5th International CEDH Conference - June 24-26, 2016
Chronic Diseases in Children
Robert C Dumont, MD and Youngran Chung, MD
CEDH International Conference Chicago, 2016
5th International CEDH Conference - June 24-26, 2016
Approaching the Young Child
First meeting: sizing up the child
5th International CEDH Conference - June 24-26, 2016
Interactions
 The Child is the most important person in the Room
 Size up the child and interact with him/her first
 Begin forming a sense of his “energy”, constitutional/behavioral style
 80-90% important elements of an exam can be from simple
observation.
 Recognize their developmental level (and where they are at the
time emotionally) and interact at that level
 Remember parents will often tell you only the things they believe are
important you or they believe is related to that particular complaint
 To Treat the Child, First Treat the Mother (parents)
5th International CEDH Conference - June 24-26, 2016
Gastrointestinal
Behavior
Respiratory
Dermatology
Pediatrics
Other
5th International CEDH Conference - June 24-26, 2016
Common Pediatric issues

Respiratory
 URIs
 Eczema
 Otitis media
 Acne
 Allergic Rhinitis
 Other Rashes
 Sinusitis

Dermatology

Neurologic/Behavior
 Bronchitis/pneumonia
•
ADHD
 Bronchiolitis
•
Autism
 Asthma
•
Tantrums and ODD
•
Insomina/parasomnias
Gastrointestinal/nutritional
 GERD/Upper GI dyspepsia
 Recurrent abdominal
pain/IBS
 Constipation
 Diarrhea
 Failure to gain
weight/feeding problems
Other
 Endocrine
 Dysmenorrha
 Genitourinary
 Urinary tract infections
 Enuresis
5th International CEDH Conference - June 24-26, 2016
Clinical Homeopathic Approach
 Histopathological or pathophysiological approach
 Pathogenetic approach
 Approach by the Chronic Reactional Mode (CMR)
 Sensitive type (ST) approach
 Etiological approach
5th International CEDH Conference - June 24-26, 2016
The range of disease and symptom expression
Etiology/Triggering event
Chronic Reactional Mode
(Sensitive Type)
Strong
Stressful event
Moderate
Weak
Pathophysiologic reaction/symptoms
Disease is predominant
Common disease expression with
individual variation of symptoms
Toxicology (detoxification)
Individual expression
is predominant
5th International CEDH Conference - June 24-26, 2016
Pathogenic
Approach
Pharmacology &
Toxicology
“Herrings Cross”
Lesional stage,
tissues, location
Sensation
modalities
concomitant
symptoms
Clinical
Indications
(Experience)
Chosen
Medicine(s)
5th International CEDH Conference - June 24-26, 2016
It is more important to know what sort of
person has a disease than to know what
sort of disease a person has.
-Hippocrates
Terrain Medicines:
Chronic Reactional Mode
and Sensitive Type
5th International CEDH Conference - June 24-26, 2016
Chronic reactional Modes Medicines
PSORIC
Arsenicum album
Hepar sulphuris
Lachesis
Lycopodium
Nux vomica
Psorinum
Sulphur
Graphites
Kali bichromicum
SYCOTIC
Causticum
TUBERCULINIC
Arsenicum iod.
Dulcamara
Calcarea phos.
Natrum sulph.
Iodum
Natrum mur.
Medorrhinum
Nitricum acidum Phosphorous
Pulsatilla
Thuja occ.
Sulphur iod.
Rhus tox.
Tuberculinum
Phytolacca
Argentum nit.
Hydrastis can.
Ignatia
Drosera
PSORO-SYCOTIC
Silicea
Calcarea carb.
