49 mm

Hardcover 246 x 176 (+ 17 mm Beschnitt umlaufend)

Individual Paediatrics

Soldner / Stellmann

Individual PaediatricsSoldner / Stellm

ann

Integrative treatment of children

Twelve years a� er its � rst publication in German this classic work of anthroposophic and homoeopathic paediatrics is appearing as a completely revised 4th edition in its � rst-ever English translation. Recent developments in the areas of epigenetics, vaccinations, sun protection and vitamin D have been incorporated, as well as new and further elaborated therapy concepts for e.g. middle-ear ventilation disorders, asthma, atopic dermatitis, and ADHD. New case reports have been included to illustrate aspects of individual history taking, diagnostics and treatment. All drug data have been updated.

Enriching and broadening the spectrum of possibilities through integrative medicine is becoming ever more important, especially in caring for children and adolescents and accompanying their parents. A prerequisite for successful treatment is an individual diagnostic process that encompasses the somatic symptoms and constitution, psychological and personality aspects as well as developmental and environmental circumstances, including the familial and social context. The question as to why a child develops a particular condition at a speci� c moment in their life can be asked with a view to the future and to activation of the child’s own disease-� ghting resources and support of their potential.

This book o� ers:

■ Integrative ways of comprehending modern medical and physiological data ■ Inspiration and support for practicing individualized paediatrics ■ Background information on homoeopathy and anthroposophic medicine

and their application in integrative paediatrics ■ Clear medication recommendations with information on dosages

Soldner / Stellmann Individual Paediatrics – Physical, emotional and spiritual aspects of diagnosis and counselling / Anthroposophic-homoeopathic therapy

Physical, emotional and spiritual aspects of diagnosis and counselling Anthroposophic-homoeopathic therapy

Scienti� c Publishers

Scienti� c Publishers

ISBN 978-3-8047-5064-7

www.medpharm.de

ISBN 978-1-4822-0729-3

9 7 8 3 8 0 4 7 5 0 6 4 7 9 7 8 1 4 8 2 2 0 7 2 9 3

www.taylorandfrancisgroup.com

Soldner / StellmannIndividual Paediatrics

Soldner / Stellmann

IndividualPaediatricsPhysical, emotional and spiritual aspectsof diagnosis and counselling

Anthroposophic-homoeopathic therapy

Georg Soldner, MunichH. Michael Stellmann†, Bad Aibling

Georg Soldner, Paediatrician

Josef-Retzer-Str. 36

81241 Munich, Germany

H. Michael Stellmann†, MD, Paediatrician

Bad Aibling, Germany

Disclaimer

Please note that anthroposophic medicine is a complementary medicine that integrates variouselements of conventional medicine with anthroposophic concepts of health, illness and healingprocesses, homoeopathy and naturopathy. It seeks to extend, not replace, mainstream Westernmedicine. The author and the publisher disclaim any warranty of fitness for a particular purpose andwarn that readers should not rely on the content herein as a substitute for conventional medicaltreatment. This book is written for physicians trained in conventional medicine. All other readersshould consult their physician before taking any medical treatment into their own hands.

This book contains information obtained from authentic and highly regarded sources. Reprintedmaterial is quoted with permission, and sources are indicated. Reasonable efforts have been madeto publish reliable data and information, but the author and the publisher cannot assume responsi-bility for the validity of all materials or for the consequences of their use.

The use of general descriptive names, trade names, trademarks, etc. in a publication, even if notspecifically identified, does not imply that these names are not protected by the relevant laws andregulations.

Title of original German edition Individuelle Pädiatrie. Leibliche, seelische und geistige Aspekte inDiagnostik und Beratung. Anthroposophisch-homöopathische Therapie.By Georg Soldner and Hermann Michael Stellmann†.Fourth edition © 2011 Wissenschaftliche Verlagsgesellschaft mbH, Birkenwaldstrasse 44, 70191 Stuttgart,Germany.

Translation from the fourth German edition by David Martin, MD, PhD

Bibliographic information published by the Deutsche NationalbibliothekThe Deutsche Nationalbibliothek lists this publication in the Deutsche Nationalbibliografie;detailed bibliographic data are available in the Internet at http://dnb.d-nb.de.

Cataloging-in-Publication Data available from the Library of Congress

Sole distribution rights for North America granted to CRC Press, Taylor and Francis Group, LLC,6000 Broken Sound Parkway, NW, Suite 300, Boca Raton, FL 33487, USA

ISBN 978-3-8047-5064-7 MedPharm Scientific Publishers, an imprint ofWissenschaftliche Verlagsgesellschaft mbH, Stuttgart, Germany

ISBN 978-1-4822-0729-3 CRC Press,Taylor and Francis Group, Boca Raton, London, New York, Washington, D.C.

All rights reserved. Any utilization of this work outside of the limitations of the German Copyright Act isforbidden and liable to prosecution. In particular, no part of this book may be translated, reproduced,stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photo-copying, microfilming, recording, or otherwise, without written permission from the copyright holder.

English language edition © 2014 MedPharm Scientific Publishers, an imprint ofWissenschaftliche Verlagsgesellschaft mbH, Birkenwaldstrasse 44, 70191 Stuttgart, Germanywww.wissenschaftliche-verlagsgesellschaft.de

Printed in ItalyComposition: primustype Hurler GmbH, NotzingenPrinting & binding: Longo AG, I-BozenCover Design: deblik, Berlin, using a detail from the watercolour “With Green Stockings”by Paul Klee (1939)

V

Foreword

The ideal of complete health is only of interest from a scientific perspective. Illness is partof being an individual.Novalis

The positive response to the first three editions of this book was gratifying and encoura­ged the authors to produce a thoroughly updated and enhanced new edition. For manycolleagues this book has become a consultative resource, both for the treatment of child­ren and the support of parents. An individualized approach to paediatrics is dependent ondialogue between parents and physician, with the child at the centre. In this way the childand, later, the adolescent can be recognized in his or her developmental potential as aunique individuality. In encountering both physical illness and psychological crises, thispotential is particularly challenged; however, overcoming illness may also support thedevelopment of the child's individualization.

