Paul Herscu on Troubled Children
Reprinted from Volume 3, #3 of the New England Journal of Homeopathy
SEMINAR REPORT
With the increase in popularity of homeopathy worldwide, it is not surprising to observe the proliferation of homeopathic courses being offered. Practitioners now have many options when charting their training course, and information regarding the content of the various programs, as well as the approach and style of the presenters, will help the student make appropriate choices with regard to continuing education. We hope this column will give you a feel for the seminar presented, especially with regard to its content, and help you to build upon your foundation of homeopathic knowledge.
Paul Herscu on Troubled Children
Julian Jonas, CA
Calcarea carbonica, Sulphur, Phosphorus, … Tired of prescribing the same old kid’s remedies over and over? Medorrhinum and Tuberculinum… Doesn’t every troubled child look like these same old nosodes? What to do when all the physical generals and keynotes either melt away or blend together in cases with extreme emotional components?
With questions like these on the docket, the third meeting of the New England School of Homeopathy Level III class convened in a Springfield, Massachusetts hotel this past January . As the presenter for this session, Paul Herscu, N.D. played to a hometown crowd of some 70 or so graduates of the NESH Level II class as well as other experienced homeopaths.
Over three days, he held forth on a variety of subjects pertaining to children, especially ones with emotional or mental disturbances. Included were video cases, a fascinating live case, materia medica for relevant remedies, as well as some thought provoking theoretical speculations on the interrelationship between various types of remedies.
It was a seminar born out of his intense interest and ever deepening experience in pediatric homeopathy. The purpose was to enable the assembled practitioners to further their differential diagnostic skills and increase their capacity to manage challenging cases.
On entering the conference room the first day, participants were greeted with a half dozen or so copies of a chart hung on the walls which was an attempt to schematize the relationship of remedies across the entire spectrum of the materia medica. Although there is nothing hard and fast about the diagram, its purpose is to give the prescriber a better sense of what group of remedies might be indicated in any given case-particularly when dealing with behavioral or mental problems in kids. Moreover, the schematic should facilitate remedy selection for later prescriptions.
What followed was a description of a continuum, listed from stage I to IV, representing an ever decreasing capacity of the patient’s psyche to contain subconscious thoughts and urgings from breaking into the conscious realm of daily life.
Children in stage I tend to be in a relatively balanced state in spite of the inherent vulnerabilities of their constitutional condition. That is, the behavior of a typical Calcarea carbonica child is fairly well adapted to the circumstances of everyday life, although he or she is still prone to anxieties and fear, Similarly, while the Natrum muriaticum child may be emotionally withdrawn, the capacity to function in a controlled and productive fashion is present.
In stage II, the boundaries between the conscious and unconscious mind remain relatively strong. Naturally , in these remedy states there is a genetic or miasmic disposition or weakness leads to certain states of mind and behavior. It is Paul’s contention that an appropriately prescribed remedy for a child (or adult) in phase II, many times a nosode, will oftentimes result in a follow-up prescription of a phase I remedy somewhere down the road.
In other words, the correct phase II remedy has the capacity to remove the miasmic influence and return the child to a more compensated phase I remedy state. Likewise, if a trauma is experienced while in a phase II state, this can very well push the child into the less compensated states in phase III or IV.
Phase III remedies, then, represent the breaking of the unconscious into the conscious mind in an uncontrollable fashion. Paul chose Baryta carbonica and Stramonium as representative remedies where this phenomenon most frequently occurs.
This pair exemplifies two basic and divergent psychic reactions to trauma. The first is a clouding over of consciousness, a withdrawal from an assertive presence in the world. The second is an upsurge of violence, either latent impulses or manifest behavior, which begins to dominate the conscious mind.
In the ensuing discussion, it became clear that the choice of these particular remedies for the third phase was somewhat arbitrary . Other remedies of a similar nature, such Cannabis indica for the passive type and Hyoscyamus for the aggressive one, could be substituted for them.
