oxidase levels in disruptive behavior disorders, while lower levels of methoxyhydroxyphenyl glycol also exist in aggressive patients (Steiner and Wilson, 1999). In ADHD individuals, it has been observed that they only have 10-25% of the levels of Dopamine and Norepinephrine compared to non-ADHD individuals, thus affecting the stimulation and repression of the brain cells 37 . Depression has also been linked to abnormalities in neurotransmitters serotonin, norepinephrine, and dopamine38. Low levels of Serotonin has been linked to depression. Low levels of Norepinephrine is related to inattention and distractibility. While low levels of Dopamine leads to inability to control impulsive behavior, the increase in dopamine production during violent video games is similar to that smoking marijuana, injecting amphetamines or consuming the ADD drug, Ritalin. Children playing video games are addicted to the higher level of dopamine and cannot concentrate without them39.

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Diagram 3: Neuron and Synapse

Source: www.humanillnesses.com

Autonomic Findings40 Conduct Disorder individuals possess autonomic hypoactivity, which leads to slower responses to stressful stimuli or arousals such as those required to escape harm. Raine et al (1995) discovered that 15 year old males with higher electrodermal and cardiovascular arousal were less likely to be engaged in criminal activities by age 29 than those with less reactivity.

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6. Psychiatric Assessment41
The current psychiatric method of assessment gathers information from multiple sources regarding the mental and behavioral signs, symptoms and risk factors of children with disruptive behavioral problems. Besides diagnostic interviews, information can come from rating scales and a review of records from the school, healthcare and mental health clinics, and juvenile court (Wiener et al, 2004). Commonly used disruptive behavior rating scales include The Child Behavior Checklist (Achenbach, 1992), Iowa Conners Aggression Factor (Loney and Milich, 1985) and the Modified Overt Aggression Scale (Kay et. al, 1988). The teachers and peers poor rating of the childs behavior and likeability in school are also important markers of disruptive behaviors. To fully understand the etiology, treatment and prognosis, knowledge about the cognitive and developmental history, social impact such as family setting and dynamics, and other biopsychosocial information is pertinent. Working with aggressive and defiant young patients also require prudence and management of behaviors of patients such as missed appointments, reckless behavior and speech and potential legal problems, which may be targeted towards the patient or the therapist. Children and adolescents with Disruptive Behavioral Disorders have different psychopathology due to the different social and health histories. Some children, solely have conduct disorder or oppositional defiant disorder. Others are inflicted with ADHD or/and other mood or mental disorders such as depression and psychosis. Thus, a full description of the presenting and non-presenting symptoms of the behavioral disorder, an awareness of other possible disorders, overlapping symptoms in the disorders and comorbidity needs to be known. Differential Diagnosis can help classify and distinguish the disorders (see Diagram 4 and Table 1).

7. Treatment of Oppositional Defiant Disorder and Conduct Disorder42


There is a variety of treatment for youths with disruptive behaviors. According to Weiner and Dulcan (2004), the settings include inpatient psychiatric units, residential and day treatment centers, correctional facilities, and outpatient settings. Therapies available include: behavioral, cognitive, family, individual, group, parent management training, systems theory based and pharmacotherapy. In general, a multi-treatment approach over an extended period that covers the areas of impairments has an evidently higher chance of success (Steiner, 1997). These treatments also benefit children and adolescents suffering from ADHD and mood disorders. Skills Training Disruptive Behavioral Disorder children and adolescents with difficulty in their cognitive abilities will undergo treatments that aid them in their communication, anger and impulse control and problem solving skills (Faulstich et. al, 1988). Successful approaches include 22

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role-play, modeling, rehearsal, and self-evaluation (Kazdin, 1987); with problem-solving skills training providing more pro-social behavior than relationship therapy.

Family-Focused Treatments Tolan et. al (1986) found consistently good results from family therapy, especially in terms of behavioral, structural, strategic and communication techniques. Functional family therapy that increase reciprocity, improve family communication and well-being towards each other have good empirical results (Kazdin, 1987), however, the efficacy still depends on the severity of the dysfunction, treatment duration and external social support. Parent management training that attempts to break coercive parenting style and foster prosocial behaviors are also effective. Another good practice is the multi-systemic approach based on the systems theory that attempts to identify and inhibit disruptive behaviors from being rewarded, and improve the upbringing of the child (Henggeller et. al, 1998). Peer and School-based Interventions Initial studies show that social skills programmes that seek to improve peer relationships (Bierman and Furman, 1984), as well as academic skills programmes that reduce school drop-out rates can help lower the risk of anti-social behaviors (Kellam et. al, 1991). Parents and teachers have to work side by side to update each other on observations, as well as finding ways to help encourage the children and help them get back on track.

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8. Differential Diagnosis
Children displaying symptoms of a disorder need to be checked for other possible disorders to prevent misdiagnosis. According to the DSM-IV-TR Handbook of Differential Diagnosis, psychiatry nosology can make further breakthrough in the study and classification of aggression. Below is a simplified diagnosis method, in chronological order, derived from Decision Tree for behavior problems in a child or adolescent43: Diagram 4: Decision Tree for Differential Diagnosis Behavior Problem Diagnosis

Due to the direct effect of a substance abuse: No Due to the direct effect of a medical condition: No Associated with low IQ and impairment in adaptive functioning: No Yes

Occurring as part of a pattern of antisocial behavior No Part of a pattern of negativistic, hostile and defiant behavior No Yes

Conduct Disorder (age 18 and below)

Yes Behavior occurs more frequently than typical for child of that age and causes clinically significant impairment No No Mental Disorder Occurs in at least 2 situations and causes clinically significant impairment and distress; onset before age 7 No

Yes Oppositional Defiant Disorder

Part of a pattern of inattention and/or hyperactivity No

Yes Attention - Deficit Hyperactivity Disorder

In the context of elevated, depressed or irritable mood No In the context of a delusion or hallucination in the absence of mood disturbance

Yes

Manic, Hypomanic or Mixed Episode, Major Depressive Episode, Dysthmic Disorder, Cyclothymic Disorder

Yes

Schizophrenia, Schizophreniform, Schizoaffective, Delusional, Brief Psychotic Disorder

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Table 1: Differential Diagnosis of ODD, CD and ADHD44


Differential Diagnosis of Oppositional Defiant Disorder Other possible diagnosis Reasons for its diagnosis 1 Nonpathological oppositional behavior Non clinically significant and typically non persistent typical of certain developmental stages 2 Adjustment Disorder Maladaptive response to stressor and does not meet ODD criterias 3 Conduct Disorder More severe; marked aggressive and antisocial behaviors. ODD not diagnosed if criterias for CD are met 4 Oppositional behavior in Mood or Occurs in Mood Disturbances or in presence of delusions Psychotic Disorder and hallucinations 5 Oppositional behavior in Attention Occurs secondarily due to problems of inattention and Deficit Hyperactivity Disorder hyperactivity 6 Oppositional behavior in Mental Less severe and accompanied by intellectual Retardation development delay 7 Antisocial Personality Disorder In individuals over age 18 Differential Diagnosis for Conduct Disorder Other possible diagnosis Reasons for its diagnosis 1 Disruptive behavior in Oppositional Focuses on negativistic and defiant that are less severe Defiant Disorder and not antisocial. ODD not diagnosed if criteria for Conduct Disorder are fulfilled 2 3 4 5 6 7 Disruptive behavior in ADHD Antisocial due to Psychotic Disorder Antisocial behavior in Manic Episode Adjustment Disorder Child or adolescent antisocial behavior Hyperactive, non-antisocial impulse control symptoms In response to delusions or hallucinations Accompanied by elevated or irritable mood; occur more during circumscribed periods of disturbance Cause is a psychosocial stressor as compared to a more severe chronic behavior in Conduct Disorder Less severe than Conduct Disorder and is not part of chronic pattern of CD (isolated antisocial acts) No underlying dysfunction in individual. Aggression was necessary for survival and protection In individuals over age 18 Reasons for its diagnosis Does not lead to significant clinical impairments such as vision or hearing problems Due to boredom From unwillingness to conform to others' demands Is associated with a pattern of antisocial behavior Marked defect in social relations, serious delays in language, restricted range of behaviors and interests Usually occur after age 7. ADHD is not diagnosed if inattention is better accounted by mental disorders such as Schizophrenia or other Psychotic Disorder Should remit once substance or medication is removed and is diagnosed with Substance-related Disorders or unknown side effects of medications

Aggressive behavior for individuals from war-ravaged or high-crime areas 8 Antisocial Personality Disorder Differential Diagnosis for ADHD Other possible diagnosis 1 Age-appropriate behaviors in children 2 3 4 5 6 Understimulating environment Inattention in ODD Impulsivity in Conduct Disorder Inattention or hyperactivity in Pervasive Developmental Disorders Inattention due to mental disorders

Inattention or hyperactivity caused by Substance Abuse or medications (e.g. bronchodilator)

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9. Pharmacotherapy45
Oppositional Defiant Disorder and Conduct Disorders are behavioral disorder and psychotropic drugs have not indicated any consistent effectiveness in providing a permanent cure46. However, these psychotropic drugs are still used to treatment with the intention of reducing aggression and disruptive behavior. Psychotropic medications can mildly sedate anger. The possible advantages of all medications have to be weighed against the consequences of taking the medications, which can result in serious damage and permanent side effects. Below is a list of medications used that can be at least partially effective in reducing the symptoms of aggression and anger in children. Antipsychotic Medications Antipsychotic drugs are often used to treat acute and chronic aggression, to reduce tantrums and sedate ADHD, ODD, CD and Intermittent Explosive Disorder, Major Depressive Disorder, Bipolar Disorder, Schizophrenia, Borderline Personality Disorder children and adolescents. Haloperidol, an older antipsychotic drug for example, has proven effective in reducing aggression, tantrums and explosiveness (Werry and Aman, 1975) 47 . However, newer antipsychotic drugs are increasingly used for treatment of serious aggression as they are less prone to serious side effects like tardive dyskinesia. Risperidone, a newer drug, was far better than placebo in a small double-blind test of conduct disorder youths (Findling et. al, 2000)48. However, Risperidone and many other allopathic medications effect tend to wear off at night, thus causing many parents t o search for alternative solutions to pull their children through the night. Table 2: Antipsychotic Symptoms Treated and Drug Side Effect Drug Names Antipsychotic Medications Haldol (haloperidol) older, high potency Risperdal (risperidone) newer, atypical Zyprexa (olanzapine) original Seroquel (quetiapine) newer, atypical Geodon (ziprasidone) newer, atypical Abilify (aripiprazole) newer, atypical Thorazine (chlopromazine) older, low potency Related Symptoms treated Hallucinations Delusions Paranoia Unable to keep train of thought Agitation Anger and irritability Violence and Aggression Hyperactivity Impulsivity Mania Insomnia = Thorazine not named for Bipolar Disorder and ADHD =Schizophrenia also use Clozaril (clozapine) Common Side Effects Weight gain (50-100lb in teenagers, but uncommon with Geodon or Abilify) Sedation, sleepiness and fatigue Muscle stiffness Dry mouth Constipation Blurred vision Urinary retention (inability to urinate) or urinary hesitation Nausea Stomach upset Dizziness Sun sensitivity of skin; burns and rashes

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Mood Stabilizers Mood stabilizers are used for children with ODD, CD, Major Depressive Disorder, Bipolar Disorder, Schizophrenia, Borderline Personality Disorder and Intermittent Explosive Disorder. Lithium or anticonvulsants are useful for comorbid bipolar and conduct disorder (Arredondo and Butler, 1994) and in lowering aggression and explosive behavior in children with behavioral disorder and neurological impairments (DeLong and Aldershof, 1987). Haloperidol and Lithium Carbonate are effective in reducing behavioral problems in treatment-resistant hospitalized children with conduct disorder (Campbell et. al, 1984, 1995). Carbamazepines benefits are still uncertain (Cueva et. al, 1996) 49 , while Valproate was effective in youths with explosive temper and mood changes. Mood stabilizers, in combination with psychostimulants have been proven to be clinically safe and effective in the treatment of ADHD in children with mania compared to the sole use of psychostimulants which may trigger affective episodes in these children. Psychiatric management is required in addition to medications especially during the adolescent period of a bipolar child. Table 3: Mood Stabilizers Symptoms Treated and Drug Side Effect Mood Stabilizers

Eskalith, Lithobid (lithium) Depakote (valproate) Tegretol (carbamazepine) Equetro (carbamazepine) Trileptal (oxcarbaxepine) Lamictal (lamotrigine) Topamax (topiramate)

Related Symptoms treated Mania Agitation Anger and irritability Violence and aggression Hyperactivity Impulsivity Depression Insomnia

Common Side Effects


Sedation, fatigue, lethargy Dizziness Nausea Unsteady walking except Lithium Vomiting (except Topamax) Tremor (except Lamictal) Weight gain (except Trileptal & Topamax) Diarrhea (except Trileptal & Topamax) Headaches (except Depakote, Tegretol, Equetro) Confusion (except Lithium, Lamictal) Constipation (Tegretol, Equetro, Lamictal)

Other common symptoms: Lithium excessive thirst, frequent urinating, dehydration Lamictal insomnia, rash (non lethal) Topamax memory difficulty, burning or prickling sensation on the skin (paresthesia), nervousness, weight loss Topamax and Trileptal Slowed thinking, slurred speech, blurred or double vision

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Antihypertensives Antihypertensives are used in ODD, ADHD* and Intermittent Explosive Disorder. Clonidine is proved to be able to reduce aggression in ADHD children with comorbid ODD or CD (Connor et al, 2000) 50 . Propranolol, on the other hand, works well in lowering aggression in children and adolescents with chronic brain impairments and resistant to other pharmacological methods. Table 4: Antihypertensives Symptoms Treated and Drug Side Effect Antihypertensives Alpha 2 Adrenergic Receptor Agonists (Alpha Agonists) Catapres* (clonidine); or Tenex* (guanfacine) Beta Adrenergic Receptor Antagonists (Beta Blockers) Inderal LA (propranolol); or Tenormin (atenolol) Related Symptoms treated Hyperactivity Agitation Anger and irritability Violence and aggression Impulsivity Anxiety Tremors Motor tics Common Side Effects Slowed heart rate Low blood pressure Dizziness Fatigue, weakness or sleepiness Dry eyes and mouth in Alpha Agonists Rare but non lethal side effects: nausea, constipation, insomnia, bad dreams, depression; Alpha-Agonists: vomiting; Beta Blockers: diarrhea, lack of breath

Amphetamines Amphetamines are widely prescribed for children who lack attention or have ADHD, as it treats the symptoms of poor concentration and not diagnosis. They are, however, not used to treat anxiety as they tend to increase anxiety and agitation. The benefits of Amphetamines are that they improve concentration and academic performance. Despite the success, Amphetamines will not be able to modify the behavior of children who deliberately resist the drugs effects. Due to their efficacy, these drugs have been abused by college students and parents who used them to improve their own or their childrens academic performance, without concern for the side effects the drugs cause. Some addicted students even used it to achieve a high state. Ritalin, for example, is able to increase the production of neurotransmitters Dopamine and Norepinephrine to normal range, thus increasing attention and reducing impulsivity. Ritalin, which is commonly prescribed for ADHD children, tend to aggravate problems in Bipolar Disorder children and make them nastier and more aggressive. ADHD children are found to do better when there is an all-rounded treatments, rather than just being treated through medications. Examples include changes in the teaching approach, teacher to student ratio, behavior modification program and having a better homework study space and home routine. Hence, those whose treatment program includes only stimulant medication remain at a high risk for vandalism, petty crime, alcohol and drug abuse51. 28

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Table 5: Amphetamines Symptoms Treated and Drug Side Effect Drug Names Amphetamines Ritalin or ritalin LA (methylphenidate) Concerta (methylphenidate) Metadate CD (methylphenidate) Methylin ER (methylphenidate) Dexadrine (dextroamphetamine) DextroStat (dextroamphetamine) Adderall XR (dextroamphetamine) Focalin (dexmethylphenidate) Norepinephrine reuptake inhibitor Strattera (atomoxetine) Works in similar way as Tricyclic depression medications. Require 6 weeks to take effect Related Symptoms treated Poor concentration Inattention Distraction Low energy Tiredness Sleepiness Common Side Effects

Hyperactivity Poor attention

Insomnia Loss of appetite Weight Loss Stunted growth Irritability, anger, agitation, violence Depression Anxiety Increased heart rate Increased blood pressure Nausea Stomach upset Decreased appetite Insomnia Dry mouth Constipation Dizziness

Other possible side effects of amphetamines include motor tics, seizures and possibly psychosis that may be resolved once medication is discontinued. However, motor tics can sometimes become a permanent condition. Care should also be taken when a child with cardiac condition is put on Adderall XR and Strattera. Rare but potentially serious side effects of Strattera include increased blood pressure and heart rate. AntiDepressant Medications AntiDepressant Medications are used to treat Intermittent Explosive Disorder, Major Depressive Disorder, Bipolar Disorder, Generalized Anxiety Disorder, Borderline Personality Disorder, ADHD*. The common side effects and symptoms treated are given in Table 6 below. Due to the high comorbidity between conduct disorder and depression, antidepressants are commonly prescribed for such cases. In a sample of boys with comorbid major depressive disorder and conduct disorder, imipramine was found to reduce conduct disorder symptoms (Puig-Antich, 1982). Trazodone was tested to be effective in treating aggressive children (Ghazziudin and Alessi, 1992). In comorbid ADD and conduct disorder cases (Simeon et. al, 1986), as well as comorbid ADHD, substance use and conduct disorder cases (Riggs et. al, 1998) 52 , treatment with buprioprion improved the behavior. Serotonin reuptake inhibitors, typically used as antidepressants, are supposed to have antiaggressive effects. However, in an open trial, no positive effects were demonstrated 29

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and verbal aggression was seen to have risen (Constantino et. al, 1997)53. More studies need to be conducted to better research the efficacy of antidepression drugs on conduct disorder. Table 6: AntiDepressants Symptoms treated and Common Side Effects AntiDepressants Selective Serotonin Reuptake Inhibitors (SSRI) Prozac (fluoxetine) Paxil (paroxetine) Zoloft (sertraline) Luvox (fluvoxamine) Celexa (citalopram) Lexapro (escitalopram) Combined Serotonin and Norepinephrine Reuptake Inhibitors Effexor XR(venlafaxine) Cymbalta (duloxetine) Dopamine Reuptake Inhibitors Wellbutrin XL (buproprion) Presynaptic Alpha Adrenergic Antagonist Remeron (mirtazapine) Tricyclic Antidepressants Tofranil (imipramine) Pamelor (nortriptyline) Elavil (amitriptyline) Sinequan (doxepin) Anafranil(clomipramine) Serotonin Reuptake Inhibitors Desyrel (trazadone) Monoamine Oxidase Inhibitor (MAO-I) Parnate (tranylcypromine) Nardil (phenelzine) Eldepryl (selegiline) Symptoms treated Anger Agitation Sleep problems Nightmares due to trauma Appetite problems Sad or depressed mood Anxiety, nervousness, fearfulness Panic attacks Obsessions e.g. eating Compulsions Low energy, fatigue Poor concentration due to depressed or anxious moods Hopelessness Suicidal thoughts Common Side Effects Nausea Stomach upset Dry mouth Decreased appetite (except Remeron & Tricyclic Antidepressants) Sleepiness except for Wellbutrin XL SSRI Insomnia Diarrhea For Non SSRI Constipation Dizziness (except for Wellbutrin XL) Increased appetite and weight gain (except for Dopamine and =Tofranil, Pamelor, Elavil, Serotonin Reuptake Sinequan and Anafril not Inhibitors, and for Bipolar Disorder Wellbutrin XL) *Wellbutrin XL =All used for ADHD Headache, insomnia, except Anafril restlessness Tricyclic =Desyrel used for Antidepressants insomnia and nightmares blurred vision, urinary in traumatized children, retention & hesitation with or without depression Desyrel headache MAO-I Insomnia, muscle pain and stiffness

In 2004, parents claimed that Selective Serotonin Reuptake inhibitors caused their adolescents to attempt or commit suicide. However, Dr. Julio Licinios research proved that SSRI actually reduce suicide rates in United States54. As soon as the energy level of patients are restored to pre-depression period, which will take about 6 weeks, all 30

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symptoms including suicidal ideation will be resolved. Hence, parents should watch their children in the initial stage of their treatment when the depression symptoms still exist. Rare but potentially permanent or serious side effects of: 1. Serotonin and Norepinephrine Reuptake Inhibitors increased blood pressure 2. Dopamine Reuptake Inhibitors over recommended doses increase seizures 3. Remeron Agranulocytosis (reduced production of white blood cells) 4. Tricyclic Antidepressants Heart complications; overdosage in suicide attempts 5. Serotonin Reuptake Inhibitors Heart complications and Priapism 6. MAO-I Tyramine-Induced Hypertensive Crisis thus is rarely used as children cannot eat tyramines rich food such as cheese, meat, beans, pickled products, packaged soups, orange pulp and alcohol

Psychotherapy, not just Pharmacotherapy It is crucial to understand the side effects of medications used in treating aggressive and oppositional children for homeopathic doctors as certain symptoms will then be understood as possibly due to the side effects of medications and may then be given less importance during case taking. According to Dr. Elizabeth J. Roberts, medicated children with Conduct Disorder still continue to exhibit aggressive and hostile behaviors as no medication can teach a child the difference between moral and immoral behavior. Hence, it is crucial to couple medications with behavioral training. The earlier the child is started on the behavioral program, the higher are the chances for success.

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10. Prognosis55
The clinical results show that more severe, chronic conduct disorder takes a longer time to treat than mild ones (American Psychiatric Association, 1994). Aggressive conduct disorder has a worse prognosis with studies showing half of boys continuing to have aggressive behavior even 2 years after treatment; with indicators like fire-setting, earlyonset, family instability and lack of attention accounting for the worse prognosis (Stewart and Kelso, 1987). Other factors like antisocial behaviors in multiple settings like school, home and community, as well as having a range of antisocial behaviors also worsen the prognosis (Rutter and Giller, 1984).

11. Prevention56
Moffitt and Caspi (2001) suggest that early intervention and treatment of children with neurodevelopment impairments is helpful. Preventions targeted at the risk factors may mitigate the problem. Early efforts at helping children with parent training intervention, academic and skills training, school and community-based interventions can help stem the tides against disruptive behaviors (Weiner et. al, 2004). Goodwin advised early intervention for children with conduct disorder at 5 or 6 years old, as opposed to age 11 and above, as the chances of the teenagers entering criminal justice system will increase, leading to less successful intervention.

12. Right Parenting


Upbringing of the child involves many personal choices and is influenced by the culture and past experiences of the parents. In our day and age, the line between right and wrong has become blurred. Many parents have also forgotten the fact that they are the first few generations to bring up their children with the latest technologies that come with their own set of clout. Best parenting techniques entail the use of simple, yet timeless practices. Loving a child comes easily for most parents, but not disciplining a child. A parent needs to be able to objectively understand a situation and be able to instill discipline, which is often times lacking in the upbringing. For example, parents can monitor and instill more discipline over television and computer usage. There should be a time limit as to how many hours a child can be allowed to watch the television or surf the net. However, in order to do that, parents also need to good examples so that they can inculcate their children with the right values by practicing what they preach. Many parents also do not give their children sufficient monitoring, which are crucial for their good upbringing. This is especially since in many countries, both parents work and thus do not have time or energy to pay attention to their children. They do not, for example, bother about the type of books read, internet sites surfed or the friends their children hang out with; thus, rendering their children susceptible to negative influences. 32

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Alternative Management
13. Alternative Treatments
Every system of medicine has their advantages and disadvantages, and their efficacy in helping children with disruptive behaviors. Alternative treatments are safe and natural, and can be used in conjunction with allopathic mode of treatments. Since some of these systems work similarly to homeopathy, it is best not to use some of them in conjunction with homeopathy as homeopathic remedies might become less effective. For example, Bach flower remedies, ayurvedic and Chinese medicine, and strong smelling oils should try not to be used in conjunction with homeopathy as it may alter the mental and physical state of the patients, hence changing the constitutional or symptomatic picture of the patient required in homeopathic case taking.

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14.Bach Flower Remedies


Bach flower Essences are safe and natural remedies that do not have side effects. They gently bring the mind and body back to health by nullifying negative mental and emotional states. Different essences can be combined to give different results. Bach flowers proved effective in ADHD cases57. Below is a list of flower remedies:

Table 7: Bach Flower remedies and symptoms treated ADHD, Oppositional Defiant Disorder and Conduct Disorder Critical and judgemental Beech Desperate and destructive impulses; uncontrollable emotion (e.g.anger) Cherry Plum and mind; impulsive; violent; intolerable; thoughts of killing; shrieking, throwing things, biting, screaming, tantrums, uncontrollable cravings, bedwetting, depression & bipolar disorder Lack of observation; anti-social; disobedient; impulsive; reckless; feels Chestnut bud like running away; laughs at reprimands; ADHD for inattentiveness, mental hurriedness and hyperactivity; bipolar disorder Hatred; revengeful; suspicious; jealous and envious; irritable; anger Holly easily; lack of love Fear; aggressive and violence Rock Rose Cruel, insensitive, unsympathetic, manipulative, greedy, egoistic, instill Vine fear in others; seeks revenge; violent; threaten others Lack of focus: undertake many activities but persevere in none Cerato Boredom; procrastination; cannot concentrate; developmental or Hornbeam learning disabilities Talks and moves very fast; aversion to company; irritable, easily Impatiens offended; Mania; Bipolar Disorder Extreme mental energy; mind jumps ahead of body; hyperactive Vervain Lack of concentration; dabbles in too many things Wild Oat Bipolar Disorder and Depression Double mindedness; mood swings Scleranthus Melancholic especially after a setback; pessimistic; doubtful Gentian Gorse & Sweet hopelessness, resignation and despair Chestnut Depression with no reason Mustard

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15.Ayurveda
Ayurveda is one of the oldest and more holistic system of medicine in the world, dating back to more than 5000 years. According to Ayurveda, human body (microcosm) is a miniature version of the universe and when in a healthy state is self-correcting similar to the macrocosm58. Dr. Hahnemann, the founder of Homeopathy, is said to have made a lot of investigations into Ayurveda, thus the similarities in the 2 systems59. Homeopathy, like Ayurveda, believes in the uniqueness of individuals in their treatment and that diseases are symptoms of the underlying inbalance in the body. Ayurveda philosophizes that everything in the universe is made up of 5 basic elements, which are earth, water, fire, air and ether. Earth represents the solid matter, and is stable and unchanging such as the bones. Water represents change, and the liquid state such as blood and other fluids in our body. While fire is the innate power that transforms solid into liquid, and liquid into gas and bonds atoms together. It is responsible for our digestion, attention, feelings and thoughts. Positively, it is associated with comprehension and intelligence, while negatively it is responsible for anger, hatred, criticism, competitiveness, and jealousy. Air represents gas, which is dynamic and mobile and is found in breathing, neural inpulses, pulsations of the heart. Ether is the empty space in which everything happens. Space is found in various body parts like mouth, nose, gastrointestinal tract and psychologically, it represents freedom, peace, love, consciousness and negative emotions of insecurity, anxiety and fear60. These 5 elements are combined in 3 basic doshas (energies), namely Vata (made of ether and air), Kapha (made of water and earth) and Pitta (made of fire and water). Depending on our constitution (body type and personalities), these 3 basic energies intermingle with 1 or 2 of these energies dominating over the others. When Vata is chronically aggravated or increased, it leads to more restlessness and ADHD 61 . While aggression, anger, oppositional defiant disorder, conduct disorder are due to aggravation or increase of Pitta in the body. Memory problems are usually due to a Kapha stagnation or an increase in Vata. And, depression can be due to an imbalance of either of the 3 doshas depending on the symptoms. Thus, in order bring the body back to balance, it is necessary to reduce the excessive dosha and control the doshas through ayurveda remedies (which may differ depending on whether it is a clinical or home treatment). Hence for behavioral disorders, it is crucial to identify the comorbid disorders, in order to understand the dosha imbalance involved. Ayurveda Home Treatment of Aggressive, hostile and defiant behavior Diet - a pitta-pacifying diet is recommended for anger and hostility Pitta-pacifying diet: Avoid hot, spicy and fermented food, caffeine, citrus and sour fruit. Take simple and bland food and cooling (not ice) drinks. Vata-pacifying diet: Avoid bitter, pungent, astringent food and drinks. Sweet, sour and salt food and drinks are good. Kapha-pacifying diet: Avoid food that is sweet, sour and salty. Consume food that is pungent, bitter and astringent.