For this reason, it is of considerable consequence whether one approaches paediatricmedicine in purely technological terms, aiming to restore complete and permanenthealth, or whether children are encouraged to actively overcome their health crisesthrough providing them with sustained support in their capacity for self­regulation. Thelatter approach, combined with accompanying paediatric expertise, enables the child andparents to experience that they themselves can contribute to achieving the condition ofhealth. In this process their skills are strengthened and their trust in – and familiarity with– their own capacity to overcome crises is enhanced. Health, particularly during child­hood, is not a given state that only needs to be protected and maintained by means ofmedical intervention: health has to be permanently striven for and stabilized – even thesuccess of an operation relies on the body's inherent capacity to self­heal. Research inrecent years has shown that childrens' experiences and initiative in early childhood makea significant contribution to the development of health, on both physical and on psycho­logical levels. Against this background, anthroposophic medicines and homoeopathicremedies can be understood as offering regulating impulses that encourage the child toovercome the pathological one­sidedness of the disease, thereby utilizing their ownstrength, and establishing a new, healthy equilibrium. It is evident that if this form oftreatment is to be successfully practiced, it does not only require familiarity with thepathology but also a willingness to assess each patient on an individual basis with respectto their available bodily and psychological resources. Such an approach certainly does notignore the general contributions and specific medical interventions of conventional medi­cine, as and when these are considered to be necessary by the physician and parents.Indeed, the doctor­parent­child relationship is supported and encouraged as and whenthe therapeutic approach is jointly affirmed and reviewed at suitable intervals in the lightof all the available options.

The present new edition of this book has been thoroughly updated. All new material isbased, as before, on the clinical experience of the authors. Parents and children feel a gro­wing need to be acknowledged as individuals, enter a dialogue, and to be understood andinvolved themselves in decisions on prophylaxis and treatment. The present volume att­empts to outline the foundations that can support and facilitate such a dialogue in dailypractice, based on current knowledge and experience. Medical prescribing is supported

ForewordVI

by a comprehensive index and detailed table of contents, enabling quick access to specificthemes and treatment options. However, to appreciate the context of individual therapeu­tic interventions, reading a whole chapter or subject area remains indispensible. In thisrespect, the book can be used both as a practical guide that can quickly be consulted, andalso as a resource for a more in depth study and discussion among colleagues.

The authors would like to thank Dr. Tim Kersebohm for the agreement of the Wissen­schaftliche Verlagsgesellschaft Stuttgart to publish a thoroughly revised new edition andMs. Luise Keller for her careful editing. Many suggestions were incorporated, arising fromvarious discussions with colleagues. The authors are indebted to René Madeleyn, JanVagedes, Matthias Girke, Markus Sommer and Friedwart Husemann for valuable sugges­tion regarding the text as a whole, and to Thomas Fuchs (Introduction), Martin Hirte(Vaccination), Till Reckert (Vitamin D), Franziska Roemer (Allergic diseases, Atopic der­matitis, Acne), Bernd Ulrich, Dieter Ecker and Bernhard Wingeier (Bronchial asthma),Karl­Reinhard Kummer, Lüder Jachens and Christoph Schempp (Atopic dermatitis, All­ergies), Reinhard Schwarz (Anthroposophic medicines), and Johannes Lorentz (Rheuma­tology) with regard to individual chapters. We would also like to use this opportunity tothank the many other colleagues, not mentioned specifically by name, for their suggesti­ons and critiques.

The present book has grown out of dialogue between the authors. In this context the“leading thought”, expressed in the words of Novalis, have stood before us like a guidingstar. The death of Michael Stellmann on 2 April 2010 represented a profound caesura, alt­hough in my experience, this dialogue continues to provide the foundation from whichthe form of this book derives. Very warm thanks are due to Michael Stellmann’s family forallowing full access to his medical estate. This new edition is accordingly dedicated to thememory of H. Michael Stellmann, one of the great pioneers of anthroposophic and homo­eopathic paediatrics.

Georg Soldner

VII

Foreword to the first German language edition

The original stimulus for writing this book arose in response to conversations with colle­agues. Nowadays, many paediatritians have the desire to extend the paradigms of theirpractice beyond treatment protocols that are based exclusively on conventional guideli­nes, derived from a so­called evidence­based science. Although, substantial and detaileddocumentation also exists concerning the empirical efficacy of medicines used in bothhomoeopathic and naturopathic practice, in the absence of an extension of correspondingdisease­specific diagnostic paradigms, suggestions for possible therapeutic interventionsin these fields of practice remain unsatisfactory. Such an extension, moreover, wouldrequire an integrative understanding of both physical and soul­spiritual aspects of childdevelopment. When assessed within this broader context, the potential treatment optionsand their associated risk factors for a specific disease thereby acquire a different perspec­tive. A re­evaluation of risks and treatment options then becomes possible, which alsotakes the particular character and possible developmental role of the illness under consi­deration. Such a comprehensive diagnostic evaluation then provides a sound basis forassessing which therapeutic direction would be appropriate for a specific illness, and in aparticular situation.