Yet, Baryta carbonica and Stramonium were chosen perhaps due to the frequency with which both are seen in practice and the basic nature of the remedies themselves. They also make a good pair since the fearful nature of both remedies gives them a surprising amount of shared symptoms and can lead t difficulty making a differential diagnosis.
The group of phase IV remedies are of a similar dichotomous nature, with one branch sharing the passive nature of Baryta carbonica (Cannabis indica, Opium, Helleborus, etc.) and the other the aggressive nature of Stramonium (Hyoscyamus, Tarentula hispanica, Veratrum album, etc.) This stage signifies an further development an intensification of both of these unconscious tendencies.
As was mentioned above, in a case that calls for phase III or IV remedy, the “direction of cure” would suggest that second and third prescriptions would come from phase I or II. For example, Tarentula hispanica child might eventually move into Medorrhinum and later end up a Sulphur. Likewise, with proper homeopathic care, one would not expect a Sulphur to evolve into a Tarentula hispanica.
A corollary to this idea is that, when choosing between remedies that are in various phases (a things being equal), a preference should be given t ones that are in the more advanced state. The reasons are both practical as well theoretical.
On a more theoretical level, it often happens that a case that needs phase III or IV remedy will, on first glance, look like a common garden variety of polycrest or nosode. With experience, we all begin to recognize that much (or most) remedies that are associated with extreme emotional or mental pathologies -like Stramonium or Bufo– do not manifest with the full blown symptomatology we have studied in the materia medicas. In fact, it is reasonable, to say that one of the hallmarks of a gifted prescriber is the ability to differentiate between the subtle expressions of these states.
So, a case that looks like a Lycopodium or a Tuberculinum with a fair amount of data to support that conclusion will, on deeper analysis, turn out to need a phase III or IV remedy. The difference might be a lack of certain keynotes or the appearance of deeper emotional or mental symptoms. These deeper symptoms will be an expression of the most important, most characteristic disturbance in that individual- and be the key to the proper prescription.
It should be added that similar difficulties commonly appear when differentiating between a polycrest and a nosode. For instance, a child may look very much like a Calcarea carbonica, but there are also a few hints of Medorrhinum. If certain keynotes for Calcarea carbonica are missing or if other information might contraindicate its choice, the nosode would then be favored.
Another disturbing possibility often seen in practice, is when the choice of a more common remedy is made incorrectly, instead of a more “extreme” one, what ensues is partial action leading to improvement in some areas while not touching the deeper aspects of the case. During the first few follow-ups practitioner and parents both may feel that things are progressing smoothly. But eventually the case stalls. It ends up in a homeopathic purgatory without any profound healing.
Without the appearance of strong symptoms, it may be hard to prescribe at this stage. With a vague sense of unfulfillment, one then needs to wait until the organism sees fit to display the symptoms necessary for the next prescription. And this could take a very long time.
From this point of view, it can be seen that the schematic introduced in this seminar is useful clinically. In fact, its value is greatest as a pragmatic tool than as a theoretical doctrine.
These overviews are devices which help to define the landscape or terrain of homeopathic remedies. Like so many of the ideas that abound in homeopathy, its purpose is to describe traits and tendencies that are noted by a perceptive prescriber. It functions as a guide to help others understand the cases before them and how to manage them over the long term. In this light, the schematic is similar to Hering’s Law.
If, on the other hand, we try to understand it in some axiomatic or rigid fashion, questions begin to surface. For instance, where do we put the large number of other remedies that are not found in the diagram? Some might be easily located in the polycrests, some in the more extreme groups, but others, like, let’s say Nitric Acid or Capsicum, might not find a natural niche.
Another interesting question that Paul raised in his presentation is the difference between deeper pathological states of a polycrest and the extreme pathology of the remedies in phases III and IV. As an example, in a Calcarea carbonica or Phosphorus state very strong anxieties, fears, phobias and disassociative behavior can manifest. Certainly, these also are elements of the subconscious coming to the surface with great force like a Stramonium or Veratrum album.