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Keep Cool a pitta body should avoid hot baths, or get overheated from exercises. Exercise during the cooler part of the day Oil Massage Bhringaraj or coconut oil rubbed on the scalp or soles of the feet before going to bed can help reduce pitta. Wearing socks or putting towel on the pillow can prevent staining Sandalwood Oil place a drop of the sandalwood essential oil on the third eye area between the eyebrows, and on the throat, breastbone, navel, temples and wrists Herbal tea Chamomile, tulsi (holy basil), rose petal powder can be taken together as tea. Drink it 3 times a day Ghee Nasya Lubricate small amount of brahmi ghee inside the nostrils, and gently inhale Breathing Exercises (Pranayama) There are various types of breathing exercises that will help with various doshas and diseases. The ancient seers have discovered the relationship between the right and left breath cycle. One breathes more easily through a particular side of the nostril in every 45 to 90 minutes. Breathing better through the right nostril, for example, will activate the right, creative and feminine side of the brain. Shitali Pranayama (Cooling Breath) involves curling the tongue into a tube with the (opening of the tube facing the opening of the mouth. Inhale through the tube and exhale through the nose (keeping mouth closed). If one has difficulty curling the tongue, one can clench the teeth and press the tongue against the teeth before inhaling. Do a repetition of 12. Yoga postures Do the Camel, Cobra, Cow, Boat, Goat, Bridge poses and Moon Salutation. Avoid the Sun Salutation, Head-stand and other inverted poses. Yoga has evident merits for helping ADHD, especially when medications wear off in evening62.

ADHD Ayurvedic Remedies: Suvarna Bhasma, Suvarna Malini Vasant, Pancha Tikta Ghruta Guggulu, Vishatinduk Vati, Pippali (Piper longum), Vacha (Acorus calamus), Kapikacchu (Mucuna pruriens), Ashwagandha (Withania somnifera) and Jyotishmati (Celastrus paniculatus)63. To reduce inattentiveness and improve memory and organizational skills: Brahmi (Bacopa monnieri), Mandukparni (Centella asiatica) and Shankhpushpi (Convolvulus pluricaulis) To reduce hyperactivity: Jatamansi (Nardostachys jatamansi) and rarely, Sarpagandha (Raulwofia serpentina) For improving brain function: Chirayta (Swertia chirata), Guduchi (Tinospora cordifolia), Amalaki (Emblica officinalis) and Musta (Cyperus rotundus).

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Diagram 5: Yoga Poses

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16.Aromatherapy
Aromatherapy is an ancient healing method using botanical plants and their abstracts. The essential oils can be extracted from different parts of the plants. Different oils can be combined in varying proportions to produce the desired health effect. They can either be massaged or taken in through inhalation. These essential oils go through the epithelial tissues such as the skin, nasal passages, lungs and gastro-intestinal tract and then penetrate the lymphatic and blood system into the general circulation64. Recent researches have proven that aromatherapy is useful for treating children with behavioral and emotional disorder65. Just like in ayurveda, there are different essential oils to suit different doshas and gunas (the 3 type of qualities of Vata, Pitta and Kapha). Essential Oils to Bring Vata back to Equilibrium 1. Moody Benzoin, bergamot, clary sage, elemi, frankincense, geranium, rosewood 2. Unfocused Basil, cypress, lemon, lemongrass, rose, rosemary, petitgrain 3. Sleepless (insomnia) Basil, chamomile, lavender, mandarin, orange, neroli, rose, rosemary, thyme Essential Oils to bring Pitta back to Equilibrium 1. Angry Borage, cardamom, champa, coriander, blue chamomile, lotus, musk, rose, saffron 2. Stubborn Lavender and peppermind 3. Opinionated Jasmine and yarrow 4. Hurtful Hina, oud musk, geranium and yarrow 5. Domineering Amber and geranium 6. Frustrated Brahmi and gold chamomile 7. Irritable Benzoin, frankincense, Roman chamomile, rose, lavender, ylang ylang Essential Oils to bring Kapha back to Equilibrium 1. 2. 3. 4. 5. 6. Depressed Bergamot, lemongrass, geranium, clary sage, grapefruit, orange, petitgrain Disinterest Lavender, champa, orange, bergamot, cajeput, patchouli Attached Mint, ginger, myrtle Uncertain (low self-esteem) Ylang ylang, immortelle, petitgrain, jasmine Resistant Grapefruit, lime, bergamot, chamomile Sad Benzoin, jasmine, rose, rosewood, clary sage, melissa, neroli

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17.Chinese Medicine
Chinese Medicine has proven effectiveness in treating children with ADHD, enuresis and other pediatric diseases, although there is a lack of data on treatment of children with Oppositional Defiant Disorder and Conduct Disorder. According to Chinese Medicine, a childs body is mainly composed of yang (masculine energy) and less yin (feminine energy). As a result, in ADHD cases, yang overdominates the insufficient yin, causing an unsettled heart spirit and a lack of attention. The causes are believed to be varied, ranging from congenital defects, wrong diet, injury or trauma blocking the qi (energy), obstructing meridiens (energy points), disturbing yin-yang balance, and malnourishing the heart and the mind. The therapeutics thus lie in balancing yin and yang. Firstly, treatment should focus on tonifying the kidney, while concurrently treating the heart and the brain. Tonifying of kidney methods involve removing heat from heart, nourishing the liver and brain, tonifying the spleen, clearing phlegm and blood stasis. Secondly, regulating yin and yang through replenishing the deficient and removing the excess of either energy. Drugs of bitter and cold-nature should be used less as they are less effective for hyperactive patients. There are 3 main differential syndromes and accompanying treatments66: Excessive yang of liver and yin deficiency of kidney Main symptoms: ADHD, irritability, impetuous, wild with lack of self control, heat of chest, palms and soles, dry mouth and throat, night sweat, likes cold drink, red tongue with little or no fur, rapid pulse that is either thready or taut Therapeutics: Nourish yin and tranquilize mind Prescription and drugs: Radix Rehmanniae Praeparata, Rhizoma Dioscoreae, Fructus Corni, Fructus Lycii, Poria, Plastrum Testudinis, Semen Biotae, Os Draconis Fossilia, Radix Glycyrrhizae Praeparata Malnourishment of mind due to yin deficiency of the heart and spleen Main symptoms: ADD, short breath, sweating, palpitation, restless sleep with nightmare, stuttering, pale and lusterless complexion, pale red tough with thin, whitish fur, feeble and weak pulse Therapeutics: Tonify heart and spleen, calm the mind Prescription: Radix Glycyrrhizae Praeparata, Fructus Tritici Levis, Fructus Ziziphi Jujubae, Caulis Polygoni Multiflori, Radix Paeoniae Alba, Radix Salviae Miltiorrhizea, Radix Pseudostellariae, Os Draconis Fossilia, Concha Ostreae, Radix Polygalae, Rhizoma Pinelliae, Magnetitum

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Phlegm and heat affecting the heart due to dampness and heat accumulation ADHD, impetuous, wild with lack of self-control, heatiness of chest, heartburn, insomnia, poor appetite, dark urine, thirst, constipation, irritable bowels, red tongue with yellowness, thick and greasy fur, slippery and rapid pulse Therapeutics: Clearing heat and phlegm, inducing dieresis and calming the mind Prescription: Huanglian Wendan Decoction with other ingredients like Pericarpium Citri Reticulatae, Rhizoma Pinelliae, Poria, Caulis Babbusae in Taeniam, Aresaema cum Bile, Fructus Trichosanthis, Fructus Aurantii, Rhizoma Coptidis, Rhizoma Acori Graminei, Concha Margaritifera Usta Modifications of each treatment are provided depending on other concomitants present such as tendency for cold, restlessness and constipation. Other combinations of drugs have also been created for use. In a study by Yang Hong, ADHD children taking both Chinese and Western medications showed higher cure and amelioration rates (72.2% and 94.4% respectively), much lower symptoms reappearance (13.9%), and less severe side effects (poor appetite and sleeping difficulty) compared to a comparison group taking sole Western medications67. In the article by Zhao Qiran and Peng Hong-xing, the author treated 30 cases of ADHD with a classical formula of Gui Zhi Tang. 8 of the cases were successfully treated (in 2-3 courses with 7 days equal to a course) by the author, while 17 showed marked improvement, 3 became better and 2 showed no improvements; resulting in a total amelioration rate of 93.3% 68 . According to the Journal of Traditional Chinese Medicine, gotu kola, kava kava, Asian or Siberian ginseng, skullcap and chamomile, were proven useful for ADHD due to their efficacy in improving brain and nervous system health69. In another study, Vaccaria seeds were taped on to ear acupuncture points of 33 children, 9 showed marked effect, while 19 showed some effects; with total amelioration rate of 84.8%70. While in a case study, a child was cured with Liu Wei Di Huang Tang Jia Wei (Six Flavors Rehmannia Decoction with Added Flavors)71. Acupuncture Acupuncture is the insertion of very fine needles on the bodys surface to stimulate the bodys functioning, sometimes in conjunction with electrical stimulus or heat. Its main use is to stimulate the Meridians (or Channels), which are special pathways where energy flows through. Acupunture helps restore the energy by balancing the yin and yang. 72Dr. Chia Chay Puay, a Chinese Medicine doctor in Singapore, told of acupunctures effectiveness in curing a teenager with defiant behavior. Besides acupuncture, there are other non-invasive methods like acupressure, which stimulates the meridian points through fingers or hard ball-shaped instruments.

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18.Meditation
Meditation is a discipline of the mind, where one goes beyond a conscious functioning mind to a deeper state of awareness and consciousness; long term practice helps one elevate from the stage of concentration to contemplation and eventually to meditation. It is often associated with religions, though it is also be for non-religious purposes. Meditation and yoga are shown to have great potential in improving a persons psychosocial behaviour as part of the psychiatric treatment and in cases of behavioural disorders73. Scientists have found out that regular meditation increases the brain and cerebral size, with significantly more grey matter (such as in the right frontal cortex). The (right) hippocampus, which is responsible for learning and memory, and other parts related to emotions are also larger 74. Meditation thus increases the concentration and help people better control their emotions, generate good emotions, reduce stress and strengthens the immune system. Singh et. al, have also effectively used meditation in helping patients shift emotionally arousing thoughts or situation to a body part that is emotionally neutral such as the feet, thus helping control aggressive behaviour 75. Daily enquiry or auto-evaluation of ones behavior will also bring about an awareness of ones deeds, and thus help keep negative deeds in check. In meditation, it is recommended that one finds a quiet spot (preferably the same one everyday), keep the eyes half-closed or fully closed, sit straight and relax the body before starting the meditation. Breathing Meditation is a simple meditation method that focuses on the breathe going in and out. Light (Jyoti) Meditation is a universal method of meditation that is also easy and safe, with testimonials on better behaviours and academic results. Parents and teachers can also guide the children in it.

Light Meditation Gaze at or imagine a flame or golden light. Take the light mentally into your forehead, between your mid-brow. Imagine that light filling up your entire mind, expanding and becoming brighter. The light brings peace to the mind and fill it only with good thoughts. The light flows down to the heart where it opens up like a lotus in bloom. The light fills the heart with love and good emotions/feelings, removing all darkness. The light pervades the limbs. The legs will only bring one to the right and good places, while the arms and hands will only do right and good deeds. The light moves up to the tongue and mouth, and the mouth will speak sweetly and softly, and say only speak truth. The light continues to ascend to the eyes, and the eyes will only see good. The light then fills the ears, and the ears will only hear good. The light moves back to the head, and it is then sent to the entire family, friends, companions, as well as enemies and the entire human race. The light is extended to the birds, trees, animals, and all living beings and then to the earth and the entire universe. May all beings be filled with light and love. Draw the light back into the heart and when one is ready, slowly open the eyes.

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19.Reiki
Reiki is a non-religious natural healing method developed originally by Mikao Usui in 1922 after 21 days of retreat that involved fasting, meditation and prayers76. He gained the revelation to teach people how to heal themselves and others by the laying of hands above the major chakras (energy points in the body)77. After attunement, the healer will be able to conduct the guided life force through the healer hands to the patients major chakras, thereby seeking to bring the energy and the person back to healthy equilibrium.

Reiki is a natural, simple and safe method to treat a person as a whole including his mental, emotional, spiritual and physical. Amongst the many benefits of Reiki are relaxation and a feeling of rejuvenation, peace and well-being. Below is a description of how balanced chakras can have a positive impact on a persons health:

Source: www.internationalholisticcourses.com

Chakras Higher chakra Crown Third Eye Throat Heart

Location Above the crown Top of the head Centre forehead Throat area of

Color White/pink Violet Indigo Medium Blue Medium Green/ pink Yellow Orange

Associated Aspects of Healing Higher spiritual consciousness Consciousness, values, ethics, wisdom, faith, understanding Intuition, awareness, intellectual and emotional abilities Communication, self-expression, will and decisiveness Love, peace, devotion compassion, emotional well-being,

Centre of chest

Solar Plexus Sacrum

Above the navel Lower abdomen, sexual organs Base of spine

Mental functioning, power, control, self-esteem, courage Sexual energy, emotion, relationships, creativity, risk taking, personal power Connection to family and humanity, survival and 78 security, instinct, grounding, material well-being

Root

Red

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20.Mudras
Mudras are ancient hand gestures that can help bring the energies of the body, mind and emotions into equilibrium. Each finger is suppose to represent each element: thumb fire; index air, middle space, ring earth, little water; thus specific postures also help bring into balance the 5 elements. There are still many postures that are not included here. Gyan Mudra Use: (1) Mudra of knowledge - Improves memory and sharpen the brain (2) Prevents insomnia (3) Helps psychological and emotions problems like anger, hysteria and depression (4) Helps in intoxication and addiction (5) Activates Pituitary and endocrine glands79 Method: Tips of the thumb and index finger touch each other, while the other fingers remain stretch out. No time duration Uses: (1) Balances the earth element in the body (2) Improves body equilibrium (3) Remove physical weakness (4) Increase tolerance and patience Method: Tips of ring finger and thumb touch each other, other 3 fingers remain outstretch. No specific time duration Vayu Mudra Uses: (1) Helps nervous ailments (2) Improves balance of air element in body (3) Reduces aches and pains (4) Reduces gas in stomach Method: Keep the index finger at the base of the thumb, pressing the thumb against it, while other fingers are kept straight. Practice at least 45 minutes daily. For better results practice for at least 2 months Surya Mudra Uses: (1) Decreases earth element in the body (2) Reduces anxiety and mental heaviness (3) Helps digestion (4) Reduces cholesterol and weight (5) Helps thyroid gland function Method: Bend the ring finger and press base of the thumb against it, while other fingers remain straight. Practice 5-15 minutes twice daily Akash Mudra Uses: (1) Removes frustration (2) Useful for heart diseases (3) Strengthen bones (4) Prevents nasal and oral cavities80 Method: Join tips of middle finger and thumb, while other fingers remain straight. Practice 15 minutes each day

Prithvi Mudra

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Hakina Mudra

Uses: (1) Improves concentration and memory (2) Promotes cooperation between left and right brain Method: Join the tips of the corresponding fingers of each hand together. Practice for 15 minutes

Udan Mudra

Uses: (1) Enhances functioning of nervous system (2) Refreshes body (3) Cures chest and navel problems (4) Enhances energy flow throughout body Method: Keep the little finger straight, while the other fingers and thumb join at the tip. No specific duration

Vyan Mudra

Uses: (1) Strengthens nervous system (2) Regain heat in body (3) Balances energy in body Method: Join the tips of the index and middle fingers with tip of the thumb, while leaving the other fingers straight. Practice for 20 minutes

Apana Vayu Mudra

Uses: (1) Strengthens heart and normalizes palpitation (2) regulates excretory system (3) ameliorate gastric problems Method: The tips of the middle and ring fingers touch the tip of thumb, while the index finger touches the base of thumb and little finger remains straight. Heart and blood pressure patients to practice 15 minutes twice daily

(a) Purn Gyan Mudra81 - Sit cross-legged. Keep hands in 'Gyan Mudra' Posture. Keep the right hand near chest region. Keep left hand lying on left knee. Uses: (1) Increases wisdom and intelligence (2) Reduces irritability (3) Improves memory (4) Improves electromagnetic activity of the brain (5) Clears the bodys aura (b) DHYAAN MUDRA - Sit cross-legged. Keep both hands in Gyan Mudra Posture on your lap. Right palm should be resting above left palm in Gyan mudra Uses: (1) Increases peace and calmness (2) Increases concentration (3) Helps in mental ailments like depression

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21.Hypnotherapy
Hypnotherapy, like meditation, focuses on going into the self. Hypnotherapy, however, has a trained hypnotherapist who helps induce the patient into a deep subconscious state to help the patient uncover and address past and current mental or emotional issues associated with the situation at hand. The hypnotherapist will then provide guidance and suggestions to resolve the issues and since it is carried out in the hypnotic state, the patient is suppose to be able to register it better than in the waking state. Some programs also train people to perform self-hypnosis on themselves to help with the progress. Hypnotherapy has many successes with helping people with problems ranging from smoking addictions to emotional disorders.

22.Sound and Music Therapy82


Music Therapy is the use of music to help reach out to patients through physical, emotional, mental, social, aesthetic and spiritual means and help them have better health 83 . Over the decades, more researches are generating positive reports on how Music Therapy are helping children with problems in self-restraint, analyzing, providing appropriate social responses, interaction(Stratton 1989; Friedlander, 1994). Results also indicate that students with problems forming and maintaining relationships with others, and their surroundings also showed improvement in self-confidence and self-worth. According to Hanshumaker (1980), music can help young children better acquire languages, read, develop intellectually, creatively and personally(1980). Boys with behavioural problems are able to get interested in music, and later open up and share their issues (Juliet Alvin, 1975). Music therapy can help reduce anxiety (Hendricks et al., 1999), increase emotional responsiveness (Wasserman, 1972) and helps with impulsive behaviour, self-control (Layman et al., 2002), mental and physical co-ordination (Montello, 1996). Free improvisation lets the therapist to understand the internal problems of the child (Tervo, 2005), and allows it to be directed at a neutral object (Bruscia, 1987). Students with behavioral or emotional disorder is observed to be more cooperative and enthusiastic, and did better than students who only participated in verbal therapy (Haines, 1989). In addition, Dr. Masaru Emoto found out that water is able to absorb the vibrational pattern of a word or music and display it in the de-crystallization process. When exposed to positive words or classical music (pasted on water filled petri-dishes), water crystallizes into beautiful flowery patterns; while negative words or non-classical music such as metallic or hard rock music cause crystals to form rigid structures 84 . Studies show that heavy metal rock more aggressive and violent behavior when compared to classical music that leads to lower pulse rate and higher IQ 85. Plants exposed to classical music also grew taller, have more flowers and even grew towards the music; while plants exposed to metallic or rock music often recorded poor growth, and even wilted; thus demonstrating how important words and sounds are to healthy living since human is 70% made up of water. Hence, religious prayers and good thoughts also help give good energetic imprints to the bodies.

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23.Nutrition86
With ADHD and other behavioral disorders, nutrition and diet should be one of the first treatment methods to be considered. Researches show that there are links between nutrition, diet and behavior. Supplementary vitamins, essential fatty acids and minerals, for example, help reduce violence and anti-social behavior amongst young adult prisoners (Gesch et. al, 2002). There is also significant improvement in conduct, intelligence or/and academic results after nutritive diets have been implemented in 813 state juvenile facilities (Schoenthaler, 1991). A significant number of ADHD children are deficient in essential fatty acids, which are important for the growth and functioning of brain and nerve tissues. Fatty acids, like Omega-3 and Omega-6 which cannot be produced by the body, have a good effect for children with learning disabilities such as reading and writing87. DHA (Docosahexaenoic Acid), one of the essential omega-3 fatty acids, has a good effect on learning and depression, a deficiency of which is associated with aggression and hostility (Horrocks, 1999). Tyrosine, an amino acid used to produce dopamine and norepinephrine, is shown to be less in ADHD children. Tyrosine can be increased through supplements, but is not required if under certain medications. In terms of micro-nutrition, zinc, iron, magnesium, calcium and copper88 deficiency has been linked to ADHD, aggression and violence in children with behavioral disorders (Rosen et. al, 1985; Sever et. al, 1997; Brophy, 1986; Watts, 1990) 89 . Thus a supplement of the micronutrients in the diet is necessary when they are lacking. Higher mineral intake, like calcium, also reduce the toxic effect of heavy metals like lead (Walsh et. al, 1997). Straobrat, 1998, proved that ADHD children require magnesium supplement. High copper and low sulphur diet also results in ADD symptoms such as lack of concentration and poor memory90. Oligoantigenic diet (Feingold diet), which eliminates food that promote allergies, improved the conduct of 24% of the children with ADHD and conduct disorder just as well compared to 44% who improved using Ritalin (Schimdt, 1997); while glyconutritional supplements like saccharides reduced the severity of symptoms associated with ADHD, ODD, CD and side effects of related stimulant medications (Dykman, 1998). In addition, a greater intake of phosphatidylserine (a main component of the cellular membranes), increases synaptic communications and dopamine production and efficiency, thus normalize brain function and lead to over 90% improvements in patients with behavioral disorders.

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24. Biochemic Tissue Salts


Biochemic cell salts are inorganic salts which are frequently used alongside homeopathy remedies, and can be used as supplements when the body shows a deficiency. They are discovered by Dr. Schuessler, a German homeopath. He found out that there exist 12 inorganic salts of iron, calcium, magnesium, potassium, sodium and quartz which are fundamental components required by the body and thus for life sustenance. Any imbalance in the amount of inorganic tissue salts in the body would result in illness. Thus by supplying these salts in the right quantity, health would be restored. These inorganic salts are prepared through trituration, whereby they are mixed in predetermined quantities with milk sugar and made into pills91. Biochemic cell salts are good mood regulators and brain tonic92. Native Remedies, a leading natural medicine manufacturer with good testimonials, recommended the use of Kali Phosphoricum, Natrum Muriaticum and Calcarea Phosphoricum for ADHD 93 . It also recommended the use of Natrum Sulphuricum, Natrum Phosphoricum and Kali Phosphoricum as supplements for people with mood imbalance and aggression as the salts will help reduce irritability and sadness, and promote a healthy level of serotonin94.

Below are examples of biochemic cell salts that are good for children with behavioral or mood disorders: Kali Phosphoricum (Kali Phos / Potassium Phosphate) A nerve nutrient good for brain, nerve, muscles and blood vessel. It can also help with nerve fluid and grey matter production. It has a calming and soothing effect and is used in tension, irritability, depression, hysteria, prostration and sleeplessness. Natrium Sulphuricum (Nat Sulph/ Sodium Sulphate) - Water regulator and cell cleanser. Reduce feelings of sadness, hopelessness, anger and rage. Natrium Phosphoricum (Nat Phos/ Sodium Phospate) Acid regulator for the cells, maintain pH balance in our bodies. Helps assimilate fat required for healthy functioning of brain. Natrium Muriaticum (Nat Mur/ Sodium Chloride) Water distributor. Maintains water balance in the cells, thus supporting brain cells as it leads to proper metabolism and assist in removal of toxins. Nat Mur should not be confused with household salt. Calcarea Phosphoricum (Calc Phos/ Calcium Phospate) A nutritive tonic that helps growth in children. It generates new cells in the body.

