He does not react to anything: a case of Carbo vegetabilis

Whenever I think of children, one striking thing that attracts me is the child’s energy! It is pure and uninhibited; it flows unbounded and expresses itself in every act. These expressions of energy are very peculiar and individualistic to each child. They are visible in every action of the child, his emotions, perceptions, fears, dreams, stories, plays, imaginations, drawings and in countless other ways. When the child is in a healthy state, he or she has a vibration pattern which is completely unique and individualized.

During disease, this unique vibration pattern is altered by another form of energy. This altered pattern expresses itself vividly and distinctly in the way the child thinks, feels, perceives senses and reacts to the whole world around him or her. The child lives through the energy of his altered pattern. This energy is easily expressed through the child’s gestures, actions, moves, behavior, and mannerisms. The child expresses this altered energy pattern without restraint. [1]

I apply the 3 steps of the case witnessing technique in children cases, too. The passive, active, and active-active case witnessing process [2] but the real challenge was when I would deal with cases where the child could not speak. I used to be at my wits end to find out the holistic picture in such special children who couldn’t express themselves verbally, wondering how to make a better prescription in such cases.

The following is a case of such a pre-verbal child who is around 2 years old. He is a factor 7 deficient child, who underwent a liver transplant and now came to me with the complaints of fever, rash, malaena and diarrhoea. The parents gave me a detailed clinical history, but the real challenge was to obtain a 3 dimensional holistic picture of the child.

Dinesh Chauhan (DC): Hi, please come in.

Father (F): “My son was factor deficient for (clotting agent) factor seven: at the age of two months he had blue spots over his body. His PT (Prothrombin Time) was prolonged: sometimes it was it was 62 or even up to 120. He passed blood in his stools and occasionally by mouth. He had a liver transplant in August 2010, and two or three days later his PT INR was back to normal. In December, he had diarrhea; he was tested positive for cytomegalovirus (CMV, PCR) so he was given oral and IV acyclovir.

“In January, he had fever with rashes and started passing bloody stools. The doctor discovered a huge ulcer of the anthrum; luckily it didn’t perforate. He was then given Novomex, Flagyl, and Ocid, but in August, he started to get fevers and rashes again: another endoscopy revealed a large ulcer with an infection of Helicobacter pylori. He was given four antibiotics for fourteen days. So, now the main problem is this fever and the rash.”

DC: Fever and rash.

F: "This morning’s report says that the Creatinine, ESR, and CRP are high, so maybe there is kidney damage. He has been given an immunosuppressive; I am quite worried about that.”

DC: To treat him homeopathically, we need to understand his particular energy pattern. Can you describe him to me, tell me what he does when he has a fever?

F: “Zero energy. He used to walk, he used to talk. He used to climb up literally everything; he was very naughty. He would open all the cupboards and check out everything. All his activity was perfectly normal, but for the past month everything stopped. He usually doesn’t just sit so quietly.”

Mother (M): “For the last two weeks he is not walking, not even one step. He wants to be carried around. He is not even sitting.”

DC: Tell me more about him, what he loves, what he does…

F: “He has a habit of putting everything into his mouth; we have to stop him because he is on immunosuppressive therapy. He is also very stubborn - what he wants to do he does. If he wants to go out, we have to take him out straight away.”

M: “He understands, he grasps things very fast.  He doesn’t talk much, barely four or five words but he can explain many things to us anyway.”

DC: What is peculiar to him, what is kind of different compared to other children? Each child has his own peculiar things that he does when he is alone. How does he behave since he’s ill?

F: “Everything has completely stopped. He use to climb but now he just sits, there’s no reaction at all. Earlier, if anyone was going out he would cry and want to go with them. I used to hide and then go out. Now, we tell him “Daddy is going” but he is not interested. For the last month and a half, he is just sleeping.”

M: “Before that, when there was fever he used to become very weak. When the fever was gone he used to move around a little, but since we came back from Delhi he’s completely lost everything. He does not walk one step. For instance, at the airport, I changed his diaper and said “I’ll wash my hands, you just wait.” Then, I called him many times to come but he just stood there, as though he was completely lost. He just wants us to carry him.”