Sepia
(Graphites)
5th International CEDH Conference - June 24-26, 2016
CRM in Children:
Tuberculinic
 Recurrent ENT infections
 Especially in thin
children with tendency
to lymph adenopathy
Arsenicum iodatum
Calcarea phosphorica
Iodum
Natrum muriaticum
Phosphorous
Pulsatilla
Sulphur iodatum
Tuberculinum
Argentum nitricum
Ignatia
Drosera
5th International CEDH Conference - June 24-26, 2016
CRM in Children:
Psoric
 reactive mode or
reactional pattern
 Skin, Mucous
membrane (and serous
membrane)
 Inflammatory or
spasmodic (and
metabolic)
 Family History
 May have begun as
rash/eczema
Arsenicum album
Hepar sulphur
Lachesis
Lycopodium
Nux vomica
Psorinum
Sulphur
Graphites
Kali bichromicum
5th International CEDH Conference - June 24-26, 2016
CRM in Children:
Sycotic
 The problem never
stops:
Causticum
 Chronic secretions (of
mucous membranes) rhinitis, chronic serous
otitis media…
Natrum sulphuricum
Medorrhinum
Nitricum acidum
Thuja occidentalis
Rhus tox.
Phytolacca
Hydrastis canadensis
 There may be a
precipitating event
Dulcamara
5th International CEDH Conference - June 24-26, 2016
And not to forget:
The Psoro-Sycotic Medicines
 Silicea
 Calcarea carb.
 Sepia
 (Graphites)
5th International CEDH Conference - June 24-26, 2016
A few Sensitive types
 Phosphorus – may start out shy but then warms up
quickly
 Pulsatilla – shy and often clingy (may see the mottled
legs)
 Silicea – shy and lack of confidence
 Sulphur- robust
 Sulphur iodatum – mild Sulphur often with increased
energy with ENT issues (infections)
 Calcarea carbonica – “steady”, may be fearful
 Calcarea phosphorica – long and lanky, fatigue
 Lycopodium – maybe quiet or open but often
correcting parents, emotionally sensitive – self esteem.
5th International CEDH Conference - June 24-26, 2016
Etiologic Treatment
 vaccines
 beginning daycare or school
 repeated antibiotic treatments
recurrent infections
major and disturbing emotional events (divorce, new
child in family
 Grief - Ignatia
 Abandonment - Pulsatilla
 Jealousy - Lachesis
5th International CEDH Conference - June 24-26, 2016
Gastroesophageal Reflux: A Way of
Thinking
 The phenomenon of reflux
We all have reflux
 The manifestations of reflux
How does reflux present?
 The root of reflux?
What is causing the reflux
5th International CEDH Conference - June 24-26, 2016
GERD: Presenting Symptoms
in Infants
 Emesis/Spitting up
 Chronic sinus problems
 Regurgitation
 Respiratory symptoms
 Irritability
 Feeding refusal/aversion
 FTT/weight loss
 Recurrent ear infections
 Apnea
 Reactive airway disease
 Pneumonia
 Hoarseness
 Cough
5th International CEDH Conference - June 24-26, 2016
There May be One or More
Contributing Factors
 Constipation (younger child) consider homeopathic treatment
 Metabolic problems
 Anatomic problems
 Dysmotility
 Protein intolerance/allergy (all ages)
 Dysbiosis
 Stress (older child, adolescent) – consider homeopathic
treatment
5th International CEDH Conference - June 24-26, 2016
Dysmotility and ppi use are
independent risk factors for
small intestinal bacterial
and/or fungal overgrowth
C Jacobs*, E Coss Adame+, A Attaluri*, J
Valestin*, and SSC Rao*,+
*Department of Internal Medicine,
University of Iowa Carver College of
Medicine, Iowa City, IA
+Department of Internal Medicine,
Georgia Regents University, Augusta, GA
Aliment Pharmacol Ther. 2013 June ;
37(11): 1103–1111. doi:10.1111/apt.12304.
5th International CEDH Conference - June 24-26, 2016
Gastroesophageal Reflux
and Dyspepsia
 Aethusa cynapium
 Sudden, profuse vomiting (projectile vomiting) right
after a meal or later (in clots)
 with great efforts during vomiting
 May see loose stools watery greenish stools or stools
with mucus
 Aethusa plus Calcarea carbonica (agg. From starches
and milk,: atopic dermatitis, seborrheic dermatitis,
diaper rash)
5th International CEDH Conference - June 24-26, 2016
Intolerance to dairy
 MAGNESIA CARBONICA Sour smelling baby, with low
tone (weak muscles) aggravated by milk, may be
cold sensitive.