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25. Homeopathy
Homeopathy is a holistic system of medicine discovered by a German Physician Dr. Samuel Hahnemann in the 18th century. It treats a person as a whole, based on the spiritual, mental, emotional and physical symptoms of the person. Homeopathy remedies are prepared from selected or whole parts of plants, minerals, metals, organic substances and animals. There are also nosodes that are homeopathic remedies prepared from human morbid or human diseased tissues such as pus. The remedies are able to effect cure due to the Law of Similar, Let likes be cured by likes, where a sick person can be treated by the same, but diluted and potentised form of the substance that produced the same kind of symptoms in a healthy person when taken in crude form. In classical Homeopathys Law of Simplex, only a simple and single drug should be prescribed. The Law of Minimum states that only the least required amount and dose of the remedy should be used to bring the body back to health. The more diluted remedies also lead to greater medicinal power. Homeopathy seeks to bring the bodys vital force back to equilibrium by stimulating the bodys own defence mechanism. Homeopathic remedies can be used to treat acute or chronic diseases. According to Hahnemann, chronic diseases will not heal on their own; if left untreated, the patient will suffer with it his whole life95. Behavioral disorders in children are considered chronic problems as they are long-standing and tend to have a gradual onset. They are deep-seated diseases that affect the mental and emotional planes. For chronic disorders, a constitutional and individualized approach to diseases is required, which takes into account the mind, emotion, personality, body, lifestyle, life experiences, idiosyncrasies of the patient. Hence, by looking at the totality of symptoms, the homeopathic doctor is thus able to select the most suitable remedy for the patient. Even if two people are suffering from the same behavioral disorder, the remedy administered for each one may be different if the totalities of symptoms differ. When administered, the curative action starts immediately, though for chronic cases, the cure will naturally take a longer time than acute cases. Some parents may fear that Homeopathy will lead to a complete change in the personality or mentality of the child if the remedy is administered for children with behavioral, mental or mood disorders. The answer is no, as the childs innate character will remain, but the tendency towards innate or acquired negative emotions and behaviors such as irritability, cursing or beating people will be diminished or cured if the remedy selected is the similimum (the most matching remedy that satisfy the totality of the symptoms). Hence, an active child will not become an inactive child, and an extroverted child will not become introverted. When a cure or an improvement is effected, the child, will, however have a sense of control, well-being and calmness to help him cope with daily functioning at home, school or the outside environment. Benefits Homeopathy is safe as substances that are toxic in their crude forms are rendered non-poisonous and non-allergic through the process of dilution; whole molecules of the substances thus could not be detected in the remedies. Homeopathy can also be used alongside other medical systems such as allopathy, acupuncture, naturopathy, physiotherapy, magnetic therapy and massage. It does not have any side effects as it seeks to bring about a gentle and permanent cure in a person. It is also economical and readily available. 48

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26.Homeopathy Case-Taking
When a patient approach a homeopathic doctor, the doctor has to observe signs (that can be seen, heard, felt by the doctor), question the patient (subjective symptoms as perceived by the patient) or the person who came with him (objective symptoms as observed by caretakers, family or teacher) and take note. In treating the person as a whole, it is important to identify the constitution of the individual with emphasis on the physical, mental and emotional make-up of the individual and the related miasm and diathesis. a. Physical Constitution Physical make-up of a person is important for chronic cases, the doctor should determine: i. Color of hair, skin and eyes ii. Body proportion: distribution of fats in the body, bloatedness, emaciation (spreading upwards or downwards; appetite) iii. Tongue: color, furry or smooth iv. Skin: health, growths e.g. moles and warts, discoloration e.g. birthmark, freckles b. Observation Through the eyes and other facial expression of the child, the doctor will be able to observe the associated tendencies and emotions (and its intensity and duration): stubbornness, sharpness, maliciousness, hatred, sadness, dissatisfaction, irritability96. Through the body movements and speech, the doctor can observe the degree of restlessness, hyperactivity, reactivity, aggressiveness, destructiveness, extrovertedness, lasciviousness and the motor coordination (developmental stage). For example, some children have more upper than lower limb restlessness. Observations can help narrow down the choice of the remedies such as in hyperactivity, there are remedies that point to more upper than lower extremities movements. When the child is already coming with a behavioral problem, it would be easier to identify the problems. However, there may be children who come for treatment of acute diseases such as a cold and the caretaker fails to mention the childs observed behavioral problem. In this scenario, it is possible for a doctor to recommend that the child come for a constitutional assessment to treat the childs chronic behavioral or emotional problems. c. Direct Questioning Besides observation, constitutional approach to case-taking also requires the doctor to be aware of several factors that need to be identified in aggressive children: 1. Identifying the cause of the behavioral or mental disorder, whether it is: a. Innate or due to an external cause b. Hereditary familys health history c. Ailments from diseases, injuries, vaccinations and medications of past and present

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d. Provoking factors whether there is any family turbulences and dynamic problems, bad peer influence, stress, school problems 2. Onset When it first occurred, whether the patient is suffering from a chronic or acute bout of the behavioral or mental disorder, is it sudden or gradual, the duration, how long the patient had the illness, the periodicity and recurrences. Example of acute would include sudden violent outburst of anger. Example of a chronic behavioral problem would be constant disobedience towards parents 3. Mental-Emotional State temperament; fears; hopes and aspirations; likes and dislikes; sensitivity to pain, injury, noise, touch, being carried; sensitivity to others pain, family turbulence, television programmes, stories; reaction to attention/consolation/griefs; imaginative 4. Behavioral analysis97 A. Sociability: approachable, sociable, adaptable, a leader/follower, interactive with younger children or peers, creative, competitive, aggressive; his attitude to animals, toys, blanket, strangers, during play, being alone B. Independence: responsibility reaction to not getting what he wants C. Activity: level, responsiveness, intensity, rhythmicity, distractibility, attention span, perseverance, patterns (feed, play, sleep) D. Destructibility: breaking things, hurting others, responsibility, reaction to not getting what he wants 5. Intellect command over the 5 senses (linguistic/logic/kinesthetic/spatial/musical) and ability or interest in various subjects 6. Physical Generals Diet (appetite, cravings and aversions, thirst), sleep (pattern, mood on waking, sleep position, light/heavy, reason for insomnia), dreams, weather affections, perspiration (parts, smell), urine and stool; Modality time when or factors that cause the symptoms to be better or worse 7. Developmental History - Mother's description of pregnancy, labor, birth, breastfeeding and her emotions; dentition, learning to talk, walk, comprehend, musculoskeletal development, toilet training 8. Family environment lifestyle, relationship with family members, divorce, family movements, religion, financial stability 9. Concomitants other unrelated symptoms accompanying the main complaint 10. Other existing diseases and physical tendencies The doctor needs to identify about 5-6 (and a maximum of about 8- 10 for chronic cases) key symptoms from the case. Key symptoms can include mental generals, physical generals, PQRS (peculiar, queer, rare or strange) symptoms and particulars of the disease. Common symptoms of the particular disease should be ruled out as these are found in most patients and ailments and is produced in the provings of many remedies. Instead, priority should be given to characteristic symptoms which are unusual and distinctive and are found in few patients and in the provings of few remedies for example, the sensation of cobwebs before the face. Characteristic symptoms can either occur when expected symptoms are not present or when unexpected symptoms are present.

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Opinions of Eminent Homeopaths


27.Hahnemann and other masters on Mental and Emotional Diseases
Hahnemann in his Organon wrote many important points for the treatment of diseases of the mental and emotional levels. He thought that mental and emotional diseases should not be classified as a separate class of malady [Aph. 210], for they are solely the mental symptoms of the whole person.98 Mental and emotional diseases are altered state of the disposition and mind [Aph. 212] resulting from a derangement in the life force. Many of the mental and emotional diseases stem from corporeal diseases in which the symptomatic derangement of the mind and disposition is increased while concurrently, the corporeal symptoms diminish to the point that the illness seemed one-sidedly stemming from mind or disposition [Aph. 215] 99 . Hence, it is important to find out the entire symptoms of the corporeal disease before it worsen into a onesided mental disease. To decipher whether a mental disease is genuinely arising from a corporeal disease or is a result of corrupt or malpractices, bad education, neglect, superstition or ignorance, one should give good, friendly advice and consolation to the patient. If the patient improves, as will be the case in acute mental diseases [Aph. 226], the latter causes are the reason for the poor mental conditions. For real moral or mental diseases, however, the disease would be aggravated by the above care and support given, such that a malicious child will become more malicious and a defiant child will become more disobedient [Aph. 224]. There are also corporeal diseases that do not degenerate into one-sided mental diseases, but are constantly excited by negative emotions; in those cases, the bombardment of negative emotions eventually lead to a greater destruction of the corporeal body. He then pointed out that the efficacy of the homeopathic system over other medicinal system stands out more clearly in chronic mental and emotional diseases [Aph. 211]. In addition, Hahnemann also mentioned that only antipsoric remedies can provide a permanent cure for the chronic mental or emotional diseases when they are chosen based on the similarity and totality of the entire person; while Aconite, Belladonna, Stramonium, Hyoscyamus, Mercury have been identified by him as useful for providing temporary relief for chronic and acute cases [Aph. 221]. Kent believes that diseases attack the vital force first as a spiritual entity and late r manifest itself from the inside out through the corporal body. According to George Vithoulkas, many serious mental disorders including anxiety neurosis and compulsive neurosis that millions of Westerners suffer are virtually non-existent in communities that do not have access to vaccinations and modern medicine. He suggested that the conventional medicine have suppressed diseases and caused the disorders to go deeper into the centre of the organisms, affecting the nervous systems. As the rampant usage of conventional medicine continues, more incurable diseases like AIDS will result and he even predicted that if this continues, most of the human population will be afflicted with mental diseases in the future100.

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28.Hahnemann on Nature of Chronic Disease101


Chronic diseases are long term diseases of at least a few weeks long. It can even stretch to years and decades. Homeopathic treatment can alleviate and restore a patients health to a good vital state. The good state often makes people oblivious to the diseases that have yet reared their full blown states, especially when coupled with improved living conditions and good weather. Sometimes, a wrong diet, a change of weather, a violent or sudden shock to the body and mind can cause the reappearance of one or more symptoms, in addition to other new concomitants that may be even more or just as difficult to treat. When initial remedies fail to cure the continuously reappearing symptoms and new concomitants effectively for chronic non-venereal diseases, one must suspect a deeper underlying pathology referred to as miasm. Hahnemann had a very successful practice with excellent results, however, there were cases that improved considerably, but did not achieve total cure. He realised that his patients had an itch, which they often forgot or failed to confess, gave him a lead into a deep seated disease which he called Psora. Hahnemann also observed that many diseases like excessive sensitiveness, excessive or non-existing sexual desires, mental and emotional symptoms of retardation, rage, depression, mania are all different manifestations of Psora. This led him to the discovery of 3 basic miasms (disease predispositions), Psora, Sycosis and Syphilis, which are the basic building blocks of all diseases; with Psora being the most important, most infectious and most misunderstood one.. Diseases like Scabies, Gonorrhea and Syphilis leave imprints in the body, which is known as acquired miasm if the infection occurs in the same generation; if it was transmitted to the future generation, it is called inherited miasm. Kent, later continued Hahnemanns work and categorised the remedies into the 3 miasms102. Since then, other miasms have been progressively added, such as Tubercular and Cancer miasms. These miasms have sometimes been suppressed by inappropriate treatments that they remain undiscovered; at times, an acute disease, a shock or a grief, violent emotions or other physical and mental changes can lead to the seeming disappearance of the miasmatic symptoms. The disappearance of miasmatic symptoms such as certain skin eruptions, does not mean that the miasm has been healed internally. 28.1 Cure of Chronic Disease 28.1.a. Sycosis Sycosis is a venereal disease of Gonorrhoea that impedes the life force and quickens life processes. It usually first manifest as excrescences on genitals and leads to a tendency of overgrowths and overproduction. Sycosis, which produce the least number of chronic diseases, is mostly cured by Thuja. Thuja can be alternated with Nitricum Acidum that must be given a long enough time to work. External applications are unnecessary unless for challenging cases, which can be given Thuja leave tincture. Medorrhinum can be used for inherited cases. Mineral remedies need to follow through for anti-psorical treatments. Remedies for Sycosis: Agar., alum., alumn., anac., ant-c., ant-t., apis., aran., Arg-m., Arg-n., aster., aur-m., aur., bar-c., bry., calc., carb-an., carb-s., carb-v., caust., cham., cinnb., con., dulc., euphr., ferr., fl-ac., graph., hep., iod., kali-c., Kali-s., lach., lyc., mang., Med., merc., mez., Nat-s., Nit-ac., petr., phyt., puls., sabin., sars., sec., sel., Sep., sil., Staph., sulph., Thuj. 103

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28.1.b. Syphilis Syphilis is a venereal disease, which leads to the destruction of life force. Syphilis treatment is usually complicated by psora, which makes cure difficult. As long as syphilis external chancre has not been changed by external medication, treatment through homeopathy such as triturated mercury will be easier. Luesinum and Siphilinum are great for suppressed or inherited cases. These nosodes need to be alternated with a mineral remedy to ensure that anti-psorical treatments are carried out. Remedies for Syphilis : Arg-m., Ars-i., ars-s-f., ars., asaf., Aur-m-n., Aur-m., Aur., bad., benzac., calc-i., calc-s., carb-an., carb-v., cinnb., clem., con., cor-r., crot-h., fl-ac., guai., hep., iod., kali-ar., kali-bi., kali-chl., Kali-i., Kali-s., lach., led., Merc-c., Merc-i-f., Merc-i-r., Merc., mez., Nit-ac., petr., ph-ac., phos., Phyt., sars., Sil., staph., Still., sul-i., sulph., Syph., thuj. 28.1.c. Psora Hahnemann named Psora as the deepest, chronic disease state where there is a huge disruption in the life force coming from within (endogenous), resulting in gradual manifestation of physical symptoms and slowing down of life processes. This incapacity of the life force to heal is mainly due to hereditary causes. Initially, remedies from the plant and animal kingdom were used, however, Hahnemann realized that these remedies were not strong enough to heal this state of disequilibrium. Hence, remedies from the mineral kingdom were utilized as anti-psoric remedies104. For psora that do not have external presentations, is still latent or has developed into other forms of chronic disease, the cure requires the use of more than one anti-psoric remedy. Over the years, if the eruption or itch recedes, it means that the psora has advanced internally. Sometimes, the patient may face acute diseases or a re-occurrence of a previously existing symptom, regardless, the doctor should stick to the anti-psoric remedy prescribed and allow it to finish its action. The re-occurrence of a previously existing symptom may be due to homeopathy excitation, which proves that the remedy is working. For undurable interrupting symptoms that have never occurred prior to taking the homeopathy remedy, it should not be taken lightly, as it means that the anti-psoric remedy chosen may be incorrect and should be cross checked with an antidote or a more suitable anti-psoric remedy. However, if the usual existing symptoms are aggravated (worsening of symptoms) on the first few days, but gets better gradually, it means that a definite cure is taking place. If the symptoms continue to aggravate with the same or increased intensity on subsequent days, it means that the dose of the anti-psoric remedy is too great and it may lead to a more severe and similar chronic disease. In this case, an antidote or another anti-psoric remedy should be provided, followed by the former anti-psoric remedy in a higher potency, if indicated. If the same symptoms that have been ameliorated or eradicated were to rise again, without any new symptoms, then a more suitable dose of the remedy should be given. The dosage of a remedy should always be given the time to run its full beneficial course, and not be interrupted by another remedy. All anti-psoric, including those short acting ones in acute diseases (like Belladonna, Sulphur and Arsenic) should be given at least 30 days to act in chronic diseases. 53

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Even the smallest dose, will provide a beneficial effect to the patient. Sometimes, a frequent repetition of doses can be injurious to the patient. The best anti-psoric remedies efficacy are limited in cases where patients suffer great emotional disturbances due to sudden or bad experiences coming their way, especially those that they have no power over. Remedies for Psora: Agar., alum., am-c., am-m., anac., ant-c., ars., aur., aur-m., bar-c., bor., calc., carb-an., carb-v., caust., clem., coloc., con., cupr., dig., dulc., euph., graph., guaj., hep., iod., kalic., lyc., mag-c., mag-m., mang., mez., mur-ac., nat-c., nat-m., nit-ac., nitrium, petr., phos., ph-ac., plat., sars., sep., sil., stann., sulph., sul-ac., zinc.

28.2. Other Pointers for Cure Miasmatic symptoms including mental ones, differ according to ones constitution. A person with a sanguine temperament for example, may suffer from pthisis if the itch is suppressed. Other psoric symptoms include insatiable hunger, hair fall, erysipelas, aversion to warm cooked food, milk and meat, thirst, vivid dreams and nightmares, stammering, colic, mental and mood disturbances of all kinds like melancholy, insanity, anxiety, fearfulness, mania and mood changes. Attention must be given to the first time of infection, the duration of complete internal development of the miasm and thirdly, its external manifestation. Whenever there is an external miasmatic manifestation on the skin, the homeopath must always first cure the patient of the disease from within; any external medical treatment without consuming a homeopathic remedy will lead to changes in the external manifestation, thus rendering the miasm to seek other survival outlets such as through the production of unwanted secondary symptoms. As symptoms start getting weaker, the homeopath must continue treating even the smallest remnants of any symptoms, as neglect will cause a new chronic disease to emerge. 28.3. Intermediate disease When a patient is having an epidemic or intermediate disease, the anti-psoric treatment may have to be discontinued temporarily, while the non anti-psoric treatment started. If the intermediate disease is not too severe, inhalation of the non anti-psoric remedy is possible. If a patient fails to get back to health after the intermediate disease is treated with non anti-psoric remedy, an antipsoric remedy can enhance the recovery. The anti-psoric treatment when restarted, must take into account the new totality of symptoms. For constitutional treatment, there are times when acute symptoms crop up such as severe cough, while treating the patient. In those cases, acute intercurrents are prescribed, which are non-deep acting and non-miasmatic and will not interfere with the mechanics of the deeper-acting constitutional remedy105.

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28.4. Remedy Intake Advice After taking the medicine the patient should keep still for at least an hour without sleeping. Sleep delays the action of the remedy. For the remedy to work more strongly, it can be stirred in water and served. In chronic diseases, Hahnemann observed that a spoonful of the solution if given at least daily or every 2 days hasten the cure. The dose of anti-psoric remedy should not be given a few days prior to and during the onset of menses, but can be given at least 4 days after the menses end. Besides consuming and inhaling, a remedy can also be rubbed on the healthy parts of the limbs until it becomes dry. 28.5. Lifestyle Advice by Hahnemann A young and strong patient will recover much faster than an older patient. A child who tends to be more sedentary should be encouraged to walk more often in the open air. Students should be discouraged from reading books and watching other media that excite the senses. In treating the more serious chronic or mental diseases, mental work and reading should be limited to avoid straining. During the course of the medication, stimulants like coffee and alcohol, as well as tea are strongly discouraged if a successful cure is desired. Other strong tasting ingredients like onions, pepper, citric acid, vinegar, herbs, old cheese, whisky, brandy and tobacco should be avoided as well. Strong smelling perfumes should not be used.

28.6. Comparisons of Miasms Each miasm has its own mental and physical manifestations. Below is a description106: Table 8: Comparisons across Miasms Psora Behavior and Selfish, fearful, anxious, nervous, mental manifestations restless, deceitful, sadness and depression, irritable, lack concentration, malicious (psorasyphilosycotic), weariness of life (psora-syphilitic), illusions with poor memory Sycosis Argumentative, rudeness, irascibility, jealous, loquacious, suspicious, mean, mischievious, self-centered and cunning with a tendency to harm (emotionally) others and to harm animals, delusions with active memory Syphilis Cruel, violent, destructive, rage, irritable, hatred, loathe, perverted and can harm others and themselves. Hallucinations and deliriums. Can only remember past chronological events Tubercular Fearless, indifferent, nonanxious, desire for change, risktaking. Unrestrained passions and perverted craving for sex. Vacillation of thoughts. Intelligent but careless

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Rapid, moderate or insidious. Depends on dominance of psoric or syphilitic Many fears due to Some fears due to Fears not Dogs and other Fears mental selfishness, manifested. animals restlessness and suspicion such as Anguish apprehension of poverty misfortune Aversion to Extroverts but Introvert with Appear gloomy Social people and show lack of great desire to and silent; do not Interaction company, confidence escape from like to be strangers. Dislike socially others and advised being alone themselves. regarding their Lonely, health untrusting and lack confidence. Dull and lacks perception Anger aggravated Fixed ideas; Irritable and Temperament Change temperament by change of obstinate. fearful. Impatient without a cause. weather e.g. Depression but and quarrelsome. Anger alternate thunderstorm keep to Mental with tearfulness. themselves. symptoms like Cry when Cold-blooded. anger aggravated depressed and after sleep. Wake others will know. up discontented. Some are silent when depressed. Complainer of life Fear death Plan death but Suicidal Dissatisfaction Death attached to life thoughts. lead to suicidal Syphilis-sycosis impulse, leads to characterised by completed indifference suicides Itch, burn, Catarrhal Cancers, Changing, Physical discharges and tumours, periodical, Manifestations inflammation, leading to growths e.g. warts ulcerations recurrent congestion symptomology; haemorrhages Pace of Action

Hyperactive

Slow and moderate, insidious, though rapid and incoordination insidious are possible

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Desires Aversions

sweet, & Desires: sour, fatty, indigestible, spicy food

Desires: salt, alcohol, fatty meat, pepper, pungent and seasoned food

Averse: milk, boiled food, cold Averse: meat, food wine, milk, spice Modalities < winter, during sleep; > natural discharges and sunrise to sunset < cold, weather changes, humidity; > growths or return of manifestations

Cruelty

No real cruelty, Mental tortures, but deceitfulness rudeness, anger exist from trifles lead to assaults Deceitful. Failed Cunning, benefits crime due to poor at expense of organisation others without having to be present

Desires: stimulants, spicy meat, cold food, sour things. Too cold or too hot food Averse: meat and animal products <night, sunset to sunrise, natural discharges, extreme temperature, thunderstorms, movement, summer, warmth; > sunrise to sunset, change of position, cold, abnormal discharge, lukewarm weather Bodily assaults, killings, physical tortures Dangerous. Physically attacks people. Fail to realise consequence

Desires: indigestible, fatty, tea, tobacco, meat, salt. Too hot or cold food Averse: meat, starchy food < thunderstorms, night, milk, fruits, fatty food, closed room; > open air, dry weather, epistaxis

Some cruelty, physical or mental torture

Criminality

Behavioral Problems

Commit to a crime, but fail to turn up or change the plans. Indifferent but is a risk taker ADHD, Conduct Mostly Conduct ADHD, Conduct Disorder Oppositional Disorder and Disorder, Bipolar Defiant Disorder. Bipolar Disorder Disorder Conduct Disorder

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Table 9: Miasmatic Weightage of Remedies107


Camph. Tarent.
2 3 2 3

Canth.

Stram.

Cham.

Nux-v.

Nit-ac.

Staph.

Sulph.

Caust.

Acon.

Psoric Sycotic Syphilitic Tubercular

2 1 1 2

1 2 1 3

2 2 2 1

3 3 1 2

3 0 1 3

3L 3 2 3L

2 1 0 2

2 1 3 2

3 3 2 3

2 2 2 1

2 2 2 1

3 2 3 2

2 3 1 2

2 3L 3 2 3 3 2 3L 2 2 3L 3L 3 3 3 3

3 2 1 2

3 3 2 2 2 3 1 3L

2 2 3 3L 1 2 1 2

2 3L 3 2 1 3 1 3

Note: Lleading anti-miasmatic remedy; 1=+(least), 2=++, 3=+++(most)

Most remedies are multi-miasmatic, except for nosodes, which tend to address a specific miasm108. 28.7. Removing Obstacles in Constitutional Treatment Anti-miasmatic remedies are prescribed when there are obstacles to permanent cure, even though the right constitutional remedy has been chosen based on similimum. To remove the blockage, an anti-miasmatic homeopathy remedy is still chosen based on the classical method of homeopathy selection of similimum and totality of the patient. Importance is given to ensure that the anti-miasmatic remedy exhibit significantly the miasm of the patient. Sometimes, a single miasm is dominantly seen in a case, while at other times, different miasms can emerge at different stages of treatment. For example, a child with ADHD and Conduct Disorder has a Veratrum Album constitution and after constitutional prescription, most of his symptoms have been alleviated. However, if he still exhibit some symptoms such as lasciviousness and indifference, and the totality seemed to be predominantly of Tubercular miasm. A strong or leading Tubercular anti-miasmatic remedy should be prescribed, such as Phosphorus, which if matches the current totality of symptoms, will result in a permanent cure in the patient.

58

Verat.
3 3 0 2

Hyos.

Anac. Ars.

Phos.

Cupr.

Lach.

Merc.

Agar.

Calc.

Hep.

Bell.

Lyc.

Plb.

Op.

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29.Potentisation109
Potentisation increases the dynamic effect of the homeopathic remedy and reduces the toxic effect of the drug in its crude form. Through potentisation, substances that are originally poisonous becomes safe for internal consumption in homeopathic healing. Potentisation comprises of 2 parts: in succussion, soluble substances are mixed in water or alcohol are shaked vigorously; in trituration, non-soluble substances are grounded and mixed in lactose. Shaking and grounding of the substance also help increase the dynamic effect of the substances. There are many potency scales depending on the usage of the remedy. Potencies are classified into low, medium and high. Low potencies are generally from Q(mother tincture) to 12C, medium are 12C to 200C, while high are 200C and upwards. Hahnemann was satisfied with the results from potentised remedies with 30C being his most extensively used potency, while 200th and 1000th were also used when required110. In the last years of his life, Hahnemann discovered and also used the LM potency which is a high and gentle potency. Decimal scale, for example, is denoted by X or D. Decimal scale of 1X is prepared by mixing one part of the substance with 9 parts of the medium (water, alcohol or lactose). 2X means that the substance is potentised twice, by taking one part of the 1X substance and mixing it in 9 parts of the medium, hence reaching the potency of 1: 100 of the substance and the medium respectively. Centisimal scale, for example, is denoted by C. 1C is prepared by mixing one part of the original substance in 99 parts of the medium. 2C is taking one part of the 1C substance and mixing it in 99 parts of the medium, thus achieving a 1: 10,000 ratio of the substance and the medium respectively and so forth.

30.Posology potency selection


Posology comprise of the dosage, potency selection, form and repetition of the remedy comes second to selecting the similimum. Posology plays an important role as a permanent, rapid and gentle cure requires the correct similimum and the most suitable potency selection, dosage and usage. Potency selection involves the choosing and using the most suitable potency for the disease at hand. According to Kent, a similimum will act across a series of potencies, while a partially similar remedy will only act in 1 or 2 potencies with the effect of changing the symptomatic picture of a person. Homeopaths remain divided over potency selections, with some favoring higher and others supporting lower potencies111. Boenninghausen wrote that high potencies increases the sphere of action and cures chronic, as well as acute illnesses more rapidly. Modern, successful homeopaths are able to use the lowest to the highest potency depending on the case; with 6C, 30C, 200C, 1M, 10M, CM and the LM scale being the most commonly used potencies at present. It is generally agreed that for acute cases that involve organs or tissues, as well as for serious pathological conditions, low potencies are recommended; while chronic cases (especially those 59

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with marked mental and peculiar symptoms) are best cured by higher potencies. Roberts advise against using high potencies in cases where similarities are uncertain. According to Close, children should be given medium to higher potencies; sensitive and intelligent individuals, as well as those under the influence of drugs should be given higher potencies. Kent, a popular proponent of high potencies observed that 30C to 200C should be given for sensitive woman and children, and allow time for improvements before being given 1M or 10M. 10M to MM is beneficial for chronic diseases in less sensitive persons; 10M, for example, should be given first and continued as long as improvements last. Fergie Woods and George Vithoulkas, however, advised against high potencies especially in sensitive and constitutionally weak individuals as it may lead to strong and unrequired aggravation or proving. High potencies also act for a longer period. Thus Vithoulkas recommend potencies of 12X to 200C in these individuals. He also stated that children with severe problems and malignancies should be given low potencies, and not more than 200C. But for children suffering from acute illnesses, a potency not less than 200C should be given. Rajan Sankaran further adds that nosodes and certain medicines act better in 200C and above. However, if a bowel nosode has been given in the 3 months before, then it is better to follow up with a low potency which can be given daily. A single high dose is also recommended in acute diseases, while high potencies of a remedy can be repeated regularly in acute phases of a chronic disease. If a patient is already taking a high potency remedy and is improving, a low potency of a drug can be prescribed for superficial symptoms. Sankaran also mentioned that different potencies produce different physiological effects. For example, Silicea in low potency encourages suppuration, but acts otherwise in high potencies. Vithoulkas mentioned that certain medicines like Lachesis and Aurum, which have a tendency towards physical pathological conditions, should be restricted to 30C or 200C, unless the individual is free of physical symptoms. In cases free from physical pathological conditions, higher potencies from 30C to Cm can thus be prescribed. Many homeopaths need to reconsider the potency selection and be comfortable with very low and very high potencies, especially in cases where they are certain of the similimum, before they start changing remedies to effect a cure.