Where then would the polycrest remedies that have advanced pathology fall in this chart? It seems most logical that they should also be listed in phases III and IV. Extrapolating from there, it could be argued that many remedies could fall into more than one phase depending on the depth of the pathology. Paul suggested that the main sphere of action of a remedy lay mostly in one phase. Thus Hyoscyamus lay more so in phase IV though it does correct many physical ailments, whereas Calcarea carbonica lay in the earlier phases, though it is possible for them to end up in a psychotic state.
Again, it would be counterproductive to understand the schematic as something more than a useful tool which is not perfectly crafted to deal with every theoretical contingency.
A good portion of the seminar was also devoted to filling in lesser known aspects of the materia medica for several remedies associated with pediatric behavior disorders. Reminiscent of his writings in the his already published book – and probably the basis for his next one, it appeared that Paul has brought together information derived from cured cases in order to develop the pictures of these remedies.
Not surprisingly, discussed in greatest detail were the two phase III remedies, Stramonium and Baryta carbonica. Other remedies presented were Mancinella, Platina, Bufo, Veratrum album, Hyoscyamus, and a few words on Lyssin and Aconite.
One of the most useful aspects of this part of the presentation was the suggestion that remedies that are associated with strong emotional and mental pictures can be prescribed for “mundane” physical problems. For instance, Paul described how Stramonium is often indicated for respiratory problems like coughs, bronchitis, asthma and pertussis. In another case, he discussed how a three year old child was relieved of a chronic skin disorder after a Stramonium prescription.
Personally, this point was reinforced the day after returning from the conference when I successfully prescribed Baryta carbonica for an adolescent boy who presented with a troublesome acute respiratory infection. His extreme shyness and sense of being overwhelmed at school were the hints I needed to find the remedy.
Aside from detailed materia medica information, another useful aspect of the discussion on these remedies was a broad characterization of their emotional nature. Oftentimes, extreme cases of behavioral disorders in children have a tendency to all resemble each other. This comparative examination of some of the leading remedies helped to define their differences in the broad strokes.
As the pathology deepens, physical symptoms diminish or lack individuality. This makes differentiation based on keynotes, generals, and other characteristic indications very difficult. Likewise, aggressiveness, attention problems, hyperactivity, and other common behaviors can look nearly identical in each case.
Many remedies were discussed accompanied by video presentations of the remedies. One very interesting discussion was the picture of Bufo whose dominant characteristic is an inability to connect and communicate with others. They tend to seek out and thrive in their isolation, often with a special gift or genius in some particular area. Their anger is stimulated by an invasion of the small world in which they reside.
This image is actually a very apt description of many autistic persons. And indeed, the remedy is often prescribed for such cases. Paul showed a video of just such a child – an autistic three year old who was something of a musical genius. With perfect pitch and rhythm, he sang Beatles tunes while accompanying himself on a toy piano in the video. Unfortunately, he was unable to speak to people or connect with them in any significant way.
The changes after the remedy were quite dramatic. After three weeks, the child was much more communicative both with his parents at home and during the interview. He came into the room, sat down in a chair and said, “Hello, Dr. Herscu.” Obviously, the walls that isolated him from the world were beginning to crumble.
Altogether, the seminar was a most useful experience for the participants. We all know that homeopathy has a wonderful potential to assist these very disturbed children. For myself, I know that what I gained over those three days was an increased ability to prescribe for and manage those types of cases.
Julian Jonas, CA, graduated from the Meiji College of Oriental Medicine in Osaka, Japan. He has practiced in Japan and Sri Lanka and holds licenses in California, Massachusetts and Vermont. He completed the NESH course in 1991. Julian currently practices in Saxtons River, Vermont. He is one of the instructors at the New England School of Homeopathy. Julian is currently participating in the 18-month NESH Level 3 course.