 May have frothy green diarrhea
 Terrain: Calcarea carbonica)
 Nux vomica
 Dyspepsia – may refuse feeding
 Irritable, hyperactive and impatient
 May be colicky with abdominal distension, +/vomiting
 tendency to constipation
5th International CEDH Conference - June 24-26, 2016
Terrain medicines: Cow’s milk
allergy
 Lycopodium
 Sulphur
 Calcarea carbonica
5th International CEDH Conference - June 24-26, 2016
Gastroesophageal Reflux
and Dyspepsia
 Pyrosis
 Robinia: Complement medicine, epigastric burning, <
eating esp. fatty foods, night time
 Sulphuricum acidum: Tendency to develop oral
aphthae) and acidic gastroesophageal reflux
(burning epigastric pain. Sour odor in babies.
 Iris versicolor: Burning of entire tract, belching and
burping
5th International CEDH Conference - June 24-26, 2016
Gastroesophageal Reflux
and Belching
 Asa foetida
 eructation with GERD, esophageal spasms
 Antimonium crudum
 nausea and vomiting, excessive eating
 tendency to overeat, coated tongue, taste-smell of food
eaten
 Argentum nitricum
 Loud belching, (inflammation, ulceration – pain)
5th International CEDH Conference - June 24-26, 2016
Tourette’s Syndrome and Tic
Disorders
 Lycopodium (facial) Often the CRM medicine given
weekly
 Agaricus muscarinus (all tic disorders and choreiform
movements)
 Mygale lasiodora (shoulder, neck)
 Magnesia phosphorica (painful facial tics)
 Manganum metallicum (throat clearing tic)
 Ignacia (tics from emotional issues, hypersensitive,
spasmodic)
 Staphysagria (tics from held in emotions)
 Ambra gresea
5th International CEDH Conference - June 24-26, 2016
“The organs weep the tears the
eyes refuse to shed”
Sir William Osler
 EK was a 13 year old with significant motor tics
 Digging into family dynamics – conflict with mother
 Treatment
 Lycopodium 30C weekly
 Staphysagria 30C 2 x daily and then tapering
 Chronic need for Staphysagria while in mother’s house
 10 years later – stable lifestyle engaged, steady job,
without tics
5th International CEDH Conference - June 24-26, 2016
The Problem Child of Pediatrics:
Diseases of Immune
Dysregulation
5th International CEDH Conference - June 24-26, 2016
Homeopathy and immune
dysregulation
What we know
about Immune
dysregulation
What we know
about
homeopathy and
how it works
Homeopathic
Intervention in
diseases of Immune
Dysregulation
5th International CEDH Conference - June 24-26, 2016
Immune Dysregulation
Let’s Set the Stage
5th International CEDH Conference - June 24-26, 2016
Clinical Homeopathic Approach
 Histopathological or pathophysiological approach
 Pathogenetic approach
 Approach by the Chronic Reactional Mode (CMR)
 Sensitive type (ST) approach
 Etiological approach
 Clearance of substances, drainage, etc
5th International CEDH Conference - June 24-26, 2016
Immune Dysregulation
 Environmental Allergy/Sensitivities
 Food Sensitivities
 Eczema
 Asthma
 Autoimmune Diseases
 Ulcerative colitis
 Crohn’s Disease
 Autism
 PANDAS
 Rheumatoid arthritis
 Alopecia
5th International CEDH Conference - June 24-26, 2016
From: Bach JF. The effect of
infections on susceptibility to
autoimmune and allergic
diseases. N Engl J Med. Sep
2002;347(12):911–920.
5th International CEDH Conference - June 24-26, 2016
5th International CEDH Conference - June 24-26, 2016
Allergic Diseases
Presentation by
Cezmi A. Akdis
Swiss Institute of
Allergy and Asthma
Research
5th International CEDH Conference - June 24-26, 2016
It is not Nature vs Nurture
Instead: Nature + Nurture
5th International CEDH Conference - June 24-26, 2016
Systems Biology
“Medical practice is three
dimensional chess and yet most
practitioners are still playing
checkers”
5th International CEDH Conference - June 24-26, 2016
Nurture
Illnesses do not come upon us from out of the
blue. They are developed from small daily sins
against nature. When enough sins have
accumulated, illness will suddenly appear.