In the author’s experience, descriptions of the human being and of outer nature thatunderlie the practice of anthroposophic medicine offer a highly differentiated lens,through which physical, soul and spiritual aspects of child development may be percei­ved and interpreted and possible pathologies in each of these spheres integrated into acomprehensive diagnostic picture. Not only will the rationale underlying a proposed the­rapeutic intervention then be evidence­based in the empirical sense, but it will alsoinclude such an individualized assessment. In the clinical setting, a comprehensiveapproach of this kind to diagnosis encourages the creation of a correspondingly differen­tiated treatment plan, in which the child can be fully honoured in every aspect of his orher individuality. Such an approach does not replace conventional paediatric training,nor will it underestimate the value of conventional scientific research and its resultant'state of the art' treatment protocols; it rather seeks to extend the depth and scope of phy­sicians’ perceptual diagnostic ability and to enhance their capacity to differentiate bet­ween the several components or levels through which human individuality is manifests ata bodily level.

This book aims to offer suggestions for such an individualized therapeutic approach,based on the practical experience gained by the authors in their clinical practice. Thepath towards this goal begins during the clinical consultation with the direct perceptionof the child and its environment, enhanced through attentive and unprejudiced liste­ning. The essential aspects of the pathological process under consideration will thenreveal themselves. To this end, suggestions are included at the beginning of each chapter.Their aim is to extend the general diagnostic concepts in use today (e. g. pneumonia,sinusitis, asthma) so that the individual background relevant to each case of illness isincluded; for example, why has this particular child developed pneumonia or asthma atthis particular time? In their suggestions for treatment, the authors can only – and onlyintend to – indicate possible interventions, even when a particular treatment has indeedshown itself to have general validity. The authors intend no more than to help prepareand offer support to paediatritians, when deciding which potential therapeutic optionmay be appropriate in the given case. Their intention is essentially to stimulate therapeu­

Foreword to the first German language editionVIII

tic skills rather than to advocate particular therapeutic measures or to offer universallyvalid prescriptions.

The respective limits and risks of the specified treatment proposals are indicated. Theauthors have consciously decided to refrain from discussing pathological conditions ofwhich they have no personal experience or where additional therapeutic interventionscannot be suggested (e. g. as in bacterial meningitis).

This book makes use of established paediatric classifications and terminology. In so faras these were considered too restrictive, the attempt has been made to extend the bound­aries of the familiar terminology in such a way that medically trained readers will find theauthor’s thinking comprehensible. By engaging with this text, readers may simply gain abroader perspective, relevance for daily practice, of their patients and their families; theirrelational and communication skills may thereby be extended. They will also encounterdescriptions of the art of extending medicine, based on the content and methodology ofhomoeopathic and anthroposophic practice. We would invite the reader to engage furtherin this dialogue, which will inevitably take on a different character for each individual. Inthis connection, the authors consider a living interest in the enhancement of skill withinpaediatric diagnosis and therapy to be the most important prerequisite, rather than thereader's level of previous knowledge. By approaching the text in this spirit, it should bepossible to test its contents in practice. With respect to epistemological questions, we referthe reader to the established cognitive methodologies underlying the respective discipli­nes of natural science, humanities and anthroposophy. Homoeopathy itself arises fromthe spirit of the Enlightenment1 and in that respect it embodies a clear methodology,albeit one that is restricted to an empirical approach. Anthroposophy needs to be under­stood as a spiritual scientific approach, whose epistemological foundations have beenpublished, and whose relevant literature is generally available for consultation. In the finalanalysis, however, the contents of this book should be evaluated in the context the reader’sencounter with the individual patient; their relevance and effectiveness can only bemeaningfully assessed on the touchstone of clinical practice. In this spirit, the authorswelcome criticism and suggestions from colleagues.

First and foremost, we would like to thank our patients who, through placing theirconfidence in us, have made this work possible. We would also like to extend thanks allteachers and colleagues who educated and supported us, listened to us and debated withus. The warmth engendered through such reciprocal giving and receiving has greatlystrengthened our confidence.

We would also like to express particular thanks to two colleagues; to Markus Sommer,who has always made his extensive knowledge freely available to us and to Andreas Kor­selt. Without their committed support, it would not have been possible to write this book.

Particularly thanks are extended to Dr. Muth from the Wissenschaftliche Verlagsge­sellschaft Stuttgart, who, with understanding and generosity translated our ideas andintentions into reality.

1 “Enlightenment was a desire for human affairs to be guided by rationality rather than by faith, supersti-tion, or revelation; a belief in the power of human reason to change society and liberate the individualfrom the restraints of custom or arbitrary authority; all backed up by a world view increasingly validated byscience rather than by religion or tradition." Dorinda Outram: The Enlightenment. Cambridge UniversityPress, Cambridge 1995, Page 3.

Foreword to the first German language edition IX

In conclusion, our gratitude extends not the least to our wives for their willingness toengage with our thoughts and ideas in a warm and creative dialogue, and for the enthusi­asm they have shown in doing this.

Munich/Bad Aibling,March 2001

Georg SoldnerH. Michael Stellmann

X

Translator’s notes and welcome to the English edition

A personal note about the authorGeorg Soldner began treating patients under the late H. Michael Stellmann’s mentorshipas a medical student. He continued doing so throughout his eight years of paediatric hos­pital work in Munich, including three years of neonatal and intensive care. He is an anth­roposophic doctor with a strong connection to homoeopathic and anthroposophic prepa­rations, hence these aspects are emphasized in this book. I have experienced him as ahighly dedicated, powerful person with encyclopaedic knowledge – not only of medicine.He really takes on responsibility for his patients, enabling them and their parents to feelsecure in his care. I was surprised to hear that many of them have his mobile phone num­ber and can call him at any time, night or day. He guides them so well that they rarely needto call him out of office hours: “This should work in such and such a way by such time,please call me at such time to tell me how the treatment is working.” By demanding brieffeedback from his patients, Georg continually assesses how his prescriptions are working,which is why his book is growing and changing from one edition to the next. Anyoneacquainted with the complexities of everyday paediatrics knows that decades of such indi­vidual experience supported by a sound memory and digested by a keen mind can onlypartially be substituted by the results of scientific studies. In fact, our present reliance onguidelines and study data, together with the costs and hurdles of clinical studies, haveslowed down the pace of relevant drug discoveries and undermine our art of practicingindividualized medicine. Kienle and Kiene have portrayed this as follows:

“After the golden ages between 1930 and 1965, when seminal discoveries irrevocablychanged medicine, the rate of remedial innovation has continuously declined despitebillions of dollars invested. The great discoveries were made by ingenious pioneeringindividuals who combined basic science and passionate clinical work: driven by thedesire to cure patients, guided by scientific thinking; open to the unexpected, and littlehampered by bureaucracy and costs. For their discoveries, clinical judgement wasindispensable. Relying on small sample sizes and discarding therapies unless therewere obvious effects in 10–20 patients, they found spectacular results and thus expedi­ted innovation. Effects that could only be seen in large trials were regarded as not worthbothering about. The spectacular, ground­breaking discoveries such as sulphonami­des, penicillin, cephalosporins, neuroleptics, antidepressants, steroids, etc. would pos­sibly not have been made within the requirements of modern research bureaucracy.[…] As long as the doctors are, in principle, considered incapable of judging whetherthey help their individual patient or not, they will need strict external guidance. Clini­cal judgement, and its further development, is therefore a key issue for the future des­tiny of the medical profession. An advancement of clinical judgement could grant arenewed cognitive basis for medical expertise and medical professionalism, and couldincrease both the intellectual and practical autonomy of the doctor.”1

Georg was sharpening his clinical skills and developing his habits of gathering feedbackand forming clinical judgments at a transition phase, experiencing the benefits of the newdevelopments (e. g. surfactant and 3rd generation cephalosporins) while guidelines andso­called evidence­based medicine were in the making. And while he always strives to

1 Kienle GS, Kiene H. Clinical Judgement and the Medical Profession. J Eval Clin Pract 2010;17(4):621-7

Translator’s notes and welcome to the English edition XI

speak out of personal experience, the hundreds of references at the end of each chapterprovide testimony to his appreciation for what other scientists and clinicians have contri­buted to modern medicine.

Georg is also the initiator of the Vademecum of Anthroposophic Medicines, a largecompendium built on the experience reports of doctors around the world. So if you expe­rience any of the indications in this book as helpful (or not helpful), please take 5 minutesto fill in this feedback form: www.merkurstab.de/Dateien/Vademecum/EN­Form­Feed­back.pdf.

Useful Addresses, links and resources for Anthroposophic Medicine󠀂 Medical Section, School for Spiritual Science, Goetheanum:

www.goetheanum­medizin.chThe international centre for anthroposophic medicine.

󠀂 International Federation of Anthroposophic Medical Associations:www.ivaa.infoEnglish-language website. To find the Anthroposophic medical associations in yourcountry, see: www.ivaa.info/about­ivaa/ivaa­member­organizations

󠀂 Anthromed Library: www.anthromed.orgOffers many articles and resources in English also includes many links to suppliers etc.on www.anthromed.org/Links.aspx

󠀂 The Journal of Anthroposophic Medicine: www.merkurstab.de󠀂 The Vademecum of Anthroposophic Medicine: www.vademecum.org

Note on vocabularyAnthroposophy differentiates four main levels of human existence: physical, life (ethericbody, which plants and animals also have), soul (with its astral body, which animals alsohave) and spirit (I, or Ego). When dealing with anthroposophic terminology, it is impor­tant to be aware that that words and ideas are invitations to pursue an experiential path,not substitutes for experience. This will help to avoid confusion and difficulties withwords. The word ego (also referred to as Ego, I or spirit), for example, is used in anthropo­sophy in a manner that sometimes differs to its use in some other branches of spiritualityor psychology. The term ego here refers to the self as a spiritual, creative entity, which hasevolved throughout world history together with the evolving human body, thus creatingbodies capable of manifesting individual spirits (hence, human bodies have an Ego­orga­nization – also called I­organization – that lifts the astral, etheric and physical to a “hig­her” organizational level).

To develop a living and useful relationship to these concepts and be able to use them toextend and differentiate perception in everyday life and in relation to modern­day thin­king and medicine, reading the first chapter of this book (1. Introduction) is recommen­dable, as well as Rudolf Steiner’s basic works (e. g. “Theosophy”) – where further differen­tiations can be found. Anthroposophically oriented doctors and therapists strive to payattention to these four levels of being, thereby making use of modern diagnostic and the­rapeutic technology as well as working towards deeper insights through various medita­tive and observational practices and study of sources of higher wisdom.

Body, soul and spirit each have a lower and a higher aspect to themselves. Thus, oureveryday thoughts and intellect are related to our spirit, but rather like a shadow is relatedto the form that casts it. Our feelings and emotions are related to our soul in a similar way.

Translator’s notes and welcome to the English editionXII

Notes on the MedicinesMedicine names1. Generally, the German registered medicine names and formulations have been kept in

the translation because different countries use different names. Many medicines availa­ble in other countries carry the same name as the German medicines e. g. Anaemodo­ron, Aconitum Napellus etc, and that which is available may differ strongly per region/country.

2. Some medicines have a different corresponding English name (e. g. Onopordoncomp.). Many English names can be quickly accessed through the general Index ofMedicines of the Vademecum of Anthroposophic Medicine (www.merkurstab.de/index.php5?page=123). This Index of Medicines can also be used to find anthroposo­phic medicines carrying different names in other countries such as Great Britain (GB),Switzerland (CH) and Austria (AT) or to source similar medicinal compositions whichhave different manufacturers and different names.