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31.Repertorial Analysis
Repertory is a homeopathic tool developed to help homeopaths select a similimum based on the rubrics provided in the repertories. A rubric is a word or set of words used by the repertory founder to describe symptoms. Different repertories have been developed over the years. Kents complete repertory, for example, is one of the most comprehensive repertory that includes many detailed rubrics and their associated remedies that are graded according to their curative power. Computer softwares such as RADAR, on the other hand, contain the different repertories and findings of well-known homeopaths and its technology makes finding a similimum less time consuming. A repertorial analysis requires the selection of the main presenting clinical symptoms and keynotes from the repertory, and then finding the similimum based on the total value and count of the remedies. The total value of a remedy is the sum of scores of all the rubrics used in the case taking, while total count measures the number of rubrics the remedy satisfies. The remedy with the highest or higher value and count should be highly considered as the similimum, if it matches the totality of the symptoms most accurately. Repertory analysis of Kent has been developed with the selection of rubrics most commonly seen in cases of disruptive behavioral disorders as per the following tables. 27 remedies more suitable for disruptive behavioral disorders of ODD and CD are included. They are also studied for their possible use in ADHD, mood and other mental disorders like psychotic disorder. Some of the rubrics described in ODD, can be used in CD and other disorders and vice versa, and are indicated with a *; others that do not have a * indication can also be used in CD and other disorders, depending on importance of symptoms. ^ denotes symptoms indicated in other disorders and have been elaborated elsewhere. Grading system using numbers have been used and represent Kents repertory: Bold fonts (3) being the most representative remedies; italics (2) and normal fonts (1). Some repertory analysis from Barollo et. al and Boericke have also been used for reference and are denoted by the letter x, without differential grading. In cases where there is a combination of 2 or more rubrics, the higher grading of each remedy is considered. In addition, there may some overlapping symptoms between the different disorders. But they are mentioned in accordance to chronological order and will be briefed again when necessary. It is to be noted that there are other existing remedies in each repertory that can also be considered accordingly. There are also specific rubrics, which are not provided in the tables, specially indicated for the individual (the PQRS) such as a specific mind symptom (like restlessness before storm), emotion, physical gesture like a desire to pull ones hair or physical generals, modalities, delusion or hallucination that need to be strongly considered in case taking.

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Table 10: Rubrics for Disruptive Behavioral Disorders and their associative disorders & features
Camph. Tarent. Canth. Cham. Stram. Nux-v. Caust. Nit-ac. Staph. Sulph. Verat. Hyos. Acon. Anac. Ars. Phos. Merc. Lach. Cupr. Agar. Lyss. Calc. Hep.

Bell.

Lyc.

Conduct Disorder Fancies, exaltation of Lasciviousness Fight, wants to Fire, wants to set things on Growling like a dog Hatred Kicks Kill, desire to Kill, threatens to; Kill, for a slight offence 1 2 1

1 2 1 x 2 x 2 2 1 1 1 2 2 1 x 1 1 2 3 1 2 2 2 2 x 1 x

2 1 x 1 2 2 3 2

1 1

x 1 1 1 1 2 1 2 2 2 x x 1 3 1 1 2 x 1

Plb.

Op.

x 1 2 2 2 2

1 2 1 1

2 2

Kleptomania + stealing Knocks head against things x x Lasciviousness 1 Laughing, sardonic Lewdness (obscene) Lie + untruthful + deceitful + false + perfidious x Mischievous 2 Moral feeling, wants of Pulling Hair Rage, fury* Scratches with hands + lime of wall Sexual excesses, mental symptoms from Shrieking Spits in faces of people Striking Threatening Throwing Violent, vehement Wildness 2 3

1 x 2 2 1

1 x

1 x 2 1 1 x 2 1 1

1 3 2 2

3 2

1 1

3 1

x x x 3 2 2

x 2

x 2 1

x 2

x 2

x 3

x 2

x 2

1 2

1 x 2 x 3 2 2 3 2 1 x 3 1 2 x 1 1 3

x x 2 2 3 1

3 1

2 1

1 1 1

1 3 2 1 1 2 1 3 2 1

3 2 2 x

2 1 3

3 3

2 1 1

1 1

3 1

3 2 1 1

3 1 1 2 3 2 2 2

1 2

3 2 2

2 1 2

1 3

x 1 1 1

1 1 2 1 3 1 1

1 1 1 1 1 1

1 1 1

3 1 1

2 1 1

3 2 2

2 3 1 2

2 2

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Camph.

Tarent.

Canth.

Cham.

Stram.

Nux-v.

Caust.

Nit-ac.

Staph.

Sulph.

Associative Features of ODD and CD Confidence, want of 3 1 1 self 2 1 2 2 1 1 Discouraged 2 Egotism 3 2 2 2 3 3 Irritability Mood Changeable, 2 1 2 2 2 Variable Stomach, Desires alcoholic drinks 1 3 1

1 1

1 1 2

1 1 3 1

1 3

1 1 2 3 2 2

1 1

1 2 2 2 1 3

2 2 3 3 1

1 1 1 2 2 1

1 1 3 1

1 1 3

1 1 1 1 2 3 1 1

1 1 3 1 1 1 2 2

1 1 2 2

1 2 2 3 1 3

2 2 1

1 Stomach, Desires 1 tobacco + smoking Other Frequently Associated Features of ODD and CD 2 1 1 2 2 1 2 Dreams, nightmare Fear, night 2 2 2 3 2 1 2 1 1 Handles genitals Masturbation, 1 disposition 3 1 1 3 3 2 1 2 2 3 Sleep, restless 2 1 3 3 1 1 Teeth, grinding, Urination, 1 1 3 3 2 1 3 2 1 involuntary, night Associative Features of CD Delusions, imaginations, hallucinations, 2 1 1 2 3 2 2 1 1 illusions Indifference, apathy, etc 2 2 2 2 2 2 1 1 2 1 Shameless 1 1 1 1 Suicidal, disposition 2 2 1 2 1 2

3 1

2 2

1 1 1 2 1 2 2 1 3 2 1 1 1 2 2 1 1 2 2 2 1

1 1 1

1 1 2 3 1 2 2 2 2

3 2

2 2

2 3 1

2 2

1 3

1 1 2

2 2

3 1 2 3 3 2

2 2

2 2

2 2

2 2

1 1 1 2 2

2 2 3 3 1 3 1 2 2

1 1

2 3

2 1 2 2

3 2

1 1 2 1

2 3 3

2 2

1 2

2 2 1

1 3

Suspicious 3 2 3 2 1 3 1 ^ anger, irascibility; courageous + audacity; heedless

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Verat.

Hyos.

Acon.

Anac. Ars.

Phos.

Merc.

Lach.

Cupr.

Agar.

Lyss.

Calc.

Hep.

Bell.

Lyc.

Plb.

Op.

2 2 1

1 2 2 1 2

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Camph.

Tarent.

Canth.

Cham.

Stram.

Nux-v.

Caust.

Nit-ac.

Staph.

Sulph.

Associative Disorders of ODD and CD Attention Deficit Disorder (Inattention) 2 1 2 1 2 2 Forgetful Concentration, 2 2 3 1 1 difficult Memory, weakness 2 1 2 3 3 1 of Memory, weakness, heard, for what has 1 1 Memory, weakness of, labor, for mental + 1 fatigue, from Mental effort Thoughts, wandering 2 1 Work, aversion to 2 1 mental Heedless Reading Disorders Mistakes reading Memory, weakness of, read, for what has Concentration, difficult, studying, reading, etc., while Reading, averse to 1 1 1 2 2 2 3 3 1 1 1 1 1 2 2 3 1 2 3 3 2 3 3 2 3 3 3 1 1 3 2 3 1 2 3 1 3 2 3 3 1 3 2 3 3 1 1 1 2 1 2 2 2 2 2 1 2 1 1 3

1 1 1 1 2 1 1 1 1 1 1 2

1 1 2 1 1 2

1 1 3 3 1 1 1 2 2

2 1

1 x

3 2

2 Mathematics Disorders Mistakes in calculating Inability for mathematics + Writing Expression Disorder Mistakes writing, in Omitting letters + syllables + words Transposing letters Inability for writing + mistakes writing + confusion while writing

2 x x x 2 2 1 1 x 3 x 3 2 2

1 x

2 x 1 1 1 x 1 1 1 1

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Verat.

Hyos.

Acon.

Anac. Ars.

Phos.

Merc.

Lach.

Cupr.

Agar.

Lyss.

Calc.

Hep.

Bell.

Lyc.

Plb.

Op.

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Camph.

Tarent.

Canth.

Cham.

Stram.

Nux-v.

Caust.

Nit-ac.

Staph.

Sulph.

Associative Disorders of ODD and CD Speech And Language Disorder Mistakes in speaking 2 Mistakes in speaking, wrong Speech, confused x Speech, incoherent Speech, loud Speech, unintelligible 2 2 1 1 2 2 2 x 1 2 1 x 1 1 1 2 3 2 3 1 2 3 2 1 2 x 1 1 1 x 1 1 x 1 3 x 1 1 3 2 3 1 x 2

1 1 2 1 2 1 2 1 3

1 ADHD With hyperactivity Mind, gestures, grasping or reaching at something 1 Mind, runs about 1 1 Loquacity Climb, desire to Extremities: restlessness 1 restlessness, upper limbs 1 1 restlessness, hand shaking, upper limbs 2 restlessness, leg 1 1 1 restlessness, feet Shaking lower limbs + leg Awkwardness, lower limbs, knocks against things + stumbling when walking 3 ADHD With Impulsitivity Hurry 2 Impulsive Impetuous Impatience Answers hastily Speech, hasty Heedless Courageous + Audacity 1 2 1 1 1 1

1 1 1 2 2 1 1 2 1 x 3 1 1 2 1 1 1 2 3 2 2 2

2 2 1 1 1 2 2

2 3 3 x

2 3 1 1

1 1 2 2 1 2 1

3 3 3

1 2 1

1 1

1 1 1

2 3 1

3 1

1 1

3 1

1 1 1 1 1

3 1 1

3 2 3

2 1 1

1 3

2 1

1 2

2 2

2 2

3 2 1

2 2 2 1 2 2 1 2 1 1 2 1 2 1 2 1 2 1 1

3 2 1 2 3 3 2 1 3 1 1

2 1

2 2 1 3 1 3 1

1 2 1 3 3

1 2 1 1 1 1 1 2 1 2 2 3 1 2 3 3

2 3 1

2 1 2 2

2 1 3 2

2 2 1 2

1 1 2

1 3

1 1

2 2 2 1 1

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Verat.

Hyos.

Acon.

Anac. Ars.

Phos.

Merc.

Lach.

Cupr.

Agar.

Lyss.

Calc.

Hep.

Bell.

Lyc.

Plb.

Op.

3 2

1 1

1 1

Jacqueline Tan/ PG-799

Camph.

Tarent.

Canth.

Cham.

Stram.

Nux-v.

Caust.

Nit-ac.

Staph.

Sulph.

Associative Disorders of ODD and CD Mood Disorders - Depression Comatose 1 1 2 3 2 Despair 2 1 3 1 3 Gestures, Wringing the hands Prostration of mind Quiet, disposition Reproaches, himself 2 Sadness, mental depression 3 1 Sleep, sleeplessness 2 2 Slowness + motion in Stomach, Appetite, diminished 1 Stomach, Appetite, increased 2 2 Stomach, Desires, bread + pastry + starch Stomach, Desires, Crave sweets Talk, indisposed to, desire to be silent, taciturn 2 2 2 3 3 2 3 1 3 3 3 2 1 1 1 1 1 1 3 2 3 1 1 1 2 2 2 2 3 2 1 2 2 3 3 2 2 2 3 1 1 1 1 1 1 2 2 2 3 1 1 2 2 1 3 1 2 1 2 2 2 1 2 2 1 1 2 2 1 1 2 1 2 3 2 2 1 2 3 1 3 2 2 1 2 2 2 2 2 2 3 2 2 3 1 2 3 3 2 3 1 1 2 3 1 2 1 1 1 3 1 2 3 2 3 2 1 3 3 1 2 3 1 1 1 3 3 2 2 2 3 2

2 1 3 2 2 2 2 3 3 3 3 2 3 1 2 3 2 1 3 3 1 3 3 1 1 3

2 1 2 1 2 3

2 1

1 1

1 2 1

1 2

1 3

1 2 2 2

1 2

1 3

^Concentration, difficult; suicidal disposition Mania Cheerfulness, gay, happy Delusion, great person, is Mania, madness Ideas abundant, clearness of mind 2 1 2 1 x 1 1 1 1 2 1 2 3 3 2 1 2 2 2 2 2 1 1 1 1 1 1 1 2 2 1 3 1 2 3 3 2 1 3 3 2 1 3 1 1 1 3 2 1 2 2 2 2 1 2 2 1 3 1 1 3 1 2 1 1 1 2 1 2 2 3 2 2 2 1 3 1

Dancing 1 1 2 2 ^Sleep, sleeplessness; loquacity; concentration, difficult; lasciviousness

66

Verat.

Hyos.

Acon.

Anac. Ars.

Phos.

Merc.

Lach.

Cupr.

Agar.

Lyss.

Calc.

Hep.

Bell.

Lyc.

Plb.

Op.

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Camph.

Tarent.

Canth.

Cham.

Stram.

Nux-v.

Caust.

Nit-ac.

Staph.

Sulph.

Associative Disorders of ODD and CD Bipolar Disorder Delusions, imaginations, hallucinations, 2 1 1 2 3 2 2 1 1 3 3 2 2 2 2 illusions 2 1 2 1 1 2 1 3 1 Mood Alternating ^Mood, changeable, variable; and other symptoms of depression, mania, hypomania Anxiety Disorder Anxiety Chest, palpitation, heart Chest, pain Chilliness Delusions, unreal, everything seems + person, thinks she is some other Fear, death Generalities, heat, flushes of Generalities, trembling externally Perspiration Respiration, difficult Skin, numbness 3 1 3 3 1 2 1 2 2 3 3 3 3 2 3 3 3 3 3 2 3 3 3 2 1 3 2 1 2 3 2 3 3 2 2 2 2 2 2 2 2 2 2 1 3 2 2 2 3 2 1 3 3 2 3 1 1 2 3 2 2 3 2 1 3

2 2 1 1

2 1

3 2

1 1

2 3 2 3

2 3 2 3 1 3 1 2

2 2 1 3

2 1

2 2 2 1

3 3 2 3

2 1 2 2

1 3 2 3 1 1 3

2 3 1 1 1 2

2 2 1 1 2 1 1 3 3 3

2 1 2 2 1

2 3 3 3 1 3

2 3 1 3 3 1 2 2

3 2 3 2 2

2 3 2 1 2

2 2 2 3 2

1 2 3 1 3 3 2 3 3 3 3

1 1 1 3 1 2

2 2 2 2 2 2

2 3 2 2 1 2 2 3 3 3 2 2

2 1 2

1 2 1

2 1 3

2 1 2

1 1 1

3 1 2

3 2 3

2 1 3

1 3 1 1 2 2 1 1 1 1 2 1 1 3 1 1 3 Skin, prickling 2 2 2 3 3 2 2 2 2 3 3 3 1 2 2 1 2 2 3 1 2 2 1 1 3 1 3 Stomach, nausea 2 1 2 3 2 2 3 3 2 2 3 3 3 1 1 2 1 1 3 2 3 2 Throat, choking Vertigo 3 3 1 2 3 3 2 2 2 2 2 2 2 2 3 1 2 2 3 3 3 1 1 2 3 1 2 Psychotic Disorder Depending on the disorder, symptoms can include ^mood disorders and have specific delusions and hallucinations Modalities 3 1 2 3 2 3 2 2 3 3 2 2 2 2 1 3 2 2 3 3 2 1 3 3 3 3 Thirst 1 2 2 2 1 1 1 2 1 1 2 1 2 1 1 1 Thirstless

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Verat.

Hyos.

Acon.

Anac. Ars.

Phos.

Merc.

Lach.

Cupr.

Agar.

Lyss.

Calc.

Hep.

Bell.

Lyc.

Plb.

Op.

3 3 2

2 3 3

Jacqueline Tan/ PG-799

32.The Three Kingdoms


Hahnemann was the first to initiate the study of the difference between the mineral, plant and animal kingdom, and to find complementary relationships between the kingdoms. Other contemporary homeopaths expanded on the research to uncover the characteristic symptoms of group remedies in the kingdoms. Dr. David Little, however, highlights the need to keep in focus the totalities of the patients symptoms, in order not to give rise to speculation or stereotyping. He does acknowledge that a person a different stage of treatment may require different kingdoms of remedies. Dr. David Little observed that plants undergo rapid transformation and are thus similar to acute diseases and miasms. Minerals are stable and change only after lengthy periods, thus are similar to chronic diseases and miasms. Animal remedies, on the other hand, being fasting acting and rapidly destructive, are suited for rapidly destructive acute and chronic diseases. Little also mentioned that the plants and animals most suited for chronic diseases are those that are most affected by minerals as in the case of Lycopodium and Calcarea Carb Ostrearum. Sulphur, Lycopodium and Calcarea Carb Ostrearum are three remedies featured in Hahnemanns antipsoric remedies. G H. Clarke suggested that these three remedies, which are incidentally from different kingdoms, should form the basis on how homeopathic remedies should be grouped112. According to Dr. Rajan Sankaran, illness results when one of the kingdoms characteristics overtakes the human element. Patients from the plants kingdom usually display a heightened sensitivity and reactivity; while an animal kingdom patients issue is that of competition an d survival, and often talks of being the victim or aggressor; last but not least, a mineral kingdom patients concern is with his structure and challenges to his structure. After ascertaining the kingdom, mostly through observation of hand gestures rather than words in a semi-hypnotic state, the emotional state is determined to find the remedy through the sub-categories within the kingdom113. Within the mineral kingdom, for example, children from the acids sub-category are like the acid substances which are irritable, abusive, sarcastic, vindictive, are highly reactive to criticisms and have a tendency to steal. They look charming, but can be filled with hatred, which are not resolved by apologies; instead they are sadistic and will ensure they get their vengence. Too much mental work will also cause debility. Children under the spiders sub-category under the animal kingdom, are hyperactive (with many hand movements), hurried, cunning, jealous, and are highly sensitive to music, noise or vibrations, likes to jump, climb, hide and dance, tease, have a fear or interest in spiders, fear of death, being trapped, and are highly sexual 114. Children under the snakes sub-category are highly jealous, quarrelsome, secretive, suspicious, are malicious and destructive with a fear or having the desire to kill or poison others115.

Remedies for Aggression and Violence According to Papaphilippou George, remedies with highest intensities of violence are: Hyos., Stram., Bell., Hep., Verat., Anac., Lyc., Nux Vom., Aur., Nit. ac., Cham., Lach., Merc., Staph., followed by other remedies.

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He mentioned that Hyos, Stram and Bell. are complementary to each other and thus, can be used together in a case (2 or 3 of the remedies combined)116. The mental and physical expressions of violence are explained below, with the PQRS related to the violent expressions. The remedies are also categorized according to the kingdom they belong.

Mineral Kingdom117
32.1 Arsenic Album118 Disorders: ADD with hyperactivity, ODD; Language and speech disorders, stammering Axis: Withdrawing + Hyperactive + Non destructive Anxious and becomes too responsible. Fearful illness, dark, thieves, being alone, wants company; cautious about dealings; grabs people to feel safe. Hide under bed, wakes up with fear and jumps out of bed. Sensitive concerned about how others perceive him. Perfectionist wants everything in order, plans for everything. Irritable wants to be carried quickly. Restless wants to be carried by different people. Selfish and easily angered. Delusion of bugs in bed and thieves in the room. Hits his head against the wall, attacks others. Cruel liar who is jealous, stingy and steals. Nervous tics, enuresis, encopresis, grinds teeth, nail biting. Sensitive to smells and noises. Generals: Chilly, sips small quantity of water at small interval; desire warm food and drinks, milk, acids and coffee; burning pains > warmth Modalities: < (worse by) cold, wet weather, after midnight; cold drinks, or food, seashore; > (better by) heat, head elevation, warm drinks 32.2 Causticum Disorders: ADHD with hyperactivity, ODD, CD; language disorder; depression Axis: Withdrawing + Hyeractive/Hypoactive + Non-destructive + Emaciated Slow to walk and talk. Want to be carried. Sensitive to noise; easily startled. Fear: night, being alone, strangers; trifles make him cry. Restless, but motionless by fear. Sympathetic towards suffering of others, can put himself in others position as he knows it can also happen to him. Revolutionary and cannot stand injustice. Idealistic, dictatorial and defiant. Sad humor with worry. Avoids risks. Long standing melancholy, insomnia, sudden fear, fright, joy, rage. Needs constant movement, which does not make him better. May become liar and anarchist, with tendency to steal. Enuresis, encopresis and nervous tics. Weight loss, despite good appetite. Tendency to warts around nails. Generals: Chilly, thirsty 69

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Modalities: <dry, cold winds, motion of vehicle; > damp, wet weather, warmth, heat of bed 32.3 Cuprum Metallicum Disorder: CD; speech and language disorder; mania Axis: Withdrawing + Hyperactive + Destructive Nervous and uneasy, fear society and keeps distance from others, aversion to change. Malicious, happy when others are suffering. Likes to imitate everyone. Rage attacks and mania; violent, bites, beats, tears things, hysterical, sudden desire to injure, shriek, scream, kick and escape. Talks incoherently, weeps, is spiteful. Stiff when being carried. Sometimes yielding, other times stubborn and dictatorial (authoritative). Diligent. Poor memory. Young men age prematurely due to vices like alcohol, substance abuse and late nights. Convulsions119. Generals: Chilly, thirsty, spasms & cramps, desire for warm food and drinks Modalities: <before menses, vomiting, contact; >cold water, perspiration 32.4 Hepar Sulphuris Calcareum Disorder ADD with impulsiveness; ODD and CD; speech disorder like stammering Axis: Withdrawing + Hyperactive + Destructive Children who can sit and do nothing. Aversion to play. Irritable and oversensitive to the smallest physical (touch, cold, draft of air, faint from pain) or psychological matters. Feels he is on the edge of a mental break down. Hypochondriac. Anxious without a cause and discontented. Becomes ferociously angry, defiant, oppositional, impulsive and hasty for the slightest reason; is vicious to others. Speaks and drinks in a hurry. Verbally abusive and quarrelsome. Violent, destructive and physically abusive kicks and hit, with impulse to kill, even loved ones; threaten with knife. Cruel and sadistic satisfaction at others sufferings, but kind to animals. Coldblooded murderer who kills without guilt; kill people with pleasure (Hering). Set things on fire. Suicidal thoughts, do not fear death. Enuresis. Generals: Chilly, thirsty, oversensitive, sour smelling, produce suppurations, purulent discharges Modalities: <dry cold winds; cool air; draught, Mercury, touch, lying on painful side; > damp weather, wrapping head, warmth, after eating 32.5 Mercurius Solubilis Disorders: ADHD with impulsivity, ODD, conduct disorder, memory weakness, reading and language disorders, stammering

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Axis: Approaching/Withdrawing + Hyperactive + Destructive + Thin Scrofulous with tissues tending to inflammation and destruction. Many fears: (a) he will act on impulses to throw things at, hit or kill loved one (b) insanity at night (c) avoid people become suspicious and hide away; everyone is an enemy who wants to hurt him. Anxious with great restlessness: constant desire for change, travel and escape; agitation; awkward with internal hastiness and slow response; hurried and rapid speech with slow answers. Destructive and aggressive against himself and others - intolerant to contradiction; angry and violent attacks; suicidal and homicidal; desire to stab and kill anyone with knife; spits on peoples face; disrespectful and resentful as a socially marginalised person. Easily excited from different stimulations; nervous laughing alternate with weeping. Dominating. Shy and embarrassed in social situations, rarely express emotions and blush easily; averse to be looked or touched, yet have inclination to catch strangers by nose. Hypersexual easily excited with eroticism, lasciviousness. Commits sexual crimes like rape. Prone to vices like gambling, drugs and alcohol. Conscience guilty, anxious and remorseful, suicidal. Selfish liar who is rude. Perfectionist (Masi Elizalde) creative; can destroy nature in order to rebuild it better. Turns from side to side and moans; dullness with aversion to play Generalities: Chilly and thirsty with moist mouth; Offensive and profuse discharges Modalities: < warmth, sunset to sunrise, night, wet, damp weather, lying right side, perspiring

32.6 Nitric Acidum Disorders: ODD and CD Axis: Withdrawing + Hyperactive + Destructive + Lean Lean, rigid fibres, brunette. Dark complexion, hair and eyes. Sunken eyes. Miserable on all level disappointed; anxiety on health matters especially cancer and leading to death; depression and suicidal thoughts but does not commit suicide due to fear of death. Irritable critical of others and themselves; others do not enjoy his company; irritated by mistakes and does not like consolation; curses, weeps; irritated by noise. Violent anger. Disinclined to work. Never forgives even with apologies. Indifferent to others. Oppositional, will injure and play rough. Obstinate, mischievous, hateful, corrupt and vindictive. Enuresis and bites the nails. Tendency to warts Generalities: Chilly, thirstless; excoriating, thin, offensive discharges, dirty; splinter like pains Modalities: < evening and night, cold climate, and hot weather; > riding in vehicles

32.7 Phosphorus Disorders: ADHD with hyperactivity and impulsivity; ODD and CD

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Axis: Approaching/Withdrawing + Hyperactive + Non destructive + Tall and stooping Lack of attention from home and thus makes superficial friends outside. Hypersensitive feel others emotions (clairvoyant, intuitive); sensitive to noise, odour, light and other impressions. Observant. Anxious and fearful of everything around, ghosts and being alone. Wakes up at night and goes straight to parents. Want of sympathy. Open, extroverted, affectionate, creative and has leadership quality. Desire to be held and magnetized. When agitated, becomes aggressive, bold, rude, violent, disobedient, quarrelsome, arrogant; strikes, spites, bites and swears. Have wild, violent rages. Restless, must move about constantly. Hypersexual with masturbation. Generals: Chilly, thirsty, burning; ravenous hunger during fever Modalities: <touch, physical and mental exertion, twilight, warm food and drink, change of weather, getting wet in hot weather, evening, lying on left or painful side; thunderstorm, ascending stairs; >dark, lying on right side, cold food, cold, open air, washing with cold water, sleep

32.8 Plumbum metallicum Disorders: ADHD, ODD, CD; depression Axis: Withdrawing + Hypoactive + Thin (Marasmus) Restless: hasty. Absent-minded. Loquacious and quarrelsome. Easily irritated, rude and defiant oppose social norms; loves taking risks and engaging in scandalous and prohibited activities (gambling away all belongings). Surpass his limits and goes against the law. Violent - attacks himself (stab) and others. Lascivious and unfaithful. Becomes more cold. Depressed with fear of being murdered. School children who are sent from one school to another due to lack of discipline. Encopresis and nervous tics; stupor state with slowness in response due to depression, with mental weakness and loss of words. Physically weak with rapid emaciation when ill. Paralysis, atrophies and GIT problems. Generals: Chilly, Thirsty Modalities: <night, motion; >rubbing, hard pressure, physical exertion 32.9 Sulphur Disorders: ADD with impulsiveness; ODD and CD; speech and language disorders Axis: Approachable + Hyperactivity + Non destructive + Emaciated with big belly Dirty and old looking with flabby skin. Restless and sleeplessness; kicks clothes off at night. Enjoy being with older company and resent when not being treated with privileges of adults. Selfish. Tendency to weep, sadness and be frightened (screams). Wants to be held to feel secure. 72

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Everything seems beautiful; boasts about his things. Religious affections, imaginative, analytical, artistic. Extroverted, jovial, however, is impatient. Averse to play and physical work - tired, at 11 am, indolent. Encopresis, enuresis, grinds the teeth and bites his own nails. Generals: Hot, thirsty, hungry at 11am, dread of bathing, sleeps without cover, burning discharges, burning feet Modalities: < at rest, standing, warmth in bed, washing, bathing, in morning, 11 a. m., night, from alcoholic stimulants. > dry, warm weather, lying on right side, from drawing up affected limbs