Hippocrates (400 B.C.)
5th International CEDH Conference - June 24-26, 2016
“When a patient is sick, the doctor should
first regulate the patient’s diet and lifestyle”
Sun Si-Miao
5th International CEDH Conference - June 24-26, 2016
Hahnemann on curable
and non curable disease
Those diseases are inappropriately named chronic, which
persons incur who expose themselves continually to
avoidable noxious influences, who are in the habit of
indulging in injurious liquors or aliments, are addicted to
dissipation of many kinds which undermine the health,
who undergo prolonged abstinence from things that are
necessary for the support of life, who reside in unhealthy
localities, especially marshy districts, who are housed in
cellars or other confined dwellings, who are deprived of
exercise or of open air, who ruin their health by
overexertion of body or mind, who live in a constant state
of worry, etc. These states of ill-health, which persons bring
upon themselves, disappear spontaneously, provided no
chronic miasm lurks in the body, under an improved mode
of living, and they cannot be called chronic diseases.
5th International CEDH Conference - June 24-26, 2016
Environmental factors
Diet and lifestyle
Opportunity for new “targets”
5th International CEDH Conference - June 24-26, 2016
Nature + Nurture
Nurture:
 Triggers (sycotic induction) - clearance of effects vaccines, viral infections, etc
 Toxins, heavy metals, pesticides (detox, body of
substances and hepatic/renal clearance
 Hygiene theory/Microbiome - parasites, dysbiosis and
regulation of immune system
 Food sensitivities, leaky gut, mucosal integrity homeopathics?
 Generation of an inflammatory state
 Residual damage
5th International CEDH Conference - June 24-26, 2016
Functional Medicine
Lifestyle and Diet
Diet
Stress
Sleep
Physical activity
Environmental toxins
Healthy
Non Healthy
Genetic predisposition
5th International CEDH Conference - June 24-26, 2016
Non Homeopathic
Interventions
 Determine and eliminate “sensitive” foods (often Dairy
and Gluten)
 Organic, nutrient rich anti-inflammatory and
microbiome supportive diet
 Avoidance of Pollutants and toxicants
 Adequate restful Sleep
 Adequate Physical activity
 Adequate periods of rest and relaxation
 Supportive
5th International CEDH Conference - June 24-26, 2016
Toxins, pollutants and Heavy
Metals
 “We’ve got 80,000 chemicals approved for use in
commerce, but we know very little about their
immune effects. Our lifestyles are also different than
they were a few decades ago, and we’re eating
more processed food.” Should prevalence rates for
heart disease and cancer continue their decline, Miller
says, autoimmune diseases could become some of
the costliest and most burdensome illnesses in the
United States.
Fred Miller, director, Environmental Autoimmunity Group at the
National Institute of Environmental Health Sciences in: volume 119
| number 6 | June 2011 • Environmental Health Perspectives
Environmental Factors in Autoimmune Disease
Charles W. Schmidt, MS
5th International CEDH Conference - June 24-26, 2016
Autoimmune Disease and
the Environment
 Hereditability of the disease accounts for 50–60 % of its
variance, the HLA-DRB1 shared epitope–containing
allele being the strongest genetic risk factor
 active and heavy tobacco smoking which is the most
important environmental risk factor for RA with its
attributable risk sustained for up to 20 years after
discontinuation
 Sources of air pollution including traffic and probably
solid fuels are associated with Rheumatoid Arthritis
Is air pollution a risk factor for rheumatoid arthritis?
Mickael Essouma and Jean Jacques N. Noubiap. Journal of
Inflammation (2015) 12:48
5th International CEDH Conference - June 24-26, 2016
There is an association between
Autoimmune Disease and
environmental Toxicants
 Hemdan NY, Emmrich F, Faber S, Lehmann J, Sack U.