3. The Country of manufacture is Germany unless otherwise specified. Informationregarding availability of a medicine outside of the country of manufacture is not inclu­ded. See manufacturer contact information below.

Procuring medicines1. International pharmacies

Medicines from an international pharmacy can be ordered in the country of manufac­ture or through a pharmacy willing to dispatch products internationally. Manufactur­ers and the international professional pharmaceutical associations, the IAAP and itsmember organizations can be consulted for further information in this regard (seeAppendix I for a list of addresses).The situation on organ preparations is particularly difficult: Weleda UK, for example,has ceased trading most of these (mainly Wala) preparations. Especially all central ner­vous system ones are only obtainable through the German ‘international pharmacies’

2. Special preparationsNot all the medicines included in this book are available in ‘ready­to­use’ form andmay need to be specially prepared (see also “prescribing medicines” below). In suchcases, the basic formula is given and where relevant, the particular pharmacy experi­enced in preparing the medicine at the reported level of quality. The Gesellschaft Anth­roposophischer Pharmazeuten in Deutschland (GAPiD, www.gapid.de ) [Associationof Anthroposophic Pharmacists] is actively involved in further education and certifica­tion in the field of anthroposophic pharmacy and could be of valuable assistance in thisregard.

Prescribing medicinesIn this book two kinds of prescriptions are used: noncompounded and compounded.

A noncompounded (or precompounded) order consists of a drug or a mixture ofdrugs supplied by a pharmaceutical company by its official or proprietary name and, if itcontains more than one substance, the specific ingredients do not have to be listed.

A compounded prescription, also called formula magistralis (from Latin word magis­ter – teacher) or extemporaneous prescription is an order that requires mixing of one ormore ingredients (active medicaments) with one or more pharmaceutical necessities(vehicle, suspending agent). The physician selects the drugs, doses, and pharmaceutical

Translator’s notes and welcome to the English edition XIII

form that he or she desires and the pharmacist prepares the medication accordingly. Thename of each drug is placed on a separate line under the preceding one. The order ofingredients is as follows:

Remedium cardinale (basis). The basis is the principal drug and gives the prescription itschief action.

Remedium adjuvans (adjuvant). As the name suggests, the adjuvant is a drug that aids orincreases the action of the principal ingredient.

Remedium corrigens (corrective). The corrective modifies or corrects undesirable effectsof the basic or adjuvant.

Remedium constituens (vehicle). The vehicle is the agent used as a solvent in the solu­tion, to increase the size and volume, or to dilute the mixture. The most potent or princi­pal drug is written first, the other ingredient second, and the vehicle last, as shown in theexample.

Example: Rp./Spanish fly (pulvis) 1.57 gYellow wax 3.07 gPeanut oil 0.77 gTurpentine 0.77 gMix and put on textile (misce fiat emplastrum ) 9 x 12 cm

There is a long list of (mainly latin) abbreviations used for compound prescriptions (seethe list below and en.wikipedia.org/wiki/List_of_abbreviations_used_in_medical_prescriptions). However, such abbreviations are increasingly discouraged since they canlead to confusion (see also “conventions for avoiding ambiguity in en.wikipedia.org/wiki/Medical_prescription).

Side effects and contraindicationsManufacturer prescribing and patient information concerning side effects and contrain­dications is not included and is only mentioned if considered particularly relevant. Thisvast subject cannot be explored here at any depth. Suffice to say that the obligatory prescri­bing and patient information fulfils official requirements and partly reflects an inadequatelevel of knowledge (e. g. absence of child studies) and is therefore of varying significancefor practicing physicians. Much of the information provided is more the result of a lack ofknowledge rather than positively confirmed knowledge.

The official prescribing information should be consulted regarding pharmaceuticaladditives such as wheat starch in tablets or cetylstearyl alcohol and lanolin in ointmentvehicles. The field of medicine production is continually developing and therefore chan­ges in the medicine ranges, names, additives, and dosage forms are unavoidable. Pleaserefer to the official prescribing information.

Translator’s notes and welcome to the English editionXIV

Note on homoeopathic potency symbolsThe commonly used German symbols denoting potency strengths have been kept throug­hout the text, rather than using English (or other) conventions. Below is a guide to equiva­lency.

Thank you notesMy co­translators (Christian von Arnim, Susan Nurmi­Schomers, David McGregor,Jonathan Bruton, Anna Meus and Paul Motley) and the following people and institutionsare warmly thanked for their involvement in this translation project: The Mahle Stiftung,Vidarstiftelsen, Hausserstiftung, the Medizinisches Seminar Bad Boll, the Medical Sec­tion at the Goetheanum, Physicians’ Association for Anthroposophic Medicine (USA),New Zealand Anthroposophic Medical Association, Anthroposophic Medical Associa­tion (United Kingdom), Läkarförening För Anthroposofiskt Orienterad Medicin (Swe­den), Canadian Anthroposophic Medical Association, Alicia Landman­Reiner MD,Frank Mulder MD, Stefan Geider MD, Simon Bednarek MD, Ursula Flatters MD, NediEckler MD, Kenneth McAlister MD, Renee Meyer MD, Nancy Spates MD, Steven John­son MD, Mark Kamsler MD, Michael Allen MD, Nicole Shorrock MD, David GershanMD, James Dyson MD, Judith Klahre­Parker, Judith Soleil and Elia Gilbert from RudolfSteiner Library, New York, and last but definitely not least the team at the Wissenschaftli­che Verlagsgesellschaft Stuttgart (above all Dr. Tim Kersebohm). Please address any com­ments regarding the translation to Priv.­Doz. Dr. med. David Martin, Die Filderklinik, ImHaberschlai 7, 70794 Filderstadt, Germany.