Plant Kingdom
32.10 Aconitum Napellus Disorders: ADHD with hyperactivity and impulsiveness; reading and speech disorders, stammering; ODD Axis: Approaching/Withdrawing + Hyperactive + Destructive + Fat Restless and hurried; changes position frequently. Anxious with hypersensitivity. Fear of death, dark, fear to leave, to be in same place with many people, to be injured. Anything frightens; night terror. Cautious and suspicious of surroundings. Mischievous. Child of the other extreme is bold, oppositional, rude, disobedient, angry, aggressive and quarrelsome: bites, throws and breaks items. Enuresis. Generals: Chilly, intense burning thirst; craves for alcohol, acidic and bitter drinks Modalities: <cold, dry wind, warm room, evening, night, lying on affected side, music, tobacco; > open air

32.11 Agaricus Muscarius Disorders: ADHD with hyperactivity; CD; Reading, speech and language disorders Axis: Approaching + Hyperactive + Destructive + Thin (slender) Alternate irritability and depression. Angry with himself and others. Aggressive and threatening uses force, defiant. Cold, cruel; likes to be near fire. Enjoys and need dance in his life. Excessively bold with exaggerated and vengeful behavior. Outburst of crying. Unimportant things causes sadness. Delayed milestones due to slower brain development; mental weakness. Intoxicated look; incoordination between mind and body. Says foolish things, poetry and prophecies. Does not respond to others. Can become indifferent; stubborn and proud. Averse to touch, mental and physical labor. Feels like ice needles on the skin with stinging sensation. Muscles move involuntarily, tremors, nervous tics. Enjoys stories on aliens, ghost or horror stories, makes up out of the world stories to attract friends. 73

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Generals: Chilly, diverse symptoms, speech lack clarity Modalities: < open cold air, after eating, after coitus, in cold weather, before a thunderstorm, pressure on dorsal spine; > moving slowly

32.12 Anacardium Orientale Disorders: ADD with impulsivity; ODD, CD Axis: Withdrawing + Hyperactive + Destructive Hard against others due to inferiority complex and lack confidence, leading to rage, aggression and cruelty. Initially, begins with weak memory and later progresses to violence. Easily irritated and offended - speak rudely with irony, belittling others. Blames others and not himself. Keeps a distance from others as fear everybody is an enemy; thinks others are responsible for his plight. Restless and nervous. Hard (not portrayed in front of doctor, harder than Med.), does not care about others feelings when speaking; curse and swear for slightest irritation. Dual personality: has a good side and an evil side that ask him to do wrong. Indecision between right and wrong; aggression and peace; values in general. Cruel without remorse, sadistic, merciless, malicious and socially maladjusted torment animals, impulse to kill, attack with violent sexual language; with immediate demands. Attacks when in company or when victims are defenseless. Fear he will be violent and out of control strikes and hurt others, even using a knife. Throws knife away. Fear of examinations. Contradictory reaction: laughs at serious matters and remain serious at jokes. Religious fervour, with obsession to save his soul. Feels abandoned and isolated. Extreme cases lead to schizophrenia. Olfactory and hearing hallucination. Sensitive to draughts. Children are often child abuse victims where the parents are abusive, highly criticial, over strict, shows high expectations and gives severe punishments. The child eventually becomes shameless and display anti-social behavior. He becomes indifferent and shows hatred towards parents. Generals: Chilly; Constant thirst; Loss of appetite with violent hunger; symptoms go from right to left; Wedge-like pain Modalities: < application of hot water; >after eating, lying on side, rubbing

32.13 Belladonna Disorders: ADHD with impulsiveness, ODD and CD; speech and language disorders Axis: Approach (Withdraw during illness) + Hyperactive + Destructive Great intensity of symptoms. Explosive anger with violence: climbs, pulls (hair), bites like a dog, spits, tears and throws things, strikes, knocks the head, sets fire and steals. Face becomes red 74

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(due to rush of blood) and frightening. Rage is strong without malice (like Stram.) and stops suddenly. Arteries pulsate during rage. Laughter attacks. Talks fast. Restless. Weeps easily. Fear of dogs, insects, black animals and wolves, as well as imaginary things like ghosts, horrible faces. In diseased state, can produce delusions, deliriums and have unstoppable violence. Desire to escape from home. Grinds teeth. Enuresis, tics Generals: Chilly, thirsty (great thirst for cold water); symptom comes and goes suddenly; strawberry tongue Modalities: < reproach, draughts (uncovering head), hair cut, touch, jar, noise, after noon, lying down. > semi-erect

32.14 Camphora Disorder: ADD; CD Axis: Withdrawing + Hypoactive + Destructive Mind and memory almost non-existent, retardation, does not answer questions. Delirium with rage and mania. Wants to jump out of bed or window. Screams and ask for help. Anxious and almost losing consciousness. Confusion comes with violence, becomes cold and wants to uncover, cold and open air. Destroys clothes. Desire to kill. Sexually aroused. Generals: Great exhaustion and prostration Modalities: < motion, night, contact, cold air; >warmth

32.15 Hyoscyamus Niger Disorders: ADHD with impulsiveness; ODD, CD; speech disorder, stammering Axis: Approaching + Hyperactive + Destructive Light haired children who are irritable, nervous, hysterical. Restless and sleepless. Feels unloved. Jealous siblings; leads to changed personality - child becomes introverted and hard. Seem as if it has stopped existing. Want revenge, but cannot, thus become emotionless and cold. Usually passive, but with quarrelsome opportunity, violence arises with anger, biting, breaking, striking, killing, strangling; curse, mocks, slander. Savage. Strong desire to kill. Lascivious mania without feelings expose nudity and play with genitals, sings obscene songs. Shameless talks and behavior. Dizzying laughter, at everything. Suspicious. Feels forsaken. Fear of loneliness, of being poisoned, sold, bitten, of having things that were given to him being taken away. Incoherent talks of imaginary things. Refuses to eat. Easily agitated, tries to escape. Injures himself intentionally, suicidal. Enuresis, encopresis, tics.

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Generals: Chilly, thirsty Modalities: <night, during menses, after eating, lying down; > stooping

32.16 Lycopodium Clavatum Disorder: ODD and CD; learning difficulties, reading, counting and writing problems; ADD with impulsivity Axis: Withdrawing (Emaciated)/ Approaching (Obese) + Hyperactive + Non destructive Serious, cautious and never smiles. Lack self-confidence - insecure and cowardly, fear responsibility, aversion to play; avoids situations where he has to show his fears. Acts dictatorial with loved ones and inferior ones, while showing pleasant persona to outsiders especially superiors. Fear of authority, darkness, noises, ghosts or imaginary things. Rude to parents who are too soft. Tend to have difficult relationship with father (Masi Elizalde). Express his anger by violence: violent rage, screams, curses, hits family and weaker ones. Hypersensitive to impressions, cannot tolerate jokes, feels he is always right and cannot tolerate contradiction. Obstinate, resentful, selfish and offensive, disobedient, oppositional. Irritable, kicks and pushes people angrily. Wants to be alone, but fear solitude: wants to be near familiar people and not strangers. Wakes up miserable, sleeps all day and cries all night; laughs or weeps in sleep Intellectually strong but physically weak children with nervous tics, enuresis, encopresis, GIT diseases, looks older with wrinkles and early white hair Generals: Hot; thirsty; Capricious appetite with ravenous hunger at times; craves sweets, warm food and drinks. Red sand in urine (cries before urinating); right sided symptoms Modalities: <4-8pm, right side, above downwards; heat, warm room; warm applications (except throat and stomach); > motion, midnight, warm food and drinks, cold, being uncovered

32.17 Matricaria Chamomilla Disorders: ADHD with impulsiveness, ODD Axis: Withdrawing + Hyperactive + Destructive Appearance: Light brown hair; one cheek red and the other cheek pale Hypersensitive and irritable easily annoyed, sensitive to pain (on themselves, others), before menses; does not want people nearby, dislikes being talked to, answers curtly, does not want to be touched; impatient. Bitter and violent has to be distracted constantly; child weeps and only stops when carried or are in a moving car. Can become blue and faint from weeping. They throw the thing that was offered, screams, curses, kicks or even hits the parents or doctor, pulls hair of 76

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others. They weep during sleep. Ill-humored wants many things, furious when not given, but when given, rejects them; unsatisfied and easily bored. Angry and quarrelsome - Over strained after anger or coffee abuse. Fear of wind. Uncontrollable stops breathing or starts convulsion when in anger, hits head against wall. Difficulties reading, writing and speaking. Feels unfairly treated (Masi Elizalde). Nocturnal terror and enuresis Generals: Warm and thirsty, excessive thirst for cold drinks, sleepy, but sleeplessness; warm sweats about head Modalities: < heat, anger, open air, wind, night; > being carried, warm wet weather

32.18 Nux Vomica Disorders: ADHD with hyperactivity and impulsiveness; ODD and CD; language disorders, stammering Axis: Withdrawing + Hyperactive + Destructive + Thin Ambitious and capable. Very irritable perfectionist, scolds and finds fault in others, before menses. Impatient and impulsive; cannot stand oppositions. Jealous, defiant, vindictive, cruel, melancholic and restless. Prefer loneliness and does not like to be looked at, yet grabs people for want of security. Quarrelsome tries to suppress anger but lead to anger outbreak with shouts, curse, throw, break and tear objects at slightest provocation. Lost of self-control and weep from irritability. Violent and destructive abusive (more self-controlled than Hepar), bite, hit, kill or set fire on people. Fear in deeper stage with weakness and depression. Anxious with oversensitivity to all external stimuli, injured pride (offended by innocent words), pain, noise, light, touch, drafts of air. Suicidal thoughts with knife, gun or falling off balcony. Generalities: Chilly; thirsty Modalities: <morning, mental exertion, after eating, touch, spices, stimulants, narcotics, dry weather, cold; > refreshing nap, evening rest, damp wet weather

32.19 Opium Disorders: ODD, CD, Mania Axis: Withdrawing + Hyperactive/Hypoactive + Destructive Child looks wrinkled and old for his age. Light hair with lax muscles. Lack of morals, will lie and steal. Easily excited and agitated with great imaginations. Hypersensitive, startles by the smallest noise, light, odor or action; otherwise will be unfeeling. Excitement emotionally or intellectually with euphoria, courage and feeling that nothing can hinder him. Night hallucinations. Fear, fright freezes him and shock initiates any disease or reaction. Violent rage 77

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with aggression bites, swears, screams. Convulsions after fright or rage. Jealous, rash, inconsiderate, malicious, cruel, wild, hysterical, laughs too much and inappropriately. Escapes. <touch. Enuresis, encopresis, Generals: Hot, great stupor and sweat, hot sweat on covered areas, painlessness in usual painful symptoms Modalities: <heat, during and after sleep; >cold things, constant walking 32.20 Staphysagria Disorders: ADD with impulsiveness and conduct disorder Axis: Withdrawing + Hyperactive + Destructive Quiet and serious. Easily angered and offended innocent or trivial action and word offends him; suppressed anger and rage leads to irritability; can subdue rage and arrive home trembling and tired. Explosive rage - throwing things at people who offend them. Strong sexual desire suppressed; starts masturbating at a young age; shy of opposite sex. Hypersensitive - slightest mental or moral impressions; touch; physical injuries; self esteem easily injured, feels he does not deserve the unfair treatment from others and will find a chance to return the treatment. Great indignation of others and himself; torments and reproach oneself of his past deeds. Most cases have history of parents or elders who abuse the child. Weeping from scolding or punishment. Averse to authority. Rude. Fear lose self control. Ill-humored - cry for things, yet when received, move or throw away the objects that were given; wakes up wants everybody and everything out; calls mother often Generalities: Chilly, Thirstless; Canine hunger even when full; Craves: sweets, milk Modalities: <anger, indignation, grief, mortification, loss of fluids, sexual excesses, tobacco, least touch; > after breakfast, warmth, rest at night 32.21 Stramonium Disorders: ADD, CD, stammering; depression, mania Axis: Approaching/Withdrawing + Hyperactive + Destructive Most violent remedy. Child with physical and mental agitations due to frightful and bad experiences. Difficulty of concentration. Frightened or fearful: of animals; at night in bed; of being injured; of suffering. Rage alternates with depression and violent behavior. Fear of his violence because of its intensity: injures, scratches, breaks things, bites, spits, tears, strikes and even kills. Does not like to be contradicted. Indifferent to physical pain. Convulsions. Sexual aggression: touches womens backs or breasts; displays and desires to be nude. Seem quiet when not angry. Feel lethargic in difficult situations or when they speak about a bad experience. Extremely loquacious; cries alternate with laughter; foolish behavior and responses. Sarcastic, 78

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begs, squeaks, curses, talks to angels, silly gestures. Religious. Fear of death, dark, being alone; holds on to others to feel more secure. The pupils dilate when scolded or punished; red, hot face, with cold extremities; red cheeks with marked boundaries. Frightening and confusing hallucinations: mice, snakes and other animals, devils; night terrors. Tries to escape. Generals: Chilly Modalities: <dark and being alone, looking at bright or shining objects, after sleep, on swallowing. > bright light, company, warmth 32.22 Veratrum Album Disorders: ODD and CD Axis: Approaching + Hyperactive + Non destructive Proud and wants to be the best and considered rich (or be the next to feel protected). Flatters and shows affection to others. Can lie and cheat; pretends to be ill to get sympathy. Will result to unscrupulous means to get object of desire; aggravated by loss of object. Restlessness physically or mentally. Untamable, full of thoughts and always on the move. Mentally curious with good understanding of things. They want to be constantly in motion and prone to damaging things. Malicious, hard, stubborn, critical, rude, jealous and oppositional; they feel they deserve more. They curse and want to belittle others. When hurt, they keep quiet or they become violent and strike. Have the urge to do bad. In religious delirium, they are not violent. In rage, they have the desire to kill, tear, cut things. Can have repetitive behavior. Hypersexual with sexual mania; show their genitals and lack discretion. In psychosis, think they are Christ or Napoleon. When scolded or punished, can be indifferent and hard. Generals: Chilly; thirsty; Vomit; desire for ice, salt and sour things. Enuresis, encorpresis, grinds teeth during sleep and bites nails. Nervous tics. Modalities: < evening, night; wet, cold weather. > walking and warmth

Animal Kingdom
32.23 Calcarea Carbonica Disorders: ADD, CD; language and mathematics disorder Axis: Withdrawing + Hypoactive + Fat Strong need for security and stability, and hence hold on to people or objects that are familiar to him (feel protected and supported). Stubborn and aggressive to parents at home, but fearful outside. Sensitive to scolding, rudeness and reproach. Change is threatening and is avoided by not being in new environment. Slow and averse to physical movements. Satisfied if basic needs 79

Jacqueline Tan/ PG-799

are met, does not pursue adventure and passion. Restless. Fear of everything: of suffering, hunger, illness, sad or terrible stories. Nightmares: scream after midnight and not easily soothed. Cries constantly. When destabilized, becomes disturbed, irritated, angry and emotional: bites, spites, able to kill. Slow psychomotor development and teething. Generals: Chilly, thirsty, head sweat, craves eggs, nail biting with feeling of abandonment. Modalities: < exertion, mental or physical, ascending, cold, water, washing, moist air, wet weather, full moon, standing; > dry weather and climate, lying on painful side

32.24 Cantharis Disorders: CD Restlessness with constant motion. Sudden loss of consciousness or stupor with red face. Fearful and confused mind with strange thoughts overwhelming him. Flooded with endless thoughts that makes him feel as if his mind was possessed by an external entity. Much excitement, violence and rage with hypersexuality (similar to Hyos. and Phos.). Sings and talk continuously and wildly about lascivious topics, urine and faeces. Violent, sexual excitement and lascivious thoughts accompany inflammation of genitals. Diseased parts lead to excitement of the part. Insolent and rude. Shiny or bright things, drink water or touch of larynx aggravate condition. Generals: Burning Modalities: <touch, approach, urinating, cold water or coffee; >rubbing

32.25 Lachesis Muta Disorders: ODD and CD Axis: Approaching + Hyperactive + Destructive + Emaciated; Speech, language, writing disorders Precocious and lively. Awareness with ability to verbally strike jesting, censorious, sharp. Cannot bear authority and restrictions. Enjoys tricking others. Great loquacity, jumps from one subject to another. Jealous and envious without reason; towards sibling. Possessive. Egotism wants to be the center of attention. Suspicious and resentful, vindictive liar and manipulator. Sexual - start masturbation early. They are revengeful, bitter and can hurt others. Difficult concentration - dull and indolent. Restless sleep and dream with groaning and moaning. Anxious as if committed a wrong. Mischievous crawls on floor and spits often. Religious insanity. Love for animals e.g. cats. Overactive mind with excessive reactions quick to respond; bites; injures others. Drinks alcohol. Desire dark blue color. Indolent, cheerless feels abandoned; parents tend to be abusive and insulting. Awkward with hands and legs

80

Jacqueline Tan/ PG-799

Generals: Hot and thirsty; Left sided symptoms; blue and purple appearance; sensitive to touch especially throat, abdomen; does not like tight clothes; trembling tongue; sleep on right side Modalities: < during and after sleep, left side, spring, warm bath, pressure or constriction, hot drinks, closing eyes; > discharges, warm applications

32.26 Lyssin (Hydrophobinum) Disorders: ODD Axis: Hyperactive + Destructive Difficult concentration. Stubborn. Great fear of water especially running water; dislikes baths, chokes when drinking water, fear swimming. Fear of becoming mad. Wakes up with anger. Cannot forget past events especially when ridiculed, will one day strike back at people who offend. Abnormal sexual desire. Emotional or terrible news makes him worse. Spits, growls, scratch, bark, crawl, aggressive120. Rage followed by swift repentance. Hide in tight places.121 Generals: Aversion to water, likes cold water; excessive saliva that is sticky, will spit it out Modalities: sight or sound of water; bright, dazzling light; vehicle riding; noise

32.27 Tarentula Hispanica Disorders: Conduct disorder, hyperactivity without ADD Axis: Approaching + Hyperactive + Destructive + Emaciated Restlessness on all levels. Hurried, does not keep quiet. Run better than walk (makes symptoms worse) and love to dance. Constant non-rhythmic and abrupt motion of arms and legs with incapacity for worthwhile pursuits; muscles contracts. Haste can be productive. Sly and malicious, selfish, dishonest, mischievous. Violent emotions and reactions aggressive, destructive, violent rage (does not want to be touched). Tears clothes, breaks and throws things. Rolls on floor, strikes and screams. Hysteria that leads to mania slightest excitement irritates him and causes sorrow. Sensitive to music dances and sings with excessive joy. Anxious intense nervousness physically and mentally; Oversexed extreme sexual excitement with fondling of genitals and masturbation. Lascivious, pulls out clothes to exhibit body. Disobedient does not obey rules, refuses to eat. Argumentative. Enuresis Generalities: Thirsty/Thirstless; sudden and violent onset; craves raw food; aversion to colors red, green, yellow, black Modalities: > open air, music, bright colors, rubbing affected areas; < motion, contact, noise, seeing others having problem 81

Jacqueline Tan/ PG-799

33.Homeopathic efficacy
In the past, there were not many studies detailing the efficacy of homeopathy in treatment of children with behavioral and mood problems. However, many recent studies and homeopathic doctors dealing with pedriatrics have proven that homeopathy does improve the behavior and mood of young patients. Drs. Judyth Reichenberg-Ullman and Robert Ullman, have treated over 3,000 children with learning and behavioral problems, mostly with great success. They have even authored several books like Rage-Free Kids, Ritalin-free Kids and Prozac Free, citing many case examples of their success. In 1994, Cortina presented a series of 20 cases of children with enuresis and behavioral problems, treated with Ilex, a plant derived remedy. They reported a 50% improvement in the enuresis and behavioral symptoms122. However, the study was said to lack control. In 2005, the European Journal of Pediatrics published a clinically controlled trial study involving 62 ADHD children. Each child is given an individualized constitutional homeopathic remedy. The medicines used included Calcarea Carbonicum (15), Sulphur (8), Chamomilla (5), Lycopodium (5), Silicea (5), Hepar Sulph (4), Nux Vomica (4), China (3), Ignatia (3) and Mercurius (3), Capsicum (1), Causticum (1), Hyoscyamus (1), Phosphorus (1), Phosphoric Acid (1), Sepia (1) and Staphysagria (1); with potency of Q3 to LM potency. No other treatments were allowed during the study, with progress measured at 4 week intervals. Only children with at least a 50% improvement on an ADHD rating scale moved on to the second phase of the study, which was a trial with a placebo group. The children will then either receive their homeopathic remedy or be given a placebo in the blinded trial. During the second period of the crossover phase, the groups were exchanged, with the children receiving their homeopathic remedy. The results showed that the homeopathic medicine does continue to improve the childrens behaviors, while the placebo did not have any effect123. In the British Homeopathic Journal of 1997, it stated that the most effective treatments for ADHD were the remedies cina, stramonium and hyocyamus niger124.

82

Jacqueline Tan/ PG-799

34. Case Studies


34.1 Singapore Faculty of Homeopathy Free Clinic Cases

All the below 5 cases have been gathered from the Singapore Faculty of Homeopathy volunteer clinics database and are cases conducted by the other doctors, while the next 5 cases are taken from book and internet sources. The write-up represents the authors best interpretation of the cases and does not guarantee its accuracy. The author is also unable to ask further questions nor assess the severity of each symptom in the cases. The names of the patients have been changed for confidentiality reasons. A reportorial analysis of the key note symptoms was conducted by the author and value and count in the reportorial result of remedies denote the total score of all the symptoms and the number of matching symptoms respectively. Free Clinic Case 1: Conduct Disorder On 11/8/2007, B is an 11 year old boy came to the clinic with his mother. He is a short tempered boy who uses bad words and fights with his mother. He prefers to play and likes games. Physically, he has hives and sinus since he was a toddler. He sniffs a lot but has no discharge or headache. He bathes in hot water and likes to sleep in a curled position in his air conditioned room. He was allergic to prawn and beef. On 15/9/2007, he was reportedly better after a dose of Apis. But he continued to use bad words and hand signs. On 2/11/2007, his mother reported that he is clumsy and spills tea on table. He sits with 1 leg up on chair or both wide open. He is extremely provocative (+++) to siblings, bullies them when bored. He was the 2nd of 4 children in the family and he cannot get along with his older sister. Once, he used a kitchen knife to try to attack his sister after she hit him at the back of his neck when he entered her room to watch television without permission. His mother feel that he is rebellious (+++), defiant (+++), violent(+++) and he fights with his mother. He continues to be non-attentive, but place his attention only on computer games. In school, he bullies his classmates verbally and physically kicks them too. He loves chocolate (+++), junk food, meat, water cress soup (+++), but hates vegetable. He does not have much appetite and argues that the cooking was not nice and was too bland. He pretends to eat the vegetables, but spits them out. He drinks a cup of water a day and has no thirst (+++) even after playing. He sleeps from 11pm to 5.15am, but would like to sleep more. He was observed to have white coated tongue. As for his family history, his mother has asthma, psoriasis, eczema, vitiligo, while his father smokes at least 1 to 2 sticks at home. His maternal grandfather died of cancer and his paternal grandmother and great-grandmother both died of stomach cancer. He was given a dose of Tuberculinum 200c in water and 2 drahms of Sac Lac 3 pills 3 times a day. In his next visit, his allergy to prawn and beef was better and he was a little more cooperative. He is likes to be thanked and given attention, he behaves better when asked politely to behave or do things and is willing to listen to his mothers firm command. However, he continues to

83

Jacqueline Tan/ PG-799

scream at his younger sister who voluntarily clear his cup from table and open his windows in his room. He was pleased that he did not have to do it himself. Analysis rubrics of keynote symptoms Mentals: 1. 2. 3. 4. Particulars: 1. 2. 3. 4. Defiant Cursing Anger, irascibility Violent

Mouth, discoloration, tongue, white Catarrh, extends to frontal sinuses Nose, snuffles Skin, eruptions, urticaria

Physical Generals: 1. Thirstless 2. Warm, ameliorates More information needs to be known about his personality; also the urticaria and sinus, the periodicity, the triggering factors and modalities.
Repertorial Result Lycopodium Nux Vomica Arsenic Album Bryonia Belladonna Pulsatilla Value 24 19 19 15 13 13 Count 10 9 8 7 7 7

1 2 3 4 5 6

In this case, Lycopodium met the criteria for all the rubrics and has the highest value. There is a need to better understand the extent of his clumsiness and the underlying cause of his defiance, whether it is more innate or due to external circumstances. Apis (Value, Count: 11, 5) is a good remedy for hives and clumsiness. Miasm He has a more psora-sycosis miasm. The psora explanation is his urticaria, with tendency of skin inflammation and congestion of his sinus. The sycosis component comes from his anger, irascibility and defiance. Thus Lycopodium as a remedy is suitable as it is a leading anti-psoric remedy, which also ranks highly for anti-sycotic and anti-tubercular.

