Recurrent Purulent Otitis
The subject is a boy; his date of birth is January17, 2005, soon he will turn 3 years old.
He is curious, immediately starts to inspect my computer. The boy is not shy and easily contacts others. He is quite active, plays all the time during interview. His complaints are about the frequent recurrent purulent otitis (otopyosis).
His case as given by his mother on January 11, 2008
“He got bilateral otopyosis 4 times. For the first time he became sick in 1 year and 4 months. He had admitted into the hospital with otopyosis, where he received treatment with antibiotics. Before the first otitis he had allergic skin rash. Doctor prescribed Zirtek, and we gave it to him. Immediately after the rash disappeared, he became sick with otopyosis.
Following 3 otopyosis were treated outpatiently (at home, without hospitalization), also with antibiotics.
His nose is always stuffed up. He usually breathes with open mouth”.
I asked her about her pregnancy, delivery and his early childhood.
“I had a morning sickness up to 12 weeks of pregnancy. I had Caesarean delivery due to myopia. His birth weight was 4100 gr and his height was 55 cm, Apgar score was 8.8 points.
He had breastfeeding up to 1 year old.
He began sit at 7 months, started walking independently in 11 months. In 6 months he got his first tooth, all other teeth appeared on time without complications; to 1.5 years he got all the teeth.
He started to attend a kindergarten in 2 years and 2 months. There he began actively speak. He was toilet trained by 2 years. Now during the day he goes to the toilet in the pot, during the night we use diapers.
He is very curious child. He loves to disassemble toys to see inside. He does not destroy anything purposely. All new is interesting for him, he loves to play active games, but at the same time he can sit long and do something, if he pursuing something.
He does not have any fears. He climbs at the highest hills and may jump from there. He has no fear: no darkness nor height as other children, he is not afraid at all. When he went to kindergarten, there was no problem with him, he stayed with strangers and easily left me, just started to do something and joined the group.
He is very big owner. He does not share his toys with peers, and if someone takes a toy he can hit him. No one can play with his toys.
His legs, especially feet are always sweating. The sweat is without smell. Other parts of the body usually do not sweat.
Usually he always feels hot. Even in the winter, in the really cold weather, he does not like to wear gloves. His hands even in this case always remain warm. When taking bath, he likes water relatively cold, put this water on himself.
He is not fussy about food and he eats everything he is offered and has a good appetite. Drinks a lot, up to 1 liter per day”.
Initial assessment:
Child looks like a well developed, in accordance with his age. He easily communicates and can make contact with other children. The main problem that he has is frequent otopyosis; because of this he should constantly take antibiotics. I immediately noticed that the first time his otitis appeared after he was taking Zirtek for allergic rash, that is, after suppressing the rash. Also there is concern about his stuffed-up nose. Child is clearly warm-blooded and thirsty. He has remarkable hyperhydrosis of feet. His mental characteristics are curiosity, courage, sociability and greed.
The remedies seriously considered based on this Repertorization were Sulphur, Pulsatilla and Calcarea Sulphurica.
Pulsatilla is a well-known medication for the treatment of children’s otitis. It also characterized by thick purulent discharges from ears, which we have seen in this case. Pulsatilla patients are usually warm-blooded as my patient. The number of rubrics for Pulsatilla in the repertorization chart is in second place, it covers all the rubrics except one: “ears; Inflammation, Recurrent, middle ears, tympanum, myringitis”. But this is very small rubric, even in Complete Repertory it contains only 6 remedies, and if the overall picture of the case is appropriate, one can ignore this rubric.
However, mental symptoms of the case are not typical for patients of Pulsatilla type. Pulsatilla can be prescribed to soft, obedient, tearful patients seeking support and comfort, who is shy. The boy is communicative, not shy, brave, inquisitive and does not like to share toys with peers and always defends his property. Pulsatilla would only be superficial remedy in this case.
Calcarea Sulphurica also can be prescribed in case of inflammatory process with thick purulent discharges. Patients of Calcarea Sulphurica are warm blooded, just like my patient. Many characteristic of Sulphur we can see in this case: otopyosis started after allopathic suppression of skin rash; patient is hot, with thirst; he is brave, inquisitive, communicative, greedy owner. Hyperhydrosis of feet is typical for both Calcarea and Sulphur. However, the boy does not have the main characteristics of Calcarea. There are no signs of calcium metabolic dysfunction; his teeth appeared on time and without problems; there is no caries, no signs of rickets (rachitis). We do not see a typical for Calcarea delay in child development, no timidity, no desire to hide in the own shell. Calcarea Sulphurica is partially similar remedy.
Sulphur covers all the rubrics. Although, of course, Sulphur the most proven and widely presented in the repertory remedy, and before its prescription one needs to think twice.
Kent writes in his lectures on Materia Medica that Sulphur is the universal antidote, and he often recommended it in cases of rash suppression. The same statement is supported by Clark, Lippie, Morrison, Coulter and others. It is under the rubric "Generalities; eruptions, agg., suppressed” in bold type.