Tübingen, Spring 2014 David Martin

Potency Ratio(dilution)

Germanusage

German example English usage English example

1 to 10 D D5 x 5x

1 to 100 C C6 c 6c

1 to 1000 M M7 M 7M

1 to 50,000 LM or Q LM8 or Q8 LM 8LM

XV

Table of contents

Note for the readerThe present book is divided into chapters that can each be read independently. Thereader will find introductory perspectives in each chapter, which support the under-standing of the text as a whole. That applies above all to chapters 1, 5, 7, 6 and 3. Ifthe book is read in that order, the methodology inherent in the volume will more easilybecome accessible to the reader. This applies above all to those readers who have notyet made closer contact with anthroposophic medicine. The authors focus on paediat-ric practice as this is reflected in the consulting room, a well as on diagnosis and the-rapy. However, this cannot replace the need for independent study of the methodolo-gical foundations of both homoeopathy and anthroposophic medicine.

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V

Foreword to the first edition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . VII

Translator’s notes and welcome to the English edition . . . . . . . . . . . . . . . . . . . . . . . . . . X

1 Introduction ............................................................. 1

1.1 The individualized human body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

1.2 Stimulating self-regulation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1.2.1 Homoeopathic medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

1.2.2 Anthroposophic medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

1.2.3 Chronic illness and unresolved self-regulation disorders. . . . . . . . . . . . . . 17

1.3 The soul-spiritual nature of the child . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19

1.3.1 The concept of the human being in medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

1.3.2 Presence of the soul-spiritual individuality during childhooddevelopment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

2 Disorders following abnormal birth.............................. 33

2.1 Anamnesis and diagnosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33

2.2 Treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

2.2.1 Maintaining warmth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36

2.2.2 Asphyxia, respiratory regulation disorders and SIDS . . . . . . . . . . . . . . . . . . . . 38

2.2.3 Shock sequelae. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

2.2.4 Birth trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

2.3 Counselling and treatment in cases of premature birth,birth defects and prolonged pregnancy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

2.3.1 Treatment goals for babies born prematurely and withbirth defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

2.3.2 Premature birth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

2.3.2.1 Nervous and sensory system disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

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2.3.2.2 Respiratory disorders: bronchopulmonary dysplasia and recurrentlower respiratory tract infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

2.3.2.3 Bowel disorders and metabolic disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

2.3.2.4 Consultation with parents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

2.3.3 Birth defects and growth disorders related to premature birth andbirth defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

2.3.4 Prolonged pregnancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

2.4 Pregnancy anamnesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

3 Disease prevention .................................................... 74

3.1 Providing medical advice regarding disease prevention andparents’ individual decisions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81

3.2 Vitamin D, rickets prevention, sun exposure and sun protection . 82

3.2.1 Sun exposure anamnesis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

3.2.2 Vitamin D deficiency and sun protection during pregnancy andbreast feeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

3.2.3 Rickets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

3.2.4 Practical implementation of individualized rickets prevention . . . . . . . 89

3.2.5 Constitutional medication for infants. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91

3.2.5.1 Potentized oyster shell calcium (Calcium carbonicum H, Conchae). . . 92

3.2.5.2 Potentized quartz crystal (Silicea, Quartz). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94

3.2.5.3 Calcium phosphoricum; Calcium fluoratum (Fluorite) . . . . . . . . . . . . . . . . . . 96

3.2.6 Rickets treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97

3.2.7 Sun protection and vitamin D deficiency in children andteenagers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99

3.3 Vitamin K prophylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100

3.4 Questions concerning general fluoride prophylaxis – tooth delayprevention and dental disorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103

3.4.1 Tooth decay prevention. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107

3.4.2 Delayed teething. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

3.4.3 Teething troubles, difficult dentition syndrome . . . . . . . . . . . . . . . . . . . . . . . . . 113

3.4.4 Pulpitis, parulis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

3.4.5 Teeth grinding, bruxism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114

3.5 Vaccination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115

3.5.1 Vaccination and prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117

3.5.2 The decision to vaccinate – general considerations. . . . . . . . . . . . . . . . . . . . . 123

3.5.3 Aspects on timing of vaccinations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124

3.5.4 Description of vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

3.5.4.1 Haemophilus influenzae serotype B (Hib) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

3.5.4.2 Pertussis (whooping cough) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

3.5.4.3 Tetanus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129

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3.5.4.4 Diphtheria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

3.5.4.5 Polio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

3.5.4.6 Hepatitis B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

3.5.4.7 Pneumococci . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 130

3.5.4.8 Rotaviruses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

3.5.4.9 Varicella . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

3.5.4.10 Measles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131

3.5.4.11 Rubella (German measles) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

3.5.4.12 Mumps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

3.5.4.13 Meningococcus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

3.5.4.14 Tick-borne encephalitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

3.5.4.15 Hepatitis A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134

3.5.4.16 Influenza . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134

3.5.4.17 HPV at school-going age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134

3.5.5 Approaches to vaccination in practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

3.5.6 Side effects – general considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

3.5.7 Complementary treatment options during and after vaccination . . . . 141

3.5.7.1 Supportive medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141

3.5.7.2 Treating side effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 142

3.5.7.2.1 Apnoeas and hypotonic-hyporesponsive episodes . . . . . . . . . . . . . . . . . . . . . 142

3.5.7.2.2 Shrill crying or screaming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143

3.5.7.2.3 Infection susceptibility and allergic reactions. . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

3.5.7.2.4 Cerebral seizures and neurological sequelae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144

4 Digestive tract disorders and gastrointestinal diseases.... 155

4.1 Breast feeding and early development of the digestive andimmune systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155