84

Jacqueline Tan/ PG-799

Repertory Sheet
Name: B

Repertory used:

Kent

Date:

23-May-09

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:


Pg No

1 Skin, eruptions, urticaria 2 Nose, catarrh, extends to frontal sinuses 3 Stomach, thirstless 4 Mouth, discoloration, tongue, white 5 Mental, anger, irascibility

1321 325 530 402 2

6 Chill, warm, amel. 7 Mental, Defiant 8 Nose, snuffles 9 Mind, cursing 10 Mind, violent

1276 17 351 17 91

1 ACET-AC. ACON AESC AETH AGAR AGN ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARS-M ARUM-T ASAF ASAR ASC-S ATRO AUR BAPT BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-S CANTH CAPS CARB CARB-AC CARB-S CARB-V CARC CAUL CAUST CHAM CHEL CHIN CHIN A CHIN S CHLOL CHLOR CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC 2

3 1 2

4 2 2 1 1

5 3 1 1 1 1 1 1 1 3

7 1

9 10 Value Count 1 1 1 9 8 0 5 2 3 2 1 4 9 4 10 0 7 6 11 0 1 5 0 7 19 6 2 0 3 2 1 2 9 2 6 13 0 2 2 6 2 15 3 2 11 0 0 4 5 0 4 0 2 6 1 0 2 6 9 0 1 11 8 7 9 4 3 3 2 7 3 2 0 0 1 6 2 5 5 1 5 5 0 5 2 3 2 1 4 8 3 5 0 3 3 5 0 1 3 0 5 8 3 1 0 2 2 1 2 4 1 5 7 0 2 2 4 2 7 3 2 5 0 0 3 2 0 3 0 2 6 1 0 1 3 5 0 1 7 4 4 5 4 2 1 2 4 3 1 0 0 1 5 1 2 3 CON COP CORN COR-R CROC CROT H CROTT CUB CUPR CYCL DIG DIOS DROS DULC ELAPS ELAT EUP-PE EUPHR FERR FERR i FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR-AC HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-N KALI-M KALI-P KALI-S KREOS LAC-AC LAC-C LAC-D LACH LAT-M LAUR LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MERC IF MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C

1 2 3 2

3 2

4 1

5 2 1

6 1

9 10 Value Count 7 5 3 3 4 2 4 1 6 4 3 3 2 6 3 2 2 7 2 3 6 2 7 0 2 3 6 11 1 5 10 2 9 4 7 2 9 7 3 12 7 3 0 9 4 5 1 3 0 7 0 2 8 2 0 0 0 24 1 3 1 0 1 0 6 0 10 3 9 3 0 5 1 6 6 4 3 2 3 3 1 4 1 4 3 2 2 2 3 3 1 2 5 2 2 4 1 4 0 2 3 4 5 1 4 4 1 5 3 5 2 5 3 2 6 4 2 0 6 2 3 1 2 0 5 0 2 4 1 0 0 0 10 1 3 1 0 1 0 5 0 6 2 6 2 0 3 1 5 5 NAT-M NAT-P NAT-S NIT-AC NUX-M NUX-V OLND ONOS OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB VERB URT-U VALER VERAT VERAT V VERB VIOL-T VIB XAN ZINC

1 3 2 1 2

3 1

4 2 2 3 2 2 1 2 1 2 2 2 1

5 3 1 2 3 1 3 1 1

9 10 Value Count 1 2 12 3 5 12 9 19 5 1 6 0 2 4 12 9 9 1 0 5 3 2 6 13 0 0 4 0 1 9 3 2 10 1 5 4 0 3 1 3 13 8 0 6 1 3 6 1 7 3 0 13 6 0 2 1 6 2 1 0 0 2 6 2 1 3 4 9 1 1 1 0 0 5 6 2 3 6 4 9 4 1 4 0 2 3 7 5 5 1 0 4 2 1 3 7 0 0 4 0 1 4 2 2 5 1 2 3 0 3 1 3 6 5 0 4 1 2 3 1 5 2 0 6 4 0 1 1 3 2 1 0 0 1 4 1 1 1 4 6 1 1 1 0 0 4

2 1

1 1 1 1 1 1 1 2 1 1 2 1 1 1 1 1 2 1 1 1 1 1

1 1

1 1

1 1 1 2

1 1

1 1 2

1 1 1 1 1 3 2 2

2 1 1 2

1 2 2 2

1 1 3 2 1 2 1 2 1

3 3 1 3 2

1 3 1

2 1

1 3

3 1 2 1 2 2 1 2 1 2 2 2 2 1 1 1 1 1 3 2 1 1 1 1 2 3 1 1 2 2 2 2 1 1 2 1 3 1

2 1 3

2 3 3

1 2 1 2

1 3 1

2 3 2 2

1 1

1 1

2 2

2 1 1 1 3 2 2 3 2

1 2 2 2 3

2 1

1 1

2 1 3 2

2 2 3 2 2 1 1 1 1 2 1 3 1

1 1

2 2

1 1 1 1 1 2

2 2

2 1

1 1 1

1 1 2

1 1 3 1 2 2 1

3 1

1 3 1 2

1 1 3 1 2 3 2 2 1

1 3

3 1 1 3 2 2 1 1 1 2 1 1

2 2 2 1 1 1 1 2 2 3

2 1 1

1 1 1 1 2 2 1 3 1 2 1 1 1

3 1 3

3 3

2 3 1 3 2 3 2

1 3 1 3 3 1 1 2 1 3

1 1

1 1 1 2 2 2 2 1

1 2 1 1

2 3 1

3 1 1 2 3 1 2

1 2 1 1 1

2 2

3 1 2 3

1 1 1

2 1

1 3 2 1 1 1 2 1 2 1 1 2 2 2 1 1

2 2 1 1 1

1 1 2

1 1 2

3 1 2

3 2

3 1 2

3 1

1 2

2 1

1 1 1 2 1 2 2

2 2

3 2

2 2

3 1 1 1 2 3 1 1 1

1 1 3

2 3 1 1 1

2 3 2 1

1 2

2 1

2 1 1 1

3 1

2 1

2 1 2 1 3 1 2 1 1 1 1 1 2 2 1 2 2

1 1 1 2 1 2 3

2 1 2 3 2 1

1 3 1 2

1 1 2 2 2 1 1

1 1 1

1 1 1 1

1 1 1 1

1 1

1 3

1 2 2

2 2 2

1 1 1 1 1

2 1 2 2

1 1

85

Jacqueline Tan/ PG-799

Free Clinic Case 2 Gender: Male, age 9 years old 26/11/2005 C gets angry very easily, especially when reprimanded. He shouts a lot and likes to throw tantrums. He is anxious boy who has a weak memory. He does not like to go to school as he is very scared of his teacher. He does not sleep well and often wets his pants. He has no appetite and does not like to eat fruits and vegetables. He was given Group Remedy 1 and Chamomilla 1 drahm 3 pills 3 times a day. In addition, rescue remedy, Horn Beam and Larch 3 pills 3 times a day. 22/3/2008 Enuresis and weak memory persist. Stress has increased due to Primary School Leaving Examination (PSLE). He is not good in his study and is very shy and hot tempered. He uses abusive language, pulls down chairs and throws things in anger. His mother is irritated by his hyperactivity. His mother said that he is slow in his development especially talking late as a child. Prescription: Tuberculinum 1M, 1 dose given. Anacardium 30c and Baryta Carb30c, given 3 pills 3 times a day for one week 3/5/2008 He is a very naughty child who kicks in fits of anger. He repeats himself, is very shy and only prefers to talk to his mother. In school, when angry or excited he shakes his hand. When teased by his classmates, he keeps quiet. Teachers insult him and he hates to go to school. He likes to eat cold things like ice cream, sweets and dislikes fruits and nuts. His appetite is poor. He is a hot patient. His enuresis is better. Prescription: 1 dose of Staphysagria 200c immediately, and followed up by Bach flower remedies Star of Bethlehem and Holly. No further update is provided about his condition.

Constitutional Analysis - Keynote symptoms with rubrics Mentals: 1. 2. 3. 4. 5. 6. Mind, Anger, irascibility Mind, Memory, weakness of Mind, kicks Mind, throwing Mind, Timidity (shy) Mind, Cursing

Physical Generals: 7. Urination, involuntary, night 86

Jacqueline Tan/ PG-799

8. Stomach, desires, sweets 9. Stomach, desires, cold food 10. Stomach, appetite, diminished

Repertorial Result 1 Lycopodium 2 Arsenic Album 3 Natrum Mur 4 Sulphur 5 Phosphorus

Value 21 16 14 15 14

Count 9 8 8 6 6

The remedy with the most matching symptoms is Lycopodium. Lycopodium is a timid, anxious and hot patient who meets all the above rubrics except for Mind, throwing. Timidity should be specially considered in this case, as not all patients who are easily angered are shy. The display of anger may be to hide the emotional insecurity of the patient. Another sign of his lack of courage is his unwillingness to attend school because of problems in class. In, addition, a Lycopodium is also restless and displays the symptom of hand shaking, which is found in the patient. His weak memory may be the cause of his lack of confidence, hence timidity and anxiety in academic performance, which eventually manifested into irascible anger with swearing, enuresis and physical gestures like kicking, throwing and hand shaking. Miasmatic Analysis He displays a more psora-sycotic miasm due to his fearful, nervous temperament, coupled with his hot temper and irascibility. A higher weightage will be placed on psora miasm due to his weak memory and timidity, which is likely the cause of his problems. Thus Lycopodium as a remedy is suitable as it is a leading anti-psoric remedy, which also ranks highly for anti-sycotic.

87

Jacqueline Tan/ PG-799

Repertory Sheet
Name: C

Repertory used:

Kent

Date:

24/5/2009

<--------------Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

2
Pg No

1 Mind, anger, irascibility 2 Mind, memory weakness 3 Mind, kicks 4 Mind, throwing 5 Mind, Timidity

2 64 60 88 88

6 Mind, cursing 7 Urination, involuntary, night, 659 8 Desires, cold food, 485 9 Desires, sweets, 486 10 Appetite, diminished

17 659 485 486

ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CANN CANN-S CANTH CAPS CARB CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC CON COR-R CROC CUPR

1 2 3 3 2 1 1 1 1 1 1 1 2 1 3 1 1 1 3 2

5 6 2

7 8 1 2

1 2 1 1 2 1

1 3

2 1

2 1 1 1 3 2

3 2 3 1 2 1 3 3

3 2 3 1

1 3 1 2

2 3 3 1 1

3 1

2 1 3

1 1 3 1 2

3 1 1 2

2 2

1 1

1 1 2 2

1 1 1 2 1 1

2 3 1 1

3 1 1 2

2 1 2

3 2 1

2 3 1 3 1 3 1 1 1

1 1 1

9 10 Value Count 8 4 2 2 3 2 1 3 3 1 2 2 1 4 4 3 7 3 5 3 1 2 9 7 3 2 10 5 0 0 0 0 2 1 3 2 7 3 1 1 1 1 4 3 3 2 12 5 0 0 7 4 1 1 16 8 3 2 1 1 0 0 1 1 2 9 4 1 1 10 6 1 13 7 0 0 1 2 2 1 5 4 1 1 1 1 1 2 10 5 1 2 2 2 4 3 2 10 5 0 0 0 0 3 2 2 8 4 0 0 0 0 2 2 1 5 5 2 1 1 1 2 1 12 7 0 0 0 0 2 12 5 7 4 1 3 3 3 1 10 6 0 0 0 0 2 5 3 0 0 0 0 3 2 3 1 2 4 3 3 1 2 4 3 2 6 3 1 1 1 1 1 1 3 3

1 CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M NAT-P NAT-S NIT-AC NUX-M NUX-V OLND 1 1 2 1

1 1 1 1 2

1 2 2 3 2 2

3 1 2 3 2 3

1 1 3 2 3 2 2 1

3 3 2 3 1 2 1 1 1 1 2 1

2 1 2 1 1 2 1 3 2 1 1 1

2 3

3 1 2

1 2 2

2 3 3 1

1 2 1 1

3 1 1

3 1

2 1

1 1 2 3

1 1 1 2 2 2 1 1 3 1 2 3 1 3 1 1 2 2 2 2 3 3 2 2 2 2 1 1 1 2 3 2 1 1 2 2 2

3 2 3 1

3 2

9 10 Value Count 2 2 1 2 3 2 0 0 1 1 4 3 2 3 2 0 0 0 0 2 6 3 1 4 4 1 6 4 2 8 4 3 1 9 4 1 1 1 2 1 1 1 1 5 3 8 3 2 4 2 1 10 6 1 1 1 9 5 1 4 3 2 7 5 1 1 1 5 4 1 2 2 3 2 2 1 11 6 0 0 0 0 1 9 5 2 2 1 11 6 1 6 3 5 2 2 3 2 2 3 2 0 0 3 2 4 3 0 0 0 0 0 0 2 3 2 21 9 2 2 3 3 2 4 2 3 1 1 1 0 0 1 1 2 4 2 1 1 7 5 1 5 3 3 2 2 3 2 3 2 1 1 1 6 4 2 1 9 5 1 1 1 14 8 1 7 5 2 1 13 5 4 2 1 1 12 7 3 2

OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

1 2 3 1 2

5 6 7 8 1 1 2 1

2 3 2 2

2 3 3 2 3 3 1 2

3 3

1 1

2 1 2

1 3

1 2 2 3

2 1

1 1 2 1 1 1

2 1 1

3 2

1 2 2 2 3 1 1 2 3 1 2 3 1 2 1 2 2 2 1 1 2 2 2 2 1 3 1 3 3 2 1 3 3 1 2 1 3 3 1

1 2

1 2 1 2 1 1

1 1 2 2 2 1 3 2 2 2

1 1

9 10 Value Count 1 1 9 7 0 0 1 1 3 2 1 12 6 6 3 1 14 6 0 0 3 5 2 5 3 2 1 10 5 2 1 2 7 4 1 13 7 0 0 0 0 2 2 2 1 3 2 1 1 2 1 12 6 1 1 1 1 5 4 2 2 6 4 1 2 2 0 0 1 2 2 2 1 1 3 2 2 4 2 0 0 2 1 12 5 1 9 5 0 0 5 4 1 5 3 4 2 10 5 0 0 1 11 7 3 2 2 2 3 1 15 6 4 3 2 1 0 0 1 3 3 6 4 1 2 2 1 2 2 0 0 1 1 0 0 1 9 5 2 8 4 0 0 2 2 1 11 7 0 0 0 0 1 8 6

88

Jacqueline Tan/ PG-799

Free Clinic Case 3 22/11/2008 Male, age 14+. D is not interested in studies as he is weak in his studies, hence he does not feel like studying. He likes to study in a group as he can then ask if he has a problem. He can remember what he likes in his studies. He is lazy and prefers to play. He has been put to work at a shopping mall and has been hardworking thus far. During his free time, he enjoys games, basketball and soccer as a striker. He gets angry easily, especially when scolded. In his violent anger, he will break things. He is very rude, violent and likes to fight. According to his mother, his friends are also wayward, and he uses foul languages with his friends. At home, he does not talk much and is very moody and obstinate. He feels jealous of his sister, whom he feels has been taken care of more. He likes to listen to songs all the time and likes to dance vigorously. He does not maintain his hygiene and his clothes are dirty and he does not like to brush his teeth. He has a lot of hunger and likes to eat dry chicken, rice, chicken nuggets, hot dogs, tidbits, fruits like grapes, cold water, ice, but not vegetable and spice. He is very thirsty and likes to pick at his lips. In addition, he also has ulcers in his mouth and headaches in the front of his head, which are the main reasons of his clinical visit. His headache is worse by hot sun, and better by pressure. Observation shows that he has white spots on his nails. Prescription: Medorrhinum, China Analysis - keynote symptoms with rubrics Mentals: 1. Mind, morose 2. Mind, jealous 3. Mind, anger, violent Particulars: 1. 2. 3. 4.

Mouth, ulcers Head, pain, forehead Head, pain, sun, from exposure to Head, pain, pressure, amel.

Physical Generals: 1. Stomach, appetite, increased 2. Stomach, thirst 3. Stomach, desires, cold drinks It would be good to know more about the condition of the ulcers and the headache. White spots on nails and fight, wants to only generate few remedies under the rubrics, hence they were not considered. His particulars are helpful as they help narrow down the remedies.

Repertorial Result 1 Nux Vomica

Value 21

Count 10

89

Jacqueline Tan/ PG-799

2 3 4 5 6

Calcarea Natrum Mur Phosphorus Bryonia Lachesis

19 18 18 18 18

9 8 8 7 7

Nux Vomica can be first prescribed as it covers all of the above rubrics, although he does not seem to be competitive in his studies, he works hard in the store. There is a need to find out whether he is competitive in his sports. His lack of cleanliness and love for dancing also needs to be further explored. Merc (value, count: 16,7) is another remedy that likes to dance and fight, but it did not display the mental symptoms of the above rubrics. Under rubric Extremities, discoloration, nails, white spots are alum, ars., nit-ac., sep., sil., sulph., but only ars., nit-ac., and alum. display his other particulars. Nit-ac. and alum. did not display the mental symptoms, while headache of ars. (value count: 17,6) is not better by pressure. Miasm He has a more syphilis-sycosis miasm as he has physical manifestation of ulcers, which is a tendency to destruction and syphilitic miasm, yet at the same time he has emotions like anger, jealousy with a tendency towards swearing, which is represented by sycosis miasm. Nux Vomica is a good remedy for sycosis, but a lesser anti-syphilitic remedy; Nux Vomica was chosen as the presenting symptoms showed a more sycotic tendencies at present.

90

Jacqueline Tan/ PG-799

Repertory Sheet
Name: D

Repertory used:

Kent

Date:

25/5/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

3
Pg No

1 Mouth, ulcers 2 Head, pain, forehead 3 Head, pain, sun, from exposure to 4 Mind, anger, violent 5 Mind, jealousy

428 152 149 3 60

6 Mind, morose 7 Stomach, thirst 8 Stomach, desires, cold drinks 9 Head, pain, pressure, amel 10 Stomach, appetite, increased

68 527 484 145 477

1 ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANAN ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-S CANTH CAPS CARB CARB-V CARC CAUL CAUST CENCH CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC CON COR-R

3 4 5 2 3

2 1 2 2

3 1 3 2 2

3 1

3 1 2

2 3

3 1 1

1 1 3

1 2 1

2 2

1 3 2 2

2 3 2

2 1 2

7 8 9 10 Value Count 3 3 2 13 5 1 1 1 1 1 2 2 2 1 1 1 2 9 6 2 2 1 2 1 1 5 4 1 1 1 2 9 6 0 0 1 1 1 3 3 9 5 2 2 1 3 2 2 1 14 7 1 1 3 3 0 0 2 1 1 7 4 1 2 1 4 3 1 2 7 4 2 1 3 2 2 3 5 2 3 2 2 7 3 0 0 2 2 1 5 3 3 3 3 17 6 2 2 4 2 4 3 1 1 2 2 0 0 3 1 1 2 10 5 2 2 7 4 1 2 2 3 2 14 7 0 0 2 2 4 2 2 5 3 1 2 1 4 3 1 2 2 3 3 3 3 1 18 7 0 0 1 1 2 2 2 3 2 2 3 19 9 2 2 4 2 0 0 2 3 2 1 3 2 1 1 14 9 0 0 2 1 1 5 4 0 0 0 0 1 2 1 7 5 3 2 1 11 5 0 0 1 2 1 1 9 6 0 0 1 1 2 2 1 3 2 2 8 4 2 1 3 3 9 3 1 2 1 1 5 4 3 3 2 3 13 5 2 2 1 2 1 1 4 3 2 3 5 2 0 0 0 0 0 0 1 2 2 7 4 1 4 3 2 2 1 1 6 4 2 2 1 5 3 2 2 1 2 7 4 1 1 1

1 CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GALC AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M NAT-P NAT-S NIT-AC NUX-M

1 1 1 2 1 1 2 3 2 2 2 1

1 1

1 3 1 1

3 1 1 3 1

3 2 1 2

1 2 1 1

1 3 2

3 2

2 2

7 8 9 10 Value Count 2 2 4 2 1 2 2 1 6 4 2 1 1 4 3 2 3 1 1 7 4 1 1 1 2 1 1 4 3 2 2 1 9 5 1 2 3 2 3 3 6 2 1 1 3 3 1 3 2 7 4 1 2 1 5 4 2 1 2 8 5 1 1 2 4 2 1 2 2 8 4 1 2 3 12 6 1 1 3 3 1 1 1 2 5 4 1 1 1 3 2 1 1 9 6 2 1 1 11 6 1 1 1 2 1 8 5 0 0 1 2 6 5 3 3 10 4 2 1 1 4 3 4 2 1 1 1 5 5 2 1 2 1 9 6 0 0 2 1 3 2 2 1 9 5 0 0 2 2 2 1 7 4 2 2 2 6 3 1 1 1 3 3 0 0 2 2 1 2 3 2 18 7 0 0 2 2 2 1 7 4 1 1 1 3 3 0 0 0 0 0 0 2 1 2 2 3 12 6 1 1 2 2 2 2 1 1 1 7 5 1 3 2 6 3 3 1 4 2 1 1 1 4 4 0 0 1 1 2 2 0 0 2 3 3 1 2 16 7 2 2 1 1 1 7 5 0 0 0 0 2 1 1 2 6 4 1 1 1 2 1 2 6 4 2 2 1 2 10 5 3 1 3 3 18 8 2 2 1 2 7 4 1 3 2 2 8 4 2 2 12 5 1 2 7 4

NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

1 2 3 4 5 6 7 8 9 10 Value Count 1 3 2 3 2 3 2 1 1 3 21 10 1 2 1 3 7 4 1 1 1 3 2 8 5 0 0 1 2 1 1 5 4 1 1 1 1 2 2 1 3 9 5 1 2 1 2 2 8 5 2 3 1 2 3 3 1 3 18 8 2 2 4 2 1 1 1 1 2 2 8 6 2 1 1 1 5 4 1 2 2 2 2 1 10 6 2 2 1 1 6 4 2 2 1 1 3 9 5 3 2 3 1 1 3 3 16 7 2 2 1 0 0 1 1 1 1 1 2 2 1 1 1 3 2 1 1 7 4 1 2 3 2 1 1 1 1 4 4 1 2 1 3 7 4 1 1 1 1 1 1 1 1 2 4 3 1 1 1 1 1 1 1 4 4 3 1 1 5 3 2 1 1 4 3 1 1 2 2 2 8 5 3 3 2 2 10 4 0 0 1 1 2 1 5 4 1 1 2 2 1 1 3 2 7 4 2 2 3 1 1 1 2 12 7 0 0 2 1 3 1 7 4 1 1 2 2 2 2 1 2 1 2 3 1 1 3 13 7 2 1 1 1 1 6 5 0 0 0 0 1 1 1 1 4 4 3 3 2 1 1 10 5 0 0 1 1 1 3 3 2 2 1 1 1 1 2 2 1 5 3 1 2 1 2 2 1 1 10 7 0 0 0 0 1 1 1 3 3 1 3 3 1 3 11 5 0 0 0 0 1 1 1 1 2 2 1 2 1 12 9

91

Jacqueline Tan/ PG-799

Free Clinic Case 4 25/6/2005 E is a 9 year old boy was adopted at 10 days old by his mothers brother as his father was dea f and mute. He started talking late at 4 years old and has a weak memory. He is hyperactive and aggressive. He has uncontrollable anger and would beat his mother and other children, pinch and fight people, and throws things. He beats especially when he is disciplined and wants to do exactly as he wishes. He has no fear. He enjoys watching television programmes and does not like to go to the playground. He has heavy perspiration, mainly on the head, which is not odorous and worse at night. He has milk intolerance, likes to drink especially soft drinks, cold drinks, eats ice-creams, cream biscuits, fruits and does not like food. He talks in sleep sometimes, about the days events. His teeth are decayed due to chocolate intake. He likes rainy and cold weather, and does not cover body during sleep. His legs are painful, especially the knee and front ankle area, and is worse at night but better by pressure. Analysis - keynote symptoms with rubrics Mentals: 1. Mind, obstinate 2. Mind, Anger, Violent 3. Mind, striking Particulars 1. Teeth, caries, hollow 2. Pain, knee 3. Pain, ankle Physical Generals 1. Stomach, desires, cold drinks 2. Generalities, milk, aggravates 3. Pressure, ameliorates 4. Head, perspiration, forehead

Repertorial Result 1 Phosphorus 2 Calcarea Carbonica 3 Nux-Vomica 4 Chamomilla 5 Arsenic Album

Value 20 18 17 17 16

Count 10 8 9 8 9

Phosphorus is the remedy with the highest value. All the remedies have generalities that are worse at night and have memory weakness. Other remedies to consider include Calcarea Carb. (Value, Count: 18,8) as Calcarea Carb children prefer to stay in front of the television than go to the playground. Phosphorus and Calcarea Carb. both enjoy eating ice-cream. 92

Jacqueline Tan/ PG-799

Miasm Syphilis miasm is involved as his fears are not manifested and he has an aggression with the ability to hurt people. At the same time, his symptoms are also worse at night, which is a Syphilis trait. Phosphorus is suitable as it is a good anti-syphilitic remedy.

93

Jacqueline Tan/ PG-799

Repertory Sheet
Name: E

Repertory used:

Kent

Date:

26/5/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

4
Pg No

1 Teeth, caries, decayed, hollow 2 Extremities, pain, knee 3 Extremities, pain, ankle 4 Generalities, milk, aggravates 5 Generalities, pressure, ameliorates

431 1072 1077 1363 1392

6 Mind, striking 7 Mind, anger, violent 8 Head, perspiration, forehead 9 Mind, obstinate 10 Stomach, desires, cold drinks

84 3 222 69 484

ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BENZ-AC BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-I CANN-S CANTH CAPS CARB CARB-AN CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC

1 2 3 4 5 6 1 2 1 1 2 3 1 1 1 2 2 1 1 1 1 2 1 2 2 1 2 1 2 2 1 1 3 2 2 2 1 2 2 2 1 1 1 2 3 3 2 2 3 1 3 2 1 1 1 1 3 1 1 1 1 1 1 1 1 3 2 1 1 2 3 1 1 1 2 2 2 2 1 1 1 2 1 1 2 1 1 2 1 2 2 2 3 1 1 1 2 1 3 2 1 1 2 2 1 1 2 1 2 1 1 2

1 2 2

3 1 3 2

2 2 2 2

1 2 2 3 2 2 3

1 1

1 1

2 1 2 1 3

7 8 9 10 Value Count 3 2 2 3 15 8 2 1 1 4 2 1 2 1 7 6 4 2 1 3 3 3 8 5 5 3 1 1 7 5 2 1 3 3 8 4 0 0 9 5 1 1 2 7 5 2 1 7 4 0 0 5 3 3 2 8 4 0 0 1 1 7 5 2 2 2 3 16 9 1 3 2 0 0 1 1 3 3 1 1 3 1 1 12 7 1 5 3 1 3 2 16 8 0 0 4 2 2 2 5 2 2 7 5 2 5 4 2 1 1 3 15 9 0 0 2 5 4 2 2 3 2 18 8 2 2 1 1 1 4 2 1 2 10 5 0 0 1 1 5 5 0 0 3 1 5 3 1 1 1 7 4 1 2 2 6 4 0 0 1 6 5 2 2 1 11 7 0 0 2 1 1 2 10 6 3 1 3 3 17 8 1 1 1 12 7 2 2 3 17 7 1 3 2 0 0 1 2 3 7 4 1 1 0 0 0 0 2 5 3 1 2 2 1 1 4 4 5 2

CON COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FORM FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC AC LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M

1 2 1 2

4 5 3 3 2

1 1 1

2 1 1 3 2

1 1 1 1

1 1

1 1 1 1 1 2 1 1 1 1 1 1 2 1 1 2 1 2 1 1 2 1 1 1 3 1 2 1 2 2 2 1 2 2 2 2 2 2 3 1 1 2 2 1 2 1 1 2 1 2 2 3 1 3 3 2 1 1 3 1 2 3 1 2 1 3 1 1 2 1 1 1 2 1 1 2 1 1 1

1 1 1 1

3 2 1

2 2 1

2 1 3 1 3 2 1 1 1 2 1 2 2 1 1 2 1 2

2 2 2 1

3 1

2 1

1 1 3 3

2 2 2 1 1 1 1 2 1 1 1 2 1 2 2 2 2 3 1

3 1

3 2

1 1

9 10 Value Count 9 4 0 0 1 2 6 4 2 8 5 1 1 1 1 1 5 5 3 3 1 6 4 2 4 2 3 3 3 4 2 1 2 2 1 4 4 1 3 3 3 3 1 5 3 3 2 2 10 6 2 7 5 1 1 1 8 5 2 2 2 7 6 2 9 4 2 2 1 7 4 1 1 2 7 5 3 2 1 5 4 2 1 3 3 1 8 5 0 0 2 14 7 1 9 6 0 0 2 2 8 6 1 2 5 3 1 4 3 4 2 3 2 3 1 1 9 6 0 0 2 12 5 6 4 2 1 1 1 0 0 1 2 16 9 3 3 1 7 5 2 9 4 3 1 1 1 1 0 0 3 2 2 2 1 3 11 6 1 9 5 4 4 1 1 1 3 2 0 0 1 6 4 2 14 6 10 7

NAT-P NAT-S NIT-AC NUX-M NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

1 2 3 4 5 6 7 8 9 10 Value Count 1 1 1 2 1 1 2 9 7 1 2 1 2 2 3 11 6 2 1 3 2 3 2 2 15 7 1 2 3 2 2 2 2 1 2 3 1 3 1 17 9 1 2 3 2 1 3 4 2 0 0 1 1 2 2 1 2 3 2 1 2 2 5 3 2 1 2 2 2 9 5 2 2 2 2 1 3 1 3 1 3 20 10 1 2 1 4 3 1 1 2 2 1 2 1 1 1 6 5 3 2 1 3 2 1 2 14 7 1 1 2 4 3 2 2 2 1 7 4 2 2 1 2 3 1 11 6 2 2 1 0 0 1 1 1 1 1 1 2 2 4 2 2 3 1 2 2 10 5 1 1 2 2 1 1 1 1 4 4 1 1 1 2 5 4 1 1 1 3 3 1 1 1 1 1 2 2 1 1 2 2 2 3 1 6 3 1 1 2 2 1 1 1 3 1 1 3 2 1 2 13 7 2 1 1 3 1 2 10 6 0 0 1 1 2 1 5 4 1 1 2 1 5 4 1 2 3 2 3 1 3 1 8 4 2 1 3 2 1 2 1 1 5 4 2 2 4 2 1 1 1 3 3 2 2 1 3 1 1 1 2 1 14 9 1 1 1 1 4 4 0 0 1 1 1 1 2 3 2 1 2 3 3 2 11 5 0 0 0 0 0 0 0 0 0 0 1 1 1 1 1 2 7 6 0 0 0 0 1 1 1 3 3 1 3 1 1 2 1 3 3 15 8 0 0 1 1 2 2 1 1 1 2 1 1 2 1 1 11 9

94

Jacqueline Tan/ PG-799

Free Clinic Case 5 22/4/2006 F is a 3 year old boy who had late speech development. At 2 years old, when he wanted to express himself, he used to bang his head. When he was 1 years old, he fell down and hurt his head and still had a mark on his forehead. He is very stubborn and would start crying if he did not get his way. He is very active and cannot sit still in one place and jump about. He has good retention power and can remember things well, is inquisitive and academically intelligent, but his speech is not very clear. He likes the outdoors, painting and music. However, his mother admits he has behavioral issues. He likes to chew books, put things in his mouth, break toys and even bite and hit. He has a fear of the public toilet, pressure cooker sound and haircut. He will wake up in the middle of the night and move to his parents room to sleep. He gets hyperactive and excited in new surroundings and misbehaves. F has milk intolerance and he cannot digest chocolate and fatty food. He had a caesarian birth and has taken all his vaccinations. He has heavy perspiration, especially on his head, forehead and neck. He constantly grinds his teeth and bites his nails. Prescription: He was given 1 dose Nat Sulph 1M, Kali Phos 30C, as well as bach flowers Cerato, Chicory and Chest nut bud. Causticum 30c was then given on 13/5/2006. On 19/5/2006, his mother mentioned that he started urinating in the living room and hits at others when reprimanded. On 26/5/2006, his mother reported that his speech is clearer at times and when somebody told him not to do anything, he stops. He was given 1 dose of Hyosymus 30c. He behaved well for 2 days and defecated in the playground. His defecation was sour smelling and he felt embarrassed. He hits at his parents and he realized he was doing something wrong. He started using only one word, instead of an entire sentence and continues to urinate in the living room, but less regularly. There is phlegm on his chest while he sleeps. On31/5/2006, he was given Belladonna 200c. On 4/6/2006, F seemed calmer, cheerful and not whiny despite his runny nose. He was given Belladonna 200c again. All mucus discharges are coming out, but he continued to be restless and will hit himself once or twice a day. In June, he was treated for his acute cough and cold. On 4/8/2006, his mother reported better language skills, better concepts of situations, his whining and clinginess had reduced, his bedwetting had stopped and he was toilet trained. He was still hyperactive and excited about new things, but now he listens to his parents. He was however still afraid of going into the public toilet. He was given a dose of Tuberculinum 200c.