Sulphur is one of the hottest remedies in our Materia Medica. Also in Kent, we find that predisposition to suppuration is very typical for Sulphur, and all types of suppurative inflammations can be cured by it.
Mind of this patient is also very similar to Sulphur. Morrison indicates that Sulphur children are curious, strong and communicative. Greediness, feeling of ownership also characterize patients of Sulphur type.
I have chosen Sulphur that was given in potency 30C. For children, if they do not have mental pathology, I usually begin treatment with this potency.
Sulphur 30C was taken on January 11, 2008
Follow up on February 25, 2008
Mother:
“Approximately 5 days after taking the remedy my son have had a running nose, a small thin nasal discharge. We did not treat it; rhinitis has gone by itself in about a week. After this his nasal breathing became better. Sometimes he breathes through the mouth during the night sleep, but more often he breathes through the nose.
No problems with ears during this time.
His feet perspire less. Now his feet sometimes wet, sometimes dry.
By nature, he has not changed, he is the same: communicative, cheerful, everything is interesting for him. He still has difficulty in sharing toys with other kids, although I try to explain how to behave”.
My assessment based on this information was that the Sulphur was acting.
I evaluated the running nose as a good sign. The boy had sycotic symptom: constantly stuffed-up nose and under the influence of Sulphur psoric inflammation began, and then nasal breathing was improved significantly.
Despite the cold weather there was no otopyosis.
A positive sign is that the boy’s hyperhydrosis of feet decreased.
His mind has not changed, but it was pretty well compensated except greed, which is also often found in such age. Therefore, I did not expect any dramatic changes in mental symptoms.
In this situation, it is better to give the remedy time to work. No remedy has been prescribed. I recommended to contact me if symptoms of otopyosis appear.
Follow up on April 3, 2008
Mother:
“He has no problems with ears. Nose breathes well. No running nose. In late March rash on his cheeks appeared and it was similar to the previous. Feet are now mostly dry, wet only after much running and not always”.
When asked about the behavior of the child mother noted that recently the child gave a toy to another child, after he asked.
My assessment based on this information was that the Sulphur was acting well.
The appearance of the previously suppressed rash is a very good sign, it suggests that the cure is in accordance with Herring’s law: from the inside out, from new symptoms to old. Hyperhydrosis of feet reduced significantly, the child obtains social skill – the skill to share. Nasal breathing is free, no complaints about the ears. I recommended coming for consultation in a month. The remedy is not prescribed.
Follow up on May 15, 2008
Mother:
“The last 2 weeks he stopped breathing through his nose. Stuffed-up nose returned again, as it was before the homeopathy treatment. Yesterday he had the pain in the right ear. The temperature is normal. I really worry that otitis can begin. Rash on his cheeks gone in 2 weeks after its appearance”.
My assessment at this point was that the case had relapsed. His prior complaints had returned. When questioned no apparent cause of the return of symptoms was detected. I decided that he should repeat the medicine in the same potency, in which it was taken previously. He took Sulphur 30C again on May 15, 2008.
Follow up on July 3, 2008
Mother:
“Everything is fine. Pain in the ear has gone on the next day after taking Sulphur. We even did not go to ENT specialist. Stuffiness of his nose is gone. There was no running nose. His general condition is good, as usual, he is cheerful, curious. He started to play with children better, not fighting, if someone takes his toys. Feet are not sweating.
The two weeks after taking the remedy the allergic rash appeared on his cheeks again, remained for a week, and then gone”.
My assessment of the follow-up that the medication works well: earache and stuffiness of nose disappeared; he is softer if other children play with his toys. The appearance of allergic rash which gone by itself showing the returning of old symptoms, in accordance with the Herring’s law.
Now better wait and watch. The medicine is not prescribed.
Follow up on August 16, 2008
Mother:
“Everything was well. No problems over the past month. Nasal breathing is good, no stuffiness of the nose, and no running nose. Ears are okay. Feet are not sweating. Skin rash does not appear. Behavior is usually active, he loves movement, curious. He shared with children his toys, has reduced his greed, although we cannot say that he had voluntarily shared all his toys”.
My assessment was that he has continued well over the past 2 months, with no complaints. Since the beginning of the treatment no otopyosis was developed and no antibiotics were taken. Nasal breathing becomes free, rhinitis gone. Constant hyperhydrosis of feet disappeared. His greed lessened and he became more willing to give his toys to other children.
I recommended to contact me if necessary. No medicine is prescribed.
Conclusion:
Sulphur worked well during all this time. The child has grown stronger, his immunity increased. His behavior also improved. His rash, which was suppressed and caused otopyosis before, returned. This time no ointment or allopathic drug has been used for its suppression; child went through this stage, and rash gone under the influence of homeopathic treatment.