4.1.1 Breast feeding and the human being’s relationship to fats . . . . . . . . . . . 155

4.1.2 Breast feeding, intestinal flora and immunological developmentof the infant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

4.1.3 Breast feeding and embodiment of the childhood sentient andI-organization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161

4.2 Breast feeding counselling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163

4.3 Digestive tract disorders during the neonatal period . . . . . . . . . . . . . . . . 167

4.3.1 Poor feeding in the newborn. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167

4.3.2 Atonic vomiting in the newborn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168

4.3.3 Icterus neonatorum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

4.3.4 Pyloric spasm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 170

4.4 Trimester colics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

4.4.1 Symptomatology and anamnesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173

4.4.2 Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

4.4.2.1 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

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4.4.2.2 Warmth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

4.4.2.3 Shock sequelae. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

4.4.2.4 Sleep deficit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

4.4.2.5 Feeding difficulties; meteorism. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176

4.4.3 Indications for supporting parents therapeutically . . . . . . . . . . . . . . . . . . . . . 177

4.4.4 Suggestions for medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178

4.5 Acute gastrointestinal illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

4.5.1 Acute gastroenteritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182

4.5.2 Acute salmonellosis and salmonella elimination . . . . . . . . . . . . . . . . . . . . . . . 185

4.5.3 Campylobacter jejuni enteritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

4.5.4 Post-enteritis syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187

4.5.5 Acute acetonaemic vomiting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 188

4.6 Nutritional advice, thrush, intestinal mycosis and dysbiosis(dybacteriosis) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189

4.6.1 Symptoms and causes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 192

4.6.2 Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 194

4.6.3 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196

4.6.3.1 Oral thrush . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196

4.6.3.2 Nutritional advice for intestinal mycoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197

4.6.3.3 Stimulating the digestion as long-term treatment for intestinalmycoses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200

4.6.4 Symbiosis control – dysbiosis (dysbacteriosis) . . . . . . . . . . . . . . . . . . . . . . . . . . . 204

4.6.5 Acute appendicitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 206

4.7 Treatment indications for chronic gastrointestinal disease . . . . . . . . . 207

4.7.1 Gastroesophageal reflux disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

4.7.1.1 Clinical diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207

4.7.1.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208

4.7.2 Coeliac disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212

4.7.2.1 Clinical picture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212

4.7.2.2 Treatment possibilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 216

4.7.3 Chronic inflammatory bowel disease – Eosinophilic colitis,ulcerative colitis and Crohn’s disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217

4.7.3.1 Disease types and individualized paediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217

4.7.3.2 Complementary medicine treatment indications. . . . . . . . . . . . . . . . . . . . . . . . 221

4.7.4 Constipation in infants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227

4.7.5 Constipation in pre-school and school-age children. . . . . . . . . . . . . . . . . . . 228

4.8 Anal fissure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231

4.9 Oxyuriasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231

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5 Inflammatory Diseases ............................................... 237

5.1 Respiratory tract inflammation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239

5.1.1 Pneumonia – a paradigm of inflammation during childhood . . . . . . . . 239

5.1.1.1 Symptomatology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239

5.1.1.2 Causes and the question of warmth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 240

5.1.1.3 From pathology to treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 242

5.1.1.4 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243

5.1.1.4.1 General nutrition measures. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245

5.1.1.4.2 External treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246

5.1.1.4.3 Medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249

5.1.1.5 Treatment options in case of inadequate treatment response . . . . . . . . 258

5.1.1.5.1 Lack of vitality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 258

5.1.1.5.2 Inhibited course of illness due to soul-spiritual and constitutionalfactors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259

5.1.1.5.3 Pleurisy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 262

5.1.1.5.4 Recurrent pneumonia, prophylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 264

5.1.1.5.5 Necessity for antibiotics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266

5.1.1.6 Convalescence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267

5.1.2 Rhinitis and sinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269

5.1.2.1 Development and relevance of the body-soul relationship in theupper respiratory tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269

5.1.2.2 Acute rhinitis and rhinoconjunctivitis in infancy . . . . . . . . . . . . . . . . . . . . . . . . 272

5.1.2.3 Acute and cumulatively recurrent rhinitis in childhood. . . . . . . . . . . . . . . . 274

5.1.2.4 Acute sinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277

5.1.2.4.1 Aspects of history taking and diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277

5.1.2.4.2 External and local treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278

5.1.2.4.3 Medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279

5.1.2.5 Chronic sinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 284

5.1.2.6 Eurythmy therapy for recurrent and chronic ventilation disordersand inflammation of the upper respiratory tract . . . . . . . . . . . . . . . . . . . . . . . . 286

5.1.3 Otitis media. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287

5.1.3.1 Treating acute, uncomplicated otitis media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290

5.1.3.1.1 Injecting potentized medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290

5.1.3.1.2 External treatments and nutritional measures. . . . . . . . . . . . . . . . . . . . . . . . . . . 291

5.1.3.1.3 Options for internal treatment with potentized medicines . . . . . . . . . . . . 291

5.1.3.2 Suppurative otitis media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 294

5.1.3.3 Seromucotympanon. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296

5.1.3.4 Chronically recurrent otitis media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300

5.1.4 Obsttructive laryngitis (pseudocroup). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 302

5.1.4.1 Treating an acute attack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303

5.1.4.2 Follow-up treatment and prophylaxis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

5.1.5 Acute bronchiolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306

5.1.6 Tracheobronchitis – differential treatment indications for coughing 307

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5.2 Inflammation of the mouth, pharynx and tonsils . . . . . . . . . . . . . . . . . . . . 310