Analysis - keynote symptoms with rubrics Based on symptoms reported from 22/4/2006-19/5/2006 Mentals: 1. Mind, fear 2. Mind, speech, unintelligible Particulars: 1. Head, perspiration, forehead 95

Jacqueline Tan/ PG-799

2. 3. 4. 5. 6.

Mind, striking, knocking his head against the wall Teeth, grinding Mind, biting Mind, striking Bladder, urination, involuntary

Physical Generals: 1. Generalities, food, milk aggravates 2. Generalities, food, fat, aggravates Need to confirm if head banging symptoms persist to 3 years old, as well as the reason behind his fear of public toilets.
Repertorial Result Belladonna Stramonium Hyoscyamus Arsenic Album Phosphorus Sepia Value 20 17 16 15 15 15 Count 8 8 7 8 8 6

1 2 3 4 5 6

Belladonna is the remedy with the highest value according to the rubric analysis.

Miasm He displays a psora-syphilis miasm with a stronger psora manifestation due to his fearfulness. Yet at the same time, his ability to cause physical harm to others is presented through syphilis miasm. Belladona is a good anti-psoric remedy; the choice of this remedy showed that the total presenting symptoms display a more psora than syphilis miasm at present.

96

Jacqueline Tan/ PG-799

Repertory Sheet
Name: F

Repertory used:

Kent

Date:

27/5/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

5
Pg No

1 Teeth, grinding 2 Mind, biting 3 Generalities, milk aggravates 4 Generalities, food, fat aggravates 5 Bladder, urination, involuntary

432 9 1363 1363 659

6 Mind, striking 7 Head, perspiration, forehead 8 Mind, fear 9 Mind, Speech, unintelligible 10 Mind, striking, knocking his head against the wall

84 222 42 82 84

ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-S CANTH CAPS CARB Carb-S CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC

1 2 3 2 1 3

4 5 6 1 2

2 2

2 1 1

1 1 3

2 1

1 1

1 3

2 3 2 2 2 3 3

1 1 1 3

2 3

1 2 1 2 2 3 1 2 1 2 2 1 1

2 3 1 2 2 1

2 1

1 2

1 3

1 2

2 2

2 2 2 3 2

3 1 2 2 2

2 2

1 1

7 8 9 10 Value Count 2 3 1 12 7 0 0 1 1 5 3 1 1 2 2 0 0 1 1 1 2 6 3 2 1 1 2 2 0 0 1 2 2 0 0 1 6 5 1 1 5 5 1 7 3 0 0 4 2 3 6 2 0 0 4 2 2 2 1 1 15 8 1 1 5 3 0 0 1 1 5 4 0 0 3 4 2 2 5 3 3 3 1 20 8 0 0 0 0 3 3 1 1 1 2 3 2 1 2 10 6 1 4 3 2 2 5 3 2 3 13 6 0 0 0 0 3 5 2 2 5 2 0 0 1 1 8 6 0 0 1 1 1 8 4 1 2 3 2 0 0 1 3 9 6 2 2 13 7 0 0 0 0 2 9 4 1 1 7 5 1 3 2 2 1 9 5 1 3 11 6 1 1 1 1 5 3 0 0 0 0 2 2 1 2 2 1 1 2 2 1 6 4 1 1 1

CON COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M

1 2 1 1 2

3 4 3

5 2

2 3

1 2 2 2 1 3

1 1 1 1

1 2 1 3 1 2 2 2 2 1 2

1 1

2 2 1 1 2 1 2 2 2 2 2 2 2 2 1 1 1 1 2 2 1 1 2 2 1 1 3 2 1 2 1 2 1 2

3 1

2 1

2 2

3 1

1 2 1 1 3

2 1

2 2 2 3 1 2

3 1 1

2 1

2 2 2 1 1

2 2 2

2 1 1

2 2 3

2 3 1

8 9 10 Value Count 2 1 9 5 0 0 1 3 3 2 12 7 3 1 3 6 3 2 1 1 5 4 1 4 2 1 3 3 3 2 1 2 2 1 5 3 2 1 2 1 2 4 2 1 4 3 3 4 2 2 1 2 1 1 1 1 10 7 2 7 4 3 2 2 3 1 16 7 1 1 1 3 9 5 2 5 3 1 5 3 2 1 3 7 5 2 1 2 3 2 7 4 2 4 2 0 0 1 5 4 1 1 1 2 1 0 0 4 2 1 6 4 0 0 4 2 2 3 2 0 0 1 1 1 0 0 3 1 14 7 3 7 4 1 5 4 2 8 4 0 0 1 1 1 0 0 0 0 0 0 2 2 9 5 1 1 1 2 6 4 1 1 1 1 3 2 1 1 1 2 10 5 3 12 6 2 9 5

1 NAT-P NAT-S NIT-AC NUX-M NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

1 1

2 2

1 2

1 1

3 4 5 6 7 8 9 10 Value Count 2 2 1 1 2 8 5 2 1 3 2 3 2 2 2 1 10 5 1 3 4 2 2 1 2 2 1 2 1 12 8 2 2 1 1 3 2 7 4 0 0 0 0 0 0 2 2 1 2 2 1 1 2 1 3 1 3 3 15 8 2 1 2 5 3 1 1 1 1 3 4 2 1 1 2 6 4 2 4 2 2 3 3 8 3 2 3 3 2 10 4 0 0 0 0 1 1 1 1 1 1 1 1 1 1 3 2 1 7 4 1 1 1 1 2 1 4 3 1 1 1 1 1 1 1 1 1 1 1 1 2 2 1 3 3 1 2 1 2 6 4 2 2 1 3 2 3 3 2 15 6 1 1 1 1 1 5 5 0 0 2 1 3 2 1 2 2 2 7 4 2 2 4 2 1 1 1 1 4 4 0 0 3 1 2 2 1 3 3 17 8 2 2 4 2 1 1 2 2 3 2 2 1 2 12 6 1 2 3 2 0 0 1 2 2 1 2 2 1 7 5 1 2 1 4 3 0 0 2 2 1 0 0 0 0 0 0 2 2 1 2 8 5 0 0 0 0 1 1 2 2 2 1 2 2 3 2 14 7 0 0 0 0 2 1 2 2 9 5

97

Jacqueline Tan/ PG-799

34.2 Other cases Case 6: Bipolar Disorder125 Boy age 10: fair looking ,athletic built, commanding voice Easily frustrated when mother talks to him or ask a question, he is impolite to his mother, even in front of other parents. His sister complained that he jumps out and scares her in a bad way and she does not trust him. Main symptoms of aggression, irritability and explosive rage started when he was a toddler. He was extremely cranky and active from babyhood. Initially, mother thought that it was her poor parenting skills. However, at 3 years old, when his mum picked him up from school, he would continue to rant, rage, scream and cry. His mother had no choice but to tie him to a stroller. When he was 4 and his sister was a new born, his preschool contacted his mother and told her that her son seemed hyperactive and aggressive. A developmental pediatrician diagnosed him with Oppositional Defiant Disorder and prescribed Zoloft, an antidepressant. The mother, however, did not want to let a 4 and a half years old take the antidepressant and hence had to hire a helper to be with him full time in school. The family is affluent. G used to wake up every morning with violent anger. His mother had to wake up at 4.30am, before G does at 5am so that she can heat up his milk and let it cool to the right temperature. Otherwise, G would hurl it across the room and rage so loud that it caused his sister and parents to go into tears. G was brought to a psychopharmacologist, who prescribed Risperdal, a new generation antipsychotic drug and was given the drug at night. He was alright in the morning and became angry, miserable, frightening and mean again after Risperdal wore off in the afternoon. Even with Risperdal and a helper, G struggled in his 2nd year in pre-school. He was restless and constantly changes activities and leaves them uncompleted. He was then diagnosed with ADHD. Ritalin was prescribed and it worsened his behavior, hence he was taken off it. In his first grade, he was shifted to a school for children with special learning needs and he would cry all the time. His mother, then realized he had depression. He would push, trip, punch and kick his sister especially when he was overstimulated. He would rage to show his dislike over how his sister chewed her food and push her plate out of the table. As a result, the family had never been on a trip or had any family meals together ever. It was common that children on psychotropic drugs often get desensitized to them, and hence, G required a number of changes in his psychotropic drug use: to Depakote, Lamictal and Abilify respectively. In 3rd grade, he demanded Mary buy him a lottery ticket, when she refused, he threatened suicide by facing an oncoming car. At the psychiatrist office next day, he spoke very fast and was hypersexual. In 5th grade, it was observed that G cannot sit in his seat and constantly interrupted the class and could not stop provoking his classmates. G is underweight and did not desire food. He was then given lithium. Another new stimulant was prescribed which caused mania, sleeplessness, incessant talking, and banging on radiators and he was asked by his school to stop the new stimulant. His symptoms aggravate in May every year.

98

Jacqueline Tan/ PG-799

He threatened to hit his mother with a stick. He even threatened to kill his mother with a knife and slice her open. But, he apologized distraughtly later. His father thought that it was as if G had a demon blasting its way out of him. Make animal yells when he is angry. His mother hopes he will grow up to be a normal functioning person who can contribute to his society. Analysis - keynote symptoms with rubrics Mentals: 1. Mind, Kill, desire to 2. Mind, Loquacity 3. Mind, Mania 4. Mind, sadness, mental depression 5. Mind, rage, fury 6. Mind, speech, hasty 7. Mind, violent, vehement etc. Particulars: 1. Extremities, restlessness Physical Generals: 1. Stomach, appetite, diminished As this case is a real life story depicting the daily life of a Bipolar Disorder patient under allopathic medications, the author is unable to obtain information regarding other symptoms peculiar to G, any particulars, his likes and dislikes, the modalities, his thermal and other details required for a homeopathic case. There is a need to know if there were changes in his symptoms over the period and when he was taken off certain medications, whether the symptoms were side effects of the medications, or whether the symptoms were repetitive and worsening. It would be helpful to also find out the type of animal yell he was making.

1 2 3 4 5

Repertorial Result Hyoscyamus Stramonium Lachesis Nux-Vomica Veratrum Album

Value 24 24 21 19 19

Count 10 10 10 8 8

All the above are good remedies for Bipolar Disorder. Hyoscyamus and Stramonium are the remedies with the greatest value and count in this case. All the remedies cover sleeplessness. If the rubric speech, hasty is used, ars. Bell., Hyos., Lach., stram. would emerge respectively. 99

Jacqueline Tan/ PG-799

Miasm Tubercular miasm is indicated in this case with a greater syphilitic trait than psora. Tubercular children are constantly restless and changing activities. They are also lascivious. The syphilitic aspect is covered by their abilities to harm others and themselves. Hyoscyamus is a better anti-tubercular remedy than Stramonium.

100

Jacqueline Tan/ PG-799

Repertory Sheet
Name: G

Repertory used:

Kent

Date:

28/5/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

6
Pg No

1 Mind, kill, desire to 2 Suicidal, disposition 3 Mind, loquacity 4 Mind, mania 5 Mind, sadness

60 85 63 63 75

6 Extremities, restlessness 7 Mind, rage, fury 8 Mind, lasciviousness 9 Stomach, appetite, diminished 10 Mind, violent, vehement etc.

1187 70 61 476 91

1 ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR AUR-M BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-S CANTH CAPS CARB CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLEM COCA COCC COFF COLCH COLOC

1 1 1 1 2 2 2

2 2

1 3 3 1 1

2 1

2 1 2

1 3

3 4 5 6 7 8 9 10 Value Count 1 1 3 1 2 1 9 6 2 1 3 2 1 1 2 4 3 1 1 3 1 1 8 6 1 1 1 3 3 1 1 1 1 4 4 2 2 2 3 10 5 1 2 2 1 7 5 2 1 4 3 2 2 1 1 2 2 2 2 12 7 0 0 1 2 5 3 1 1 1 5 4 1 2 1 2 1 7 5 1 1 2 2 2 2 2 6 3 2 1 2 6 4 0 0 1 2 2 1 6 4 1 3 3 3 2 1 1 18 9 1 3 6 3 2 1 3 2 2 3 2 1 1 1 2 3 1 2 3 14 6 3 1 7 3 1 1 2 1 1 1 7 6 2 3 2 1 3 1 3 17 9 0 0 1 1 2 2 1 1 1 1 4 4 1 1 1 2 2 1 5 3 2 1 2 5 3 1 2 1 4 3 1 2 2 5 3 1 2 3 1 1 2 1 14 9 3 3 1 2 2 1 2 1 3 2 3 1 4 2 0 0 2 2 2 2 1 10 6 0 0 2 1 3 2 1 2 2 1 3 2 1 1 13 8 2 4 2 0 0 2 1 2 1 2 9 6 0 0 0 0 1 3 2 2 1 10 6 3 1 2 6 3 1 1 2 1 1 1 7 6 2 3 3 1 2 1 15 8 2 1 1 3 8 5 2 3 2 1 10 5 1 1 2 4 3 0 0 2 3 2 1 1 2 2 2 1 2 8 4 1 1 2 2 6 4 1 2 1 2 6 4 2 1 1 2 1 8 6

1 CON COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M

2 2 1 1

4 5 2 2 2 2 2 2 2 2 1 1 1 3 2 1 3 1 3 2 1 1 3 2 2 2 1 3 3 2 1 2 1 3 2 2

7 1 1 2 1 1 1

2 2 2 1

1 1 1

3 1 2 1 1 1

1 1 2 1 1

2 3

1 2 2 3

2 2 3 2 2

2 1 1 3 1

1 1

1 2 2 3 1 2 1 2 2

3 2

2 1 1 3 2 3

3 2 2

2 1

3 1 3 3 1 1 2 2 1 3 3 1 3 2 2 3 3 3 3 1 1 3

1 1

1 2 1

1 1

2 3

2 1 1 2 1

1 1 2

8 9 10 Value Count 2 2 10 5 2 2 1 7 5 1 1 11 7 2 6 3 2 2 8 5 0 0 1 5 4 1 7 5 1 1 2 2 1 1 2 1 9 4 1 4 3 2 1 5 4 2 8 4 6 5 2 3 1 11 6 1 5 4 2 3 2 1 1 1 9 5 1 1 11 7 2 1 3 1 3 24 10 1 3 3 1 2 8 4 3 14 7 3 2 1 1 1 4 3 1 2 2 11 4 1 1 7 5 1 6 4 0 0 1 2 7 4 2 3 2 1 3 3 2 8 3 4 2 3 2 1 21 10 0 0 1 2 4 3 3 1 9 5 0 0 2 2 0 0 1 3 2 18 7 1 1 4 4 1 4 4 2 3 2 1 1 1 2 1 0 0 1 3 2 3 3 1 2 1 16 9 1 1 6 4 1 1 6 4 3 1 2 6 3 3 2 2 7 4 2 1 9 5 1 3 2 15 8

1 NAT-P NAT-S NIT-AC NUX-M NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

2 3 1

2 2

1 1 2

1 2 1

1 2

1 2 2 2

2 2 1 2

1 1

1 2 1 2

1 2

1 1 1 3

1 1 1 1 1 1

1 1

1 1 1 1

5 6 7 8 9 10 Value Count 2 2 4 2 3 2 8 3 3 2 2 1 2 1 12 7 2 1 1 2 7 5 3 2 3 3 3 19 8 1 3 1 5 3 2 1 1 3 1 2 14 8 3 4 2 2 1 1 4 3 0 0 2 1 3 2 10 6 2 2 1 2 2 2 3 1 2 17 9 2 2 4 2 1 3 2 6 3 2 3 1 1 10 6 1 2 1 1 9 6 1 1 4 3 2 3 3 11 5 1 3 3 2 2 3 16 7 2 1 0 0 1 1 2 2 1 1 2 2 1 1 2 2 3 3 1 9 5 1 2 2 2 2 1 1 6 4 1 1 1 3 1 7 5 1 1 1 0 0 1 1 1 1 1 2 2 1 1 1 1 1 2 1 8 7 2 1 5 3 2 3 1 2 2 2 14 7 2 3 2 2 10 5 0 0 2 1 1 6 4 2 1 3 2 3 2 2 1 9 5 2 3 2 8 4 1 1 3 2 3 3 2 1 3 24 10 1 1 1 3 3 2 1 3 2 2 3 2 3 2 14 7 2 1 1 4 3 0 0 0 0 2 2 1 7 5 2 1 3 1 2 1 2 14 9 1 1 1 1 1 3 3 2 3 2 3 3 1 2 2 3 1 6 4 0 0 0 0 1 1 2 2 3 3 3 2 3 2 19 8 1 1 1 0 0 1 3 3 1 1 1 14 8

101

Jacqueline Tan/ PG-799

Case 7: 5 year old boy with ADHD and Conduct Disorder126 H has ADHD symptoms since the age of 2. In desperation, his mother agreed with a psychiatrist in putting H on Metadate SR and Depakote if it helped him function in school. It did not. After 5 times of him being expelled, she attempted to homeschool him, while caring for her 2 younger children. His mother also started reducing doses of the above medications as H was losing weight from decreased appetite, along with suffering from the major side effects of Depakote. Symptoms: 1. He does not sleep long. He is awake by 6am. Without Melatonin, he would only be able to sleep at 11pm or midnight. He has never taken naps well. When he was a toddler, he only napped for 10 minutes. As he got older he refused or could not take naps. The only way to make him sleep is 5mg of Melatonin, 20 minutes before bed time every night. At age 2-3, he used to have horrible nightmares and slept walked almost nightly, but these have since disappeared. 2. When not on Metadate, he has an uncontrollable hunger and thirst - this has been a very marked since he was breastfed. On Metadate, he has no hunger and gets lethargic. 3. He has an obsession with breaking, getting into and taking things that are not his. His mother had to put combination locks on her pantry because he started eating any time during the day or night. He learned how to get past the childproof latches and always found the hidden lock keys. Even now, he would study the combination locks and fiddle with them for long periods of time. Meanwhile, he is always fed regularly. 4. He has no attention span (not even that of his 2.5 years old brother). He cannot focus on work long enough to even sit down and start it. He can only give eye contact for a few seconds and then has to be physically directed back to the focus of your face. 5. He is easily provoked and becomes very angry quickly. He is extremely argumentative. He has a meltdown when he is wrong, loses at anything or anything is changed. He has never transitioned well. When he becomes angry, he becomes violent. Will hit others (with no regard to gender or size-although he has been raised to have those regards). Scream in others face. Throw things. Say very rude and inappropriate things. He is very impulsive. Will grab something, push someone, or just go bonkers with loud noises and is very hard to calm down. He is very stubborn. Resists all kinds of authority. 6. Reports from day care workers in his past and school staff have been: Very defiant. Hits others. Refuses to do any work. Cannot sit still. Steals and destroys others property. Has an incredible vocabulary. Is highly intelligent for his age. 7.He still wets the bed. * He was born 3.5 weeks premature. He had severe jaundice for a few weeks. He weighed 5 lbs. 14 oz., but rapidly gained weight. Jaundice went away. He has been "average/above average" in weight and height since then. He has not had any shots in a long while. And has never had any reactions to any medicines or vaccinations given in his past 5 years. He has no other diseases, 102

Jacqueline Tan/ PG-799

except for hypospadia, which was corrected quite successfully. *He craves anything chocolate. He has never had sugary drinks, since His mother never started that habit. But he still asks for them, all the time. He is especially sensitive to loud music, criticism, cold, the dark, spiders, storms and heights. He is obsessed with electronic games and can figure them out quickly. * He has rare moments where he is very kind, affectionate, gentle and wants to be a big helper to his mother and others. He loves animals. Analysis - keynote symptoms with rubrics Mental: 1. 2. 3. 4. 5. 6.

Mind, destructiveness Mind, kleptomania Mind, sensitive, noise, to Mind, anger, violent Mind, fear, dark Mind, quarrelsome

Particulars: 7. Urine, involuntary Physical generals: 8. Stomach, appetite, ravenous, canine, excessive 9. Stomach, thirst, extreme 10. Generalities, during storm

Repertorial Result 1 Phosphorus 2 Nux Vomica 3 Lycopodium 4 Bryonia 5 Arsenic Album

Value 19 18 17 16 16

Count 9 7 8 8 7

All remedies are aggravated by cold, desires sweets and lack concentration. Phosphorus is the remedy with the highest value and count. Phosphorus is usually sociable and friendly people, but when the vital force is disturbed, they can become aggressive and violent. Miasm Tubercular miasm is marked as he is aggravated by storms and vacillating mind. He is more syphilitic than psoric due to his destructiveness, irritability and ability to harm others. As phosphorus is a leading anti-tubercular remedy and a good anti-syphilitic one, it would be a good match for the presenting symptoms.