F: “His appetite is completely gone. We sing songs to him, play little games, but he doesn’t react. If you offer him food he says “No”. He is hardly eating. If we force him to eat, he burps a lot and vomits. He’s also been passing some blood in his stool. His Hemoglobin is reduced to 8.5. Since the fever he has a red rash all over his body.”

DC: He vomits everything. Tell me more about him?

M: “He used to go to the neighbors’ house and play but now he just sits at home. He cries a lot, which he didn’t do before. If anyone, even my mother or my grandmother, tries to take him in their arms he just shouts ‘Mamma, Mamma’.”

DC: Tell me more observations about him, non-medical things…

M: “He loves kids; he’ll laugh on seeing them. He doesn’t shares things, he is very stubborn, whatever he says, we have to do.”

(Meanwhile, I noticed that the child has not moved at all; he is sitting in one place for the past 30 minutes.)

F: “When he has a fever, he just sleeps in his blanket like this (hands on head).”

DC: Tell me more about him…

F: “He likes Papad a lot (Indian food), even in the hospital he wanted Papad. He used to like ice-cream but now he doesn’t eat that.”

DC: What one thing does he especially like to eat?

F: “He doesn’t like fruit, only banana. He burps when he eats apples.”

DC: How much does he perspire?

F: “He likes to have the fan on, he needs it all the time.  Even if the air-conditioning is on he does not shiver during the fever, or let anyone put on his covers. During fever, we noticed that his palms and soles are cold, only his neck, head and abdomen are hot.”

Mother’s History during Pregnancy

DC: Did you notice any changes in yourself during those nine months, mentally, physically and emotionally, which were usual for you but came up only during these nine months?

M: “Before his pregnancy, I had a miscarriage, so I was very depressed. After three months, I was expecting again, so for the first three months I had bed rest. I was tense from three months on, wondering how I would manage to sleep, since I was at my in-laws’ place. In my fifth month, I went outside a lot. In the sixth and seventh month, I used to get a lot of swelling; I could not sit due to that, so I was in the house. I used to eat everything. I rarely felt the motions of the baby. In my ninth month, I sometimes used to feel a lot of movement but sometimes, I felt there was nothing there inside; I could hardly feel him.  

 “I was losing a bit of fluid, but the doctor told me I was fine. Finally, during a routine test, it turned out that my blood pressure was too high and the doctor admitted me in order to artificially induce the labour. They gave me injections, but the delivery pains did not start. I was just sleeping in the hospital, nothing was happening. The water had burst but I was still not having labour pains and the doctors were worrying why nothing was happening. They gave me another injection, then I had a severe pain and the baby came, after three days in hospital.”

DC: This will help me.  Anything else? Any dream which came up in those nine months?

M: “I had a scary dream that something was going wrong – I don’t remember what.”

DC: Any change in your food habits during those nine months, anything you suddenly started liking?

M: “I started eating bananas for the whole nine months, which I never ate before and I never eat now. I ate apples for two or three months, but then I didn’t like them anymore – I used to get a lot of acidity from them.”

DC: During the pregnancy, did you notice any changes in your body temperature?

M: “No. I had got lot of marks on my stomach; after the delivery my whole belly was black. I have never seen anything like that. It took a long time to go, about six months.”

DC: One thing you said was that there was no movement inside you.

M: “I rarely felt any movement. Obviously, the baby was moving around but I rarely felt it move.”

Analysis of the case

1. My observations of the child
- During the complete interview, the child was sitting absolutely still and motionless, or he was sleeping for the most of the time when the parents were talking to me.
- I offered him different toys to play with but he did not pick up any of them.

2. Parents’ observations

General
- The most peculiar observation of the parents was that since the illness, his energy levels had become very low – zero energy.
- He is not interested in anything.
- All the activity was perfectly normal but for the past month, everything has stopped: he doesn’t move around, he just sits and looks, or sleeps.
- He looks completely lost. He wants us to carry him, he doesn’t walk.
- He is very stubborn, whatever he says, we have to do.
- Needs his mother all the time
- Cries easily
- He likes Papad and banana, but burps from other fruit such as apples.

