Paediatrics in Homoeopathy- An Approach
This book is a culmination of the joint efforts of teams from Dr. Ram’s Children Hospital, Mulund, and a team of young homoeopathic doctors led by veterans Dr. Dilip Dikshit and Dr. Anand Kapse. This book illustrates the unique model of clinical-pathological-psychological knowledge integrated with Homoeopathic Materia Medica and philosophy.
Background of the book – This was one of its kind setup around 1997–1999, much before the paediatric research unit at Palghar. The distillate of the experience of over 2 years has been presented and a statistical analysis of the data of the number of patients treated in OPD and IPD basis has been presented. The team had a purpose. They wanted to check the consistency of the results produced, the efficacy and cost effectiveness of the treatment and comparative quality of the results vis-a-vis those in a private paediatric hospital. It is very interesting that a hospital setup was chosen. All homoeopaths treat children on OPD basis. The importance of the hospital was to deal with those cases that required monitoring and assistance. This support and help that Dr. Ram offered being a paediatrician, helped homoeopaths venture into areas into that they would have otherwise hesitated to enter. It also proved the efficacy of homoeopathic remedies. This unique setup gives a deeper dimension to the book. The range of conditions varies including diarrhoeal disorder, lower respiratory tract infection, to intussusception to haemorrhagic disease of the new born among others.
Working in an indoor setup, that too a paediatric setup, required modifications and strategies to be devised for quick case taking, arriving at accurate decisions and ensuring faster drug response. The entire team has worked in that direction and each chapter is about the approach developed to tackle the various diseases.
Key learning – The most important lesson given by Dr. Dikshit – Irrespective of the presentation or urgency of prescribing, there is no substitute for defining the case fully, comprehending the totality in its entirety at the level of expressions and disposition. While making the decision, we should not take a limited view of the presenting illness, but formulate an entire plan of treatment including the acute, chronic or constitutional and intercurrent forces as well as the sequence in which they may be needed. An accurate assessment of the susceptibility and sensitivity to ensure proper posology – the dose and repetition will inevitably follow.
Before we proceed to various disorders the book briefly talks about the normal parameters regarding development, milestones, behaviour, diet, vaccinations and investigations.
This book differs from other books which focus on various remedies for a particular condition. If we go through books such as practical homoeopathic therapeutics by Dewey or pointers to common remedies by Tyler, we will see that a chapter is dedicated to conditions and remedies discussed. In therapeutic pointers, a chapter is dedicated to conditions in children but the approach is primarily listing the drug pictures. Books usually talk of conditions such as rickets, bronchitis, asthma, convulsions, typhoid, and cholera usually arranges in alphabetical order.
This book follows a different approach. It takes a presenting symptom such as fever and discusses the common causes, enquiry to differentiate the various conditions, the patient examination, the investigations needed and the ancillary measures advised. The book teaches a case based approach. Common presenting conditions such as diarrhoea, fever and abdominal pain have been addressed. The approach is clinically to understand the condition and use diagnostic aids if necessary, then define the remedy, assess the susceptibility, sensitivity, miasmatic load and then think of any ancillary measures and advice if required. Therefore, it is a complete comprehensive experience of a clinical setup and dealing with patients in OPD or IPD. For example, in cases of diarrhoea, the criteria for treating a patient on OPD or IPD have been laid including practical factors such as the choice of the intravenous fluid.
Thus, the focus is not just the remedy, although very important, is not be all and end all. It is very important to diagnose the case, know about the possible conditions, their likely progress, and to be able to judiciously decide if patient needs admission for closer monitoring. The book thus addresses Aphorism 3, where the master has talked about the various knowledge’s in day-to-day practice.
One of the key features of the book is the algorithmic thinking process that helps to expedite the thinking and arrive at a conclusion. A few algorithms have been posted in the book.
Overall, it is a guide to the clinical practice and the common remedies that one encounters. The book highlights both the scientific aspect and the artistic quality needed for a good homoeopathic practice. It will help build confidence in young physicians to deal with various paediatric conditions and it will also streamline the thinking process of the senior practitioners.