103

Jacqueline Tan/ PG-799

Repertory Sheet
Name: H <-------------Pg No

Repertory used:

Kent

Date:

29/5/2009

Case Ref No:

7
Pg No

1 Mind, destructiveness 2 Kleptomania 3 Mind, sensitive, noise 4 Urine, involuntary 5 Stomach, appetite, ravenous

36 61 79 659 478

6 Stomach, thirst, extreme 7 Mind, anger, violent 8 Mind, quarrelsome 9 Mind, fear dark 10 Generalities, during storm

529 3 70 43 1403

1 ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-S CANTH CAPS CARB CARB-S CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC

3 4 5 3 2

1 1 1 1 1

2 1 1

1 1 1

1 3

2 2 2 2

3 2 3 3

3 2 2 3

2 3

1 1 1

2 1 1 2

2 2 1 1

1 1

1 1 1 2 2

1 2

2 2 1 3 1 1

3 1 2 2 2

2 3 1

6 7 8 9 10 Value Count 3 3 1 2 14 6 2 2 1 1 1 1 2 1 1 1 6 5 2 2 4 2 1 1 2 1 1 7 5 1 2 2 3 1 6 4 2 1 3 2 2 1 3 2 9 5 0 0 2 4 3 2 1 4 3 2 2 9 5 0 0 3 3 1 3 8 3 0 0 1 2 7 4 3 3 2 2 16 7 3 1 9 4 0 0 1 1 1 1 4 2 2 1 3 3 1 12 6 1 1 1 1 8 6 1 2 1 2 14 7 0 0 2 2 1 2 1 6 3 1 2 2 5 3 2 1 3 2 2 3 2 2 2 16 8 1 5 4 2 2 3 3 2 1 2 15 8 0 0 0 0 3 1 6 3 3 3 1 1 8 4 0 0 1 2 2 2 12 7 0 0 1 2 2 1 1 5 4 1 1 1 4 4 0 0 3 1 1 9 6 1 2 2 2 1 12 7 0 0 1 1 1 2 3 2 1 1 15 8 3 3 2 11 5 2 1 4 3 3 3 1 12 5 1 4 3 1 1 3 1 6 3 0 0 0 0 0 0 2 1 5 3 2 1 1 7 4 2 2 7 4 2 2 4 2

1 CON COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M

3 4 5 3 2 2

6 7 1 2 2 2 3 1 2 2 3 2 1 1

1 2 1 3 2 2 2 2 1 1 2 2 2 1

1 2 2 3 1 2 1 3 2

1 2 1 2 1

2 2 2 2 2 2

1 1 2 2 3

2 1 1 1 3 2 1 1 1 2 2 1 1 2 2 2 2 2 1 1 2 1

2 1

3 1 1

1 1 1

3 1 2 1 2 2 2 1 2 1

1 1 1 1 1

2 2 2 1 1 2 2

3 1 1

3 1 1 1 1

2 2 2 2 1

2 2 2

2 2

2 3 1 1 1 1 2 3

2 2 2 3

1 2 2

2 2 3

8 9 10 Value Count 2 10 5 1 1 1 2 4 2 2 2 10 6 2 1 1 6 3 0 0 3 3 2 7 3 1 5 3 7 3 0 0 1 10 6 6 4 1 7 4 2 6 4 0 0 8 4 2 2 3 2 1 1 8 4 8 4 2 1 2 11 7 1 1 3 11 6 8 4 1 5 3 0 0 1 5 5 2 2 2 1 2 9 5 1 5 4 0 0 7 4 2 2 5 3 3 2 2 2 2 2 11 7 0 0 3 2 2 2 0 0 0 0 0 0 2 2 17 8 1 6 4 4 3 6 4 1 1 2 2 0 0 1 1 2 2 8 4 2 1 12 6 1 1 5 4 2 1 8 6 0 0 1 6 4 0 0 1 7 5 2 3 13 6 2 1 15 7

1 NAT-P NAT-S NIT-AC NUX-M NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

1 1

1 2 1 1

3 4 5 6 7 8 9 10 Value Count 1 1 2 2 1 7 5 2 2 2 1 7 4 3 2 2 2 3 2 1 15 7 3 2 1 6 3 2 3 2 3 2 3 3 18 7 2 3 2 1 8 4 3 2 2 2 10 5 0 0 1 1 1 1 4 4 1 1 2 2 2 3 2 2 3 1 13 6 1 2 2 2 7 4 2 3 3 3 1 2 2 2 19 9 2 2 1 0 0 2 2 1 2 8 5 1 1 1 4 4 2 2 2 6 3 3 3 2 1 9 4 1 2 3 3 1 2 12 6 3 3 1 0 0 1 2 2 5 3 1 1 2 4 3 1 2 3 2 1 3 2 2 1 9 5 1 1 1 2 1 1 1 5 4 1 3 1 5 3 0 0 1 1 1 1 2 3 2 2 1 3 2 0 0 2 2 1 5 3 2 1 3 2 1 3 3 2 2 1 2 2 16 8 3 1 3 3 2 12 5 0 0 2 2 1 1 6 4 2 2 2 1 7 4 1 2 1 1 5 4 1 3 2 1 3 2 13 7 0 0 1 2 3 2 3 13 6 1 1 2 5 4 1 1 1 1 2 3 3 1 3 14 7 1 2 1 4 3 0 0 1 1 2 2 1 1 2 2 1 1 1 1 3 3 12 7 1 1 1 1 2 3 2 1 1 1 1 1 1 3 1 4 2 2 2 1 2 1 8 5 2 1 0 0 1 1 1 3 3 2 3 3 1 2 13 6 0 0 0 0 3 1 1 2 1 1 9 6

104

Jacqueline Tan/ PG-799

CASE 8 : Conduct Disorder I, a 13 year old boy, arrived at Dr. Ullmans clinic with his mother who considered it as her last hope in changing his behavior. I was shy, had low self-esteem and had difficulties making friends in his new school after his parents divorce. He habitually said that he was stupid and would not attempt any examination (by just sitting and doing nothing). His violence at home was increasing and his mother felt uneasy leaving his younger siblings with him. He resented changes in plans and he was rude. He was farting openly, picking his nose and thought that was funny. He always scratched his head, bit his nails. He loved violence, weapons like guns, lying and stealing. His stealing is deliberate and open. I once told his mother that he had a dark side which is a voice prompting him to do bad; and that there was a constant struggle between the dark and the light. Sometimes he is like a saint according to his mother, while at other times, he would be slapping, pushing and insulting his sister and breaking her things. His swearing is sometimes loud and sometimes muttering. He can be aggressive and mean and not wanting to be touched or talked. Once, he pushed his mother and grabbed her by the shirt and threatened to kill her with a gun. Another time, he was eyeing an axe on the floor for violent mean before his mother challenged him to it and caused him to calm down. When I was 4 years old, he deliberately pushed his brother down the stairs. Even with other children, he would push them away, become hyperactive and scare them or go out to please them as he really would like to have friends. I did not nurse as well as other children as an infant. His preschool teacher reported that he had motor skills deficit. His father used to tell him that he was a rotten kid and was regularly ridiculed by other school children who called him a retard and would bully him. He was prescribed Anacardium oreintale (marking nut) which was indicated for children with poor self-esteem, usually due to criticisms and abuse, which cause a split personality (good versus evil), are cruel without guilt, malicious and swears. For the first 10 days, Is behavior continued to be challenging. After which, his mother noticed a big improvement for 2 weeks, and then got worse again for the next 3 weeks. Then, his behavior began to stabilize and he became more conscientious and could even apologise to his sister for his misdeeds. His lying and swearing stopped. He no longer smothers his family with affection, butdoes have tender moments. His mother is amazed that he can now maintain a friendship of 2 months long. He is no longer scratching his scalp, belching or farting. His grandmother, teachers and neighbors are surprised by his big change. His teachers said that he could concentrate better. He also had more friends. After 7 weeks, his mother reported 65% improvements. After 10 months of his 1st visit, his mother reported that he was 75% better. 13 months after his 1st visit, his mother was happy saying that she has no more complaints. I is cooperative, pleasant and fun, and able to handle school work. There were no more violent outbursts.

105

Jacqueline Tan/ PG-799

Analysis - keynote symptoms with rubrics Mental: 1. Mind, delusions, voices, hear 2. Mind, thoughts, two trains of thoughts 3. Mind, cruelty 4. Mind, kill, desire to kill 5. Mind, kleptomania 6. Mind, maliciousness 7. Mind, confidence, want of self 8. Mind, cursing

Repertorial Result 1 Anacardium 2 Nux Vomica 3 Stramonium 4 Hyoscyamus 5 Lycopodium

Value 14 11 10 9 8

Count 7 6 7 5 5

In this case, Anacardium has the highest value and count. This is due to characteristic symptoms of having dual personality, cruelty, despite the lack of data on particulars and physical generals. Lack of self-confidence and hearing of voices are also prominent. Miasm Syphilitic miasm is marked due to the cruelty and violence involved with the threat to kill his own mother. Delusions, such as that of voices, is also represented in syphilis miasm. Anacardium is a good anti-syphilitic remedy, though not a leading one; it was sufficient for the treatment based on the totality of the symptoms.

106

Jacqueline Tan/ PG-799

Repertory Sheet
Name: I

Repertory used:

Kent

Date:

30/5/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

8
Pg No

1 Mind, delusions, voices, hear 2 Mind, kleptomania 3 Mind, malicious 4 Mind, cursing 5 Mind, cruelty

34 61 63 17 17

6 Mind, thoughts, two trains of thoughts 7 Mind, kill, desire to 8 Confidence, want of self

88 60 13

1 ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CANN CANN-S CANTH CAPS CARB CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH COLOC CON

3 4 2

1 1 1 1 1 2 1 1

1 1 3 1 3 1 1 3

1 1 2

2 2

2 1 2 1 2

2 2 1

1 1

1 1 2

1 1 2 1

1 1 1

1 2

1 1

1 1 2 1 1

9 10 Value Count 2 1 0 0 0 0 3 3 0 0 3 3 1 1 1 1 3 3 1 1 14 7 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 9 5 2 1 0 0 0 0 0 0 4 2 3 2 7 6 0 0 1 1 4 3 2 2 0 0 3 2 1 1 0 0 4 3 0 0 0 0 0 0 1 1 0 0 0 0 1 1 4 4 1 1 0 0 1 1 0 0 0 0 3 3 2 1 0 0 4 3 1 1 0 0 0 0 0 0 0 0 1 1 1 1 2 1 0 0 1 1 1 1

1 COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M

4 5 1 1 1 2

1 2

1 1

2 1 2 1

2 2 3 1 1 1

2 1

2 1 1 2

1 1 1 2 2 2 2 2 1 2 1

2 1

2 1 1

1 1 1 1 1 1 1 1

1 2

1 1

9 10 Value Count 1 1 2 2 3 2 0 0 0 0 0 0 1 1 0 0 2 1 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 0 0 0 0 4 2 1 1 9 5 0 0 2 2 3 2 1 1 0 0 0 0 0 0 2 1 3 2 1 1 0 0 0 0 1 1 0 0 7 4 0 0 5 4 0 0 2 1 2 1 0 0 0 0 0 0 8 5 3 3 0 0 0 0 0 0 1 1 0 0 1 1 1 1 3 3 0 0 1 1 0 0 1 1 0 0 0 0 2 2 5 4

1 NAT-P NAT-S NIT-AC NUX-M NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

2 2 3 2 2 1 2 1 1

3 2 1 1 1 2 2

1 1 1 1

1 1

1 1

1 1 2 1

1 1 1 1

2 1

1 1

1 1

1 1 1 1 3 1 1 1 1 2 1

1 1

1 1

1 1 2 2

9 10 Value Count 0 0 0 0 6 3 0 0 11 6 1 1 7 5 0 0 2 1 3 3 5 5 0 0 6 4 0 0 0 0 3 2 4 4 0 0 0 0 5 4 0 0 0 0 1 1 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 1 1 2 1 0 0 0 0 0 0 1 1 1 1 0 0 10 7 1 1 0 0 3 3 1 1 0 0 0 0 1 1 1 1 0 0 0 0 0 0 1 1 1 1 0 0 4 2 0 0 0 0 5 3 0 0 0 0 2 2

107

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CASE 9: Conduct Disorder + Childhood Onset Alopecia Areata J, an 8 year old boy was brought to Dr. Jawalah Shah for hair loss treatment. He also had eruptions on the head which were better by hot bath. During the interview, the doctor found out that J would derive a lot of pleasure killing lizards, chameleons, and other animals. He would tie and hang them on the door with strings. He was very happy being able to throw the insects he caught on his friends. J was also fearless. He likes and mixes easily with everyone, except for his brother. An interesting observation was that J was very mild and gentle in the clinic but was destructive & cruel, when he was left to himself. During the case taking of family history, it was conveyed that Js father had expired due to heart and kidney complications. J was a chilly patient and has a craving for salty (2+) and pungent food, with an aversion to fish and meat. J was diagnosed with Childhood-Onset Conduct disorder; Moderate type. Treatment Anacardium orientale was prescribed based on this PQRS symptom of dual personality. Hair fall ++, boils + 1. 17/4/1993: Anacardium 200 2 PN 1/week; Sac Lac 1-1-1 * 3 weeks; Sac Lac 2-2-2 * 7 days 2. 11/5/1993: He was better (>>); Hair fall was less (>>) Remedy: Sac Lac was prescribed 3. 3/6/1993: More improvements (++). He was more active and more cooperative. Continue remedy 4. 19/6/1993: Anac 200 1 dose; followed by Sac Lac for 2 weeks 5. 26/6/1993: He was better. Sac Lac was prescribed 6. 26/7/1993: There were more improvements (++); Again hair falling was less (++); Change in behavior, child is calmer Remedy: Anacardium 200 1 PN; S.L. 1-1-1 * 15 days; S.L. 2-2-2 * 15 days 7. 10/8/1993: He was better (++); All right; Cooperative Remedy: Sac Lac was given 8. 4/10/1993: He was better (>>); All patches are full of hair, No cruelty, No troubles at all, Listens to family members, Advised to report any problems if required. 9. 23/4/2001: Patient had called up. He is fine now. No major trouble from that day till date.

108

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Analysis - keynote symptoms with rubrics Mental: 1. Mind, thoughts, two trains of thoughts 2. Mind, cruelty 3. Mind, kill, desire to kill Particulars: 1. Head, hair baldness 2. Head, eruptions Physical Generals: 3. Stomach, desires, salt things 4. Stomach, desires, pungent things 5. Stomach, aversion, fish 6. Stomach, aversion, meat
Repertorial Result Phosphorus Graphites Calcarea Carbonicum Sulphur Arsenic Album Value 14 11 10 9 8 Count 7 4 5 5 4

1 2 3 4 5

Although Phosphorus has the highest value and count, it does not satisfy the mental symptoms of the patient. While the rest do not meet the symptom of balding, except for Graphites and Phosphorus. Zinc and Anacardium also have balding as a symptom. Anacardium may not have a higher value and count compared to some of the remedies above, it does satisfy the mental symptoms of the patient the most and should be considered as the most matching remedy. More needs to be known about the type of eruptions on his head. Anacardium has boils on the head. Miasm Syphilitic miasm is manifested due to his cruelty and ability to kill animals without remorse. Since Phosphorus is a good anti-syphilitic remedy, it should be suitable based on the totality of the symptoms.

109

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Repertory Sheet
Name: J

Repertory used:

Kent

Date:

1/6/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

9
Pg No

1 Mind, cruelty 2 Mind, destructiveness 3 Head, hair baldness 4 Mind, kill, desire to 5 Mind, thoughts, two trains of thoughts

17 36 120 60 88

6 Stomach, aversion, meat 7 Stomach, desire, salt things 8 Stomach, desire, pungent things 9 Stomach, aversion, fish 10 Head, eruption

481 486 486 480 115

1 2 3 4 5 6 7 8 9 10 Value Count ACON 0 0 AESC 0 0 AETH 0 0 AGAR 1 1 1 1 4 4 ALL-C 0 0 ALOE 2 2 1 ALUM 2 2 1 AMBR 0 0 AM-C 1 1 1 AM-M 0 0 ANAC 3 2 1 1 7 4 ANH 0 0 ANT-C 0 0 ANT-T 0 0 APIS 1 2 3 2 ARAN 0 0 ARG-M 0 0 ARG-N 3 3 1 ARIST 0 0 ARN 2 2 1 ARS 2 2 1 3 8 4 ARS-I 2 1 3 2 ARUM-T 0 0 ASAF 0 0 ASAR 0 0 AUR 2 2 1 BAR-C 3 2 5 2 BELL 2 1 1 4 3 BELL-P 0 0 BERB 0 0 BOR 0 0 BOV 2 2 1 BROM 0 0 BRY 2 2 1 BUFO 1 1 1 CACT 2 2 1 CALC 1 1 3 2 3 10 5 CALC-AR 0 0 CALC-F 0 0 CALC-P 2 2 1 CALC-S 3 1 2 6 3 CALEN 0 0 CAMPH 2 1 3 2 CANN 0 0 CANN-S 2 2 1 CANTH 1 1 1 CAPS 0 0 CARB 0 0 CARB-V 2 3 2 7 3 CARC 0 0 CAUL 0 0 CAUST 1 2 2 5 3 CHAM 1 1 1 CHEL 1 1 1 CHIN 1 3 4 2 CIC 1 1 1 CIMIC 0 0 CINA 0 0 CIST 2 2 1 CLIM 0 0 COCA 0 0 COCC 1 1 1 COFF 0 0 COLCH 2 2 1 COLOC 0 0 CON 2 2 1

1 COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C NAT-M NAT-P 1

7 8 2

1 2

2 1 2 2

1 1 2 2 1 3 2 2 2

2 2 2 1

1 1 1 3 1 1 2

1 1 1

2 2 1

2 1 1 2 2

1 1 2 1

3 1

9 10 Value Count 2 1 1 1 1 1 1 3 2 0 0 0 0 0 0 1 1 1 2 1 0 0 0 0 2 1 1 1 4 2 0 0 0 0 3 3 11 4 0 0 0 0 0 0 1 1 2 7 4 1 1 5 2 0 0 2 1 2 1 0 0 0 0 1 3 2 2 4 2 1 1 1 1 4 3 0 0 0 0 1 2 2 2 3 2 1 1 5 2 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 2 5 3 4 3 2 3 2 0 0 0 0 3 2 0 0 0 0 2 1 3 6 3 3 5 2 1 1 0 0 0 0 1 1 1 1 1 1 1 1 2 8 4 1 3 3

1 2 3 4 5 NAT-S NIT-AC NUX-M NUX-V 1 2 OLND OP 1 1 2 ORIG OX-AC PALL PETR 1 PH-AC PHOS 1 2 2 PHYT PIC-AC PLAT 2 1 2 PLB 1 PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC 1 SEL SEP 2 SIL 2 SOL SPIG SPONG STANN STAPH 1 STICT STRAM 2 2 STRONT 1 STRY SULPH 1 SUL-AC SYMPH SYPH TAB TARENT 2 TELL TER TEUCR THEA 1 THER THUJA TUB 2 URT-U VALER VERAT 2 VIB XAN ZINC 2

6 7 8 1 2 2 3 1 1

3 2 3

2 2

2 1 2

2 1 1 3 3

1 3 1

2 2 1 1 2

1 2

1 1

9 10 Value Count 1 1 2 6 3 0 0 6 3 3 3 1 6 5 0 0 0 0 0 0 2 6 3 1 1 1 2 2 14 7 1 1 1 0 0 7 4 3 2 0 0 2 2 1 3 1 0 0 0 0 0 0 0 0 0 0 3 5 2 0 0 2 3 2 2 1 0 0 0 0 2 2 1 2 1 0 0 2 2 1 1 3 8 3 1 6 3 0 0 0 0 0 0 0 0 3 7 3 0 0 4 2 2 2 0 0 1 3 9 5 3 3 1 0 0 2 1 0 0 6 3 1 1 1 1 1 1 1 1 1 0 0 2 2 5 3 0 0 0 0 5 2 0 0 0 0 2 1 7 4

110

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Case 10: Attention Deficit Disorder + Oppositional Defiant Disorder A female child, 5 years old K was said to be very mischievous and disobedient. She would never take any orders given by the teacher or others. She was very destructive, and would often tear books or break her toys. Her attitude was very revengeful. She would often hit other children. The mother complained that her child, K, would pass urine and stool daily as soon as she would reach the house staircase. Just to prevent this, the mother would pick up K from the school and get her to pass urine and/ or stool in school. Regardless, K would still pass stool and urine on the staircase, even when there were no apparent reasons. K was interviewed separately by Dr. Jawahar Shah and seemed extraordinarily intelligent, witty, and showed a lot of awareness. When probed, K revealed that the mother would give more attention to her brother who was 3 years younger. Secondly, their mother would lock and leave them all alone in the house. Thirdly, K always felt that her mother did not give her things she desire, and would often hit or punish her. Hence she would intentionally pass stool and urine to take revenge. The child said it was my way of taking reven ge from my mother, who is not treating me in the right way. Treatment Tarentula hispanica was prescribed as the child showed typical symptomic picture of being smart and witty, yet very sly, revengeful and malicious. Tarentula individuals derive pleasure from giving pain and discomfort to others.
1.

Prescription, 24/9/1982: Tarentula H. 200, 3 doses, 1 every night; Sac Lac 1-1-1 * 4 weeks Auxillary treatment: The mother was advised to care for K more intelligently.

Follow up, 9/11/1982: Within 2 weeks, K stopped passing stool and urine on the staircase. No complaints. Sac Lac 3 doses 3 PN, Sac Lac 1-1-1 * 3 weeks 3. 13/12/1982: Irritability +++; Marked restlessness; Jealousy due to negative relationship with brother
2.

Prescription: Tarentula H. 200 was repeated with 3 doses 1 every night; Sac Lac 1-1-1 *4 weeks The remedy helped in focusing the childs intelligence into proper use, the child improved greatly in her academic performance and received the best student award years later.

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Analysis - keynote symptoms with rubrics Mental: 1. Mind, mischievous 2. Mind, disobedient 3. Mind, destructiveness 4. Mind, striking 5. Mind, malicious Physical Generalities: 1. Extremities, restlessness

Repertorial Result Tarentula 1 Hispanica 2 Nux Vomica 3 Stramonium 4 Hyoscyamus 5 Cuprum

Value 12 12 12 10 9

Count 5 5 5 5 5

It will be good to know if there are other particulars or physical generals. Tarentula Hispanica, Nux Vomica and Stramonium have the highest value and count. Regardless, since mischievous, disobedience and destructiveness are highly marked, Tarentula proves to be the similimum in this case (despite the fact that sly does not appear in the rubric and Tarentula is not covered under rubrics jealousy and malicious. Tarentula is the remedy with the highest value and count if the rubric Mind, malicious is not used in the analysis. Lack of control over urination and defecation is not covered in this case as these symptoms are done intentionally, and are not the root cause of her problems. Miasm Miasms involved are psora-syphilo-sycotic with a higher emphasis on syphilis and sycotic miasms due to her maliciousness and her ability to hurt others emotionally and physically. Psora is indicated in her restlessness, syphilis is found in her destructiveness and sycosis is marked in her jealousy and mischievousness. Tarentula Hispanica is a good remedy for all the above indicated miasms, especially sycotic.

112

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Repertory Sheet
Name: K

Repertory used:

Kent

Date:

2/6/2009

<-------------- Symptoms / Rubrics ----------------------->


Pg No

Case Ref No:

10
Pg No

1 Mind, mischievous 2 Mind, destructiveness 3 Mind, disobedience 4 Mind, striking 5 Extremities, restlessness

66 36 37 84 1187

6 Mind, malicious 7 8 9 10

63

1 ACON AESC AETH AGAR ALL-C ALOE ALUM AMBR AM-C AM-M ANAC ANH ANT-C ANT-T APIS ARAN ARG-M ARG-N ARIST ARN ARS ARS-I ARUM-T ASAF ASAR AUR BAR-C BELL BELL-P BERB BOR BOV BROM BRY BUFO CACT CALC CALC-AR CALC-F CALC-P CALC-S CALEN CAMPH CANN CANN-I CANN-S CANTH CAPS CARB CARB-S CARB-V CARC CAUL CAUST CHAM CHEL CHIN CIC CIMIC CINA CIST CLIM COCA COCC COFF COLCH

3 4 1

5 6 7 1 2

2 2

1 1

1 1 2 2 1 1 1 1 2

1 2

1 2

1 3

1 2

1 1

2 1 2 1 2

1 2 1

1 2

1 2 3 1 1 1 2 1 1 1 1 1

1 1 1

2 1 3

1 1

1 1

9 10 Value Count 4 3 0 0 0 0 4 3 1 1 3 2 2 1 1 1 3 2 2 2 5 2 0 0 0 0 0 0 1 1 0 0 2 1 0 0 0 0 3 3 7 3 0 0 0 0 0 0 0 0 2 1 2 2 9 5 0 0 1 1 2 1 1 1 0 0 0 0 2 2 0 0 5 3 0 0 0 0 0 0 1 1 0 0 3 2 0 0 3 1 1 1 6 5 2 2 0 0 1 1 2 2 0 0 0 0 4 3 0 0 1 1 6 3 1 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1

1 COLOC CON COR-R CROC CUPR CYCL DIG DIOS DROS DULC ELAPS EUP-PE EUPHR FERR FERR-P FL-AC GELS GLON GRAPH GRAT GUAJ HAM HELL HEP HYDR HYOS HYPER IGN IOD IP IRIS KALI-AR KALI-BI KALI-BR KALI-C KALI -I KALI-M KALI-P KALI-S KREOS LAC-C LAC-D LACH LAT-M LED LIL-T LITH LOB LUNA LYC LYSS MAG-C MAG-M MAG-P MANC MAND MANG MED MERC MEZ MOSCH MURX MUR-AC NAJA NAT-A NAT-C

5 1

6 7 1 1 1 2

2 2

2 1

2 1

1 1 1 3 2 2

2 1 2 1

3 2 1 2

2 2 1 2 2 1

2 1

3 1

1 2 1 1 1 1 1 1

1 1

9 10 Value Count 2 2 1 1 0 0 1 1 9 5 0 0 2 1 0 0 0 0 2 1 1 1 0 0 0 0 3 1 0 0 0 0 0 0 5 3 1 1 0 0 2 2 0 0 1 1 2 1 2 2 10 5 0 0 3 2 2 1 0 0 0 0 0 0 0 0 3 1 4 2 1 1 0 0 2 1 0 0 0 0 2 1 0 0 5 3 0 0 2 1 1 1 0 0 0 0 0 0 9 4 1 1 1 1 0 0 0 0 0 0 0 0 1 1 1 1 4 3 0 0 3 3 0 0 0 0 0 0 1 1 3 3

1 NAT-M NAT-P NAT-S NIT-AC NUX-M NUX-V OLND OP ORIG OX-AC PALL PETR PH-AC PHOS PHYT PIC-AC PLAT PLB PODO PSOR PULS PYROG RAD-B RAN-B RHEUM RHOD RHUS-T RUMX RUTA SABAD SABIN SAMB SANG SANIC SARS SEC SEL SEP SIL SOL SPIG SPONG STANN STAPH STICT STRAM STRONT STRY SULPH SUL-AC SYMPH SYPH TAB TARENT TELL TER TEUCR THEA THER THUJA TUB URT-U VALER VERAT VIB XAN ZINC

5 6 7 2 2

1 3 1 1 2

2 3 1 1 1

2 3 1

1 1

1 2

1 1

1 2

3 2

1 1 1 3 1 2 1 2 2 1 1 1 1 2 2 1 3 1 1 3 1 1

9 10 Value Count 4 2 0 0 0 0 5 3 0 0 12 5 0 0 3 3 0 0 1 1 0 0 2 2 0 0 4 4 2 1 0 0 5 4 3 2 0 0 0 0 3 1 0 0 0 0 0 0 0 0 0 0 3 1 0 0 2 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 1 1 3 1 0 0 1 1 0 0 3 2 2 2 0 0 12 5 4 3 2 2 3 3 0 0 0 0 0 0 0 0 12 5 0 0 0 0 0 0 0 0 0 0 0 0 2 1 0 0 0 0 7 4 0 0 0 0 4 2

113

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35. Conclusion
The above cases and research studies demonstrate that homeopathy has the ability to reduce or cure aggression and others symptoms of disruptive behavioral disorders in children. Medical treatments like allopathy and other alternative healing methods also have their roles to play in helping children with the above disorders. Psychosocial prevention, treatment and intervention should also be conducted concurrently for a well-rounded treatment. Parents, caregivers and teachers must have patience and continue to shower their love and concern, but at the same time instill discipline on these children as that will undoubtedly help them in their recovery. Symptoms described for the homeopathic remedies in Chapter 32 are usually the more extreme symptoms; many patients may display milder symptoms and characteristics. Thus, it is the homeopaths role to carefully observe the patient to ensure that the symptoms taken in totality, matches that of the patient. During repertorisation and case taking, many times, there are certain remedies that unfailingly have high value and count such as Lycopodium and Nux Vomica. Care must be taken to ensure that these stronger and deeper acting remedies do not always end up in the first rank inadvertently. Thus, peculiar, individualized symptoms, mental symptoms, likes, aversions and modalities that cater to the individuals aggression and disorders should be highly considered. Aversion and craving of food, unless is highly marked, should take a lower importance. The effect of allopathic medicine should also be taken into account so that symptoms arising due to allopathic medications are given less importance, compared to the childs other symptoms. Homeopathy has the ability to help these children, however, it has its limits. It cannot undo bad memories and experiences which some of the children have gone through. Its efficacy is also impeded in that it cannot change the external influences that impact the children on a daily basis such as a less than ideal parenting style, upbringing, peer influence, education and neighborhood. Neither can it invoke an improvement, if there is a lack of awareness or a willingness to change on the part of the patient. Even though homeopaths are able to provide listening ears and comment on diseases, they are not trained personnels who can provide professional psychosocial counseling. Nonetheless, there are a lot that homeopathy can still do for children around the world, as it remains a largely undiscovered and underutilized healing tool.

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