Physical
- Requires fan or air-conditioning all the time, dislikes being covered during air-conditioning
- Cold palms and soles, warm head, stomach and neck
- Fever with rashes
- No shivering during fever despite air-conditioning
- Blood in stools
- Ulcer of the antrum
- Blue spots all over the body
- Diarrhea
- Reduced appetite

3. Mother’s History during Pregnancy
- Much swelling
- Rarely feeling baby’s movement
- No pain despite injections to induce labour
- Craving for bananas
- Lot of acidity
- Whole abdomen was black

4. Observing the pattern running through the case
We observe that there is a lack of reaction, no movement, lost, quiet, no interest: this came up in the observations of the child as well as his mother’s history during pregnancy.

Centre of the case
- Lack of reactivity
- Craving for banana
- Palms and soles cold even during fever, but head, neck and stomach hot
- Blue, black spots on the body
- Fanning
- Blood in urine, stool

Rubrics of the case
- Generalities; reaction; lack of : CARB-V
- Generalities; food and drinks; fruits; agg. : CARB-V
- Fever, heat; uncovering; aversion to : CARB-V
- Extremities; coldness, chilliness; hands : CARB-V
- Extremities; coldness, chilliness; feet : CARB-V

References from Leaders in Homeopathic Therapeutics by Nash (Carbo vegetabilis)
- Vital force is nearly exhausted, completely collapsed, lies motionless as if dead
- Blood stagnates in the capillaries, venous congestion, surface cold and blue
- Hemorrhages (nose, bowel, stomach, bowels, bladder, or any mucous surfaces)
- Desire for fan, air-conditioning, dislikes covering
- Mucous membranes break down  and become putrid, spongy, bleed and ulcerate

Prescription: Carbo vegetabilis 1M

Follow ups
- During the first few follow, ups his activity levels gradually started improving; there were no fevers or rashes. His appetite remained the same and there was no change on the endoscopy.
- Over a period of two months, his appetite improved and his activity slowly became normal.
- His parents said that he started to become naughty again.
- After three months, the size of the ulcer had started to reduce; the base of the ulcer was much clearer and less deep than the previous gastro-duodenoscopy. The activity level of the child became normal and there were no episodes of fever, rashes and malaena. The hemoglobin, PT and creatinine levels normalised.
- After four months, he had nearly no more episodes of fever, vomiting, or diarrhea, his ulcer started to heal and his appetite improved. There was no bleeding in stools or by mouth.
- The patient improved gradually and continues to come for regular follow ups since two years now.

Trying to see through their vision…

Trying to see their world through their eyes…

Trying to listen to their song

Trying to focus on their focus

The above case illustrates how even in non-verbal or pre-verbal children we can get the individualistic holistic expression of the patient and come to the most appropriate similimum.  Compared to an adult, who has extremely well-developed verbal skills, a child does not have developed verbal skills, but their non-verbal skills come naturally to them. Their actions, behaviours, and movements are strong indicators of their energy pattern.  Hence I focus on those behaviors that come naturally to him and  are not taught to him by others: the stories, imaginations and fears which are also not part of the child’s cultural background but are part of his pure uninhibited energy right from conception.

The mother is the medium of expression of the child’s energy during the nine months of pregnancy; her feelings, and imaginations, perceptions that she has observed and experienced only during those nine months would be those that are coming from the child’s energy.

Hence, a combination of the following observations would increase one’s chances of a good prescription:

?         1: Physician’s observations about the child: What  the child does in the Consulting Room

?         2: Parents’ observations of the child

?         3: Mother’s history during pregnancy

?         4: Physician’s examination findings of the child

?         5: Observing one pattern which is running through the case

All these taken together form the totality of symptoms which leads to the appropriate similimum.

To perceive a child’s energy so pure

Undrape your conscious covering, bringing forth the child within obscure

Then beyond the verbal and non-verbal there’ll be an energy allure

That waits for you to procure

The other song is revealed to you be sure…

-          Rina

 Bibliography:

[1] For further details on children case taking refer to: Chauhan Dinesh, “A Wander with a Little Wonder”- Child Centric Case Witnessing, Philosia Publications, Mumbai India, 2010

[2] For further details on case taking refer to: Chauhan Dinesh, “The scientifically intuitive case witnessing process- A journey of three steps” Philosia Publications, Mumbai India, 2011

Photo: Flickr: Philippe Put; CC BY 2.0