Alterations of TH1/TH2 reactivity by heavy metals: possible
consequences include induction of autoimmune
diseases. Ann N Y Acad Sci. 2007 Aug;1109:129-37.
 Mishra KP. Lead exposure and its impact on immune
system: a review. Toxicol In Vitro. 2009 Sep;23(6):969-72.
 Bahadar H, Abdollahi M, Maqbool F, Baeeri M, Niaz K.
Mechanistic overview of immune modulatory effects of
environmental toxicants. Inflamm Allergy Drug Targets.
2015;13(6):382-6.
 Suzuki Y, Inoue T, Ra C. Autoimmunity-inducing metals
(Hg, Au and Ag) modulate mast cell signaling, function
and survival. Curr Pharm Des. 2011 Nov;17(34):3805-14.
5th International CEDH Conference - June 24-26, 2016
What works in the Biomedical
approach to Autism
74% of parents see behavioral improvement
in their children with chelation of heavy
metals
5th International CEDH Conference - June 24-26, 2016
Homeopathic medicines
used in Autistic Disorder
Treatment of Heavy Metals
 Alumina
 Cadmium sulphuricum
 Mercurius solubilis
 Plumbum metalicum
 Arsenicum album
 Petroleum?
5th International CEDH Conference - June 24-26, 2016
Infectious Triggers
 Streptococcus
 Epstein Barr virus
5th International CEDH Conference - June 24-26, 2016
Homeopathic medicines
used in Autistic Disorder
“Clearance” effect
 Medorrhinum
 Thuja
 Vaccinotoxinum
 Streptococcinum
 Morbillinum
5th International CEDH Conference - June 24-26, 2016
Diet and Immune Dysregulation
 “When diet is wrong, medicine is of no use; When diet
is correct, medicine is of no need.” – Ayurvedic
Proverb
 Hippocrates has been quoted as saying “death sits in
the bowels” and “bad digestion is the root of all evil” (400
B.C.)
5th International CEDH Conference - June 24-26, 2016
Autoimmune Disease and
the Environment
 Food Sensitivities
 Individuals with autoimmune disease have food
sensitivities - There are many anecdotes of individuals
who show marked improvement or resolution of
symptoms of rheumatoid arthritis in conjunction with
elimination of a particular food. There are also many
individuals with autoimmune disease feel better when
consuming an anti-inflammatory diet, in conjunction
with fish oil supplementation.
5th International CEDH Conference - June 24-26, 2016
Food Sensitivities: Difficult
Eczema Case
 17 year old girl with chronic resistant eczema (on
body, limbs and face.
 No response to conventional medications and no
response to experimental medications.
 Tried off of dairy, gluten no change
 Combination of acupuncture and homeopathy
(symptomatic and CRM): 40-50% improvement
 Reassessment of treatment protocol (correct)
 IgG sensitivity testing: Turkey
 Off turkey and completely resolved in 3 weeks
Hygiene Theory:
The role of the GI Environment,
Microbiome and Parasites in Immune Dysregulation
Marie-Antoinette
"Qu'ils mangent de la brioche"
(Let them eat cake)
Marie-Antoinette
What she really said:
Qu'ils mangent de la terre
(Let them eat dirt)
5th International CEDH Conference - June 24-26, 2016
Microbiota
 “The microbe is nothing, the soil is everything.”
 - Louis Pasteur
 « La bactérie n’est rien,
 c’est le terrain qui fait tout. »
 (Bacteria are nothing,
 the terrain is everything)
 Claude Bernard 1813 – 1878
 “If I could live my life again, I would devote it to proving
that germs seek their natural habitat – unhealthy tissue –
rather than being the cause of unhealthy tissue.”
 Rudolf Virchow (1821–1902)
5th International CEDH Conference - June 24-26, 2016
Histopathologic Approach:
Inflammatory Bowel Disease
Inflammation:
Argentum nitricum
Arsenicum album
Mercurius solubilis
Mercurius corrosivus
Nitricum acidum
5th International CEDH Conference - June 24-26, 2016