5.2.1 Aphthous stomatitis (stomatitis aphtosa). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310

5.2.2 Herpangina; hand, foot and mouth disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311

5.2.3 Acute tonsillitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311

5.2.4 Adenoids und hypertrophy of the tonsils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 314

5.2.5 Chronically recurring tonsillitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318

5.2.6 Mononucleosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320

5.2.6.1 Insight into the illness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 320

5.2.6.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 322

5.3 Childhood illnesses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 325

5.3.1 Childhood illnesses according to disease type . . . . . . . . . . . . . . . . . . . . . . . . . . . 326

5.3.2 Measles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330

5.3.2.1 Symptomatology and insight into the illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330

5.3.2.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 334

5.3.3 Exanthema subitum; three-day fever) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338

5.3.4 Scarlet fever. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338

5.3.4.1 Illness concept . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338

5.3.4.2 Multi-faceted symptomatology and course of illness. . . . . . . . . . . . . . . . . . . 340

5.3.4.3 Further insights into the illness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342

5.3.4.4 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 344

5.3.4.4.1 Acute treatment during the first week of illness . . . . . . . . . . . . . . . . . . . . . . . . . 344

5.3.4.4.2 Treatment in the second to fourth weeks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347

5.3.4.4.3 Contagious impetigo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 348

5.3.4.4.4 Lymphadenitis colli . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349

5.3.4.4.5 Concluding remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349

5.3.5 Mumps. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 350

5.3.6 Pertussis (whooping cough) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 352

5.3.6.1 Insight into the illness, associated disposition . . . . . . . . . . . . . . . . . . . . . . . . . . 352

5.3.6.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355

5.3.6.2.1 Treatment options during the incubation stage . . . . . . . . . . . . . . . . . . . . . . . . . 355

5.3.6.2.2 General treatment during the paroxysmal stage. . . . . . . . . . . . . . . . . . . . . . . . . 356

5.3.6.2.3 Differential treatment suggestions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 358

5.3.7 Varicella (chicken pox) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 360

5.3.8 Rubella (German measles) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361

5.4 Febrile, flu-like infections; febrile convulsions . . . . . . . . . . . . . . . . . . . . . . . 361

5.4.1 Nursing and external applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361

5.4.2 Medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362

5.4.2.1 Sudden onset with high fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

5.4.2.2 Acute onset (not sudden) with, moderately high fever. . . . . . . . . . . . . . . . . 364

5.4.2.3 Gradually rising, moderately high fever . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 365

5.4.2.4 Single-substance medicines for severe, persistent fever. . . . . . . . . . . . . . . 366

5.4.2.5 Composition medicines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 368

Table of contents XXI

5.4.3 Febrile convulsions (infection-related) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369

5.4.3.1 Clinical picture and insight into the illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369

5.4.3.2 Treatment options: homoeopathic and anthroposophic medicines . 371

5.4.4 Chronically recurrent febrile infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373

5.4.4.1 General basis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 373

5.4.4.2 Medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374

5.5 Urinary tract infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377

5.5.1 Diagnostic aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377

5.5.2 Acute urinary tract infections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379

5.5.2.1 Uncomplicated urinary tract infections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 380

5.5.2.2 Complicated urinary tract infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 382

5.5.3 Chronic urinary tract infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385

5.5.4 Nephritic syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 388

5.5.4.1 Generally indicated treatment measures for nephritic syndrome . . . . 388

5.5.4.2 Haemolytic-uraemic syndrome (HUS) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389

5.5.5 Nephrotic syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390

5.5.5.1 Steroid-sensitive, nephrotic syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390

5.5.5.1.1 Helleborus niger . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391

5.5.5.1.2 Further treatment options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 396

5.5.5.2 Steroid-resistant nephrotic syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 398

5.6 Lyme disease (Lyme borreliosis) and TBE (tick-borne encephalitis) 398

6 Allergic diseases ........................................................ 409

6.1 Epidemiology and pathogenesis of allergic diseases. . . . . . . . . . . . . . . . . 410

6.1.1 Lifestyle and allergy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410

6.1.2 The pathogenesis of allergies and autoimmune diseases in earlychildhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413

6.1.3 Allergy prevention and paediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 414

6.2 Atopic syndromes and nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421

6.3 General treatment of allergic diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425

6.3.1 Basic therapeutic steps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425

6.3.2 Unburdening the organism – ordering and eliminating allergeniccauses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 427

6.3.3 Strengthening the organism’s equilibrium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 432

6.3.3.1 Redressing trace element and vitamin deficiencies. . . . . . . . . . . . . . . . . . . . . 432

6.3.3.2 Regulation of organ functions disorders in the digestive tract . . . . . . . . 434

6.3.3.3 Regulation of kidney activity – Equisetum arvense . . . . . . . . . . . . . . . . . . . . . 443

6.3.3.4 Stimulating immunological digestive and regulatory organs –spleen and thymus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449

6.3.3.4.1 Spleen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 449

6.3.3.4.2 Thymus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452

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6.4 Atopic dermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455

6.4.1 Typical inflammatory skin diseases during childhood . . . . . . . . . . . . . . . . . . 455

6.4.2 Atopic dermatitis and the warmth organization. . . . . . . . . . . . . . . . . . . . . . . . . 457

6.4.3 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464

6.4.3.1 Age considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464

6.4.3.1.1 Physician-parent-child relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465

6.4.3.1.2 Stress during pregnancy – early childhood attachment disorders. . . . 466

6.4.3.1.3 Further causes for the early onset of eczema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469

6.4.3.1.4 Appearance of eczema after infancy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 472

6.4.3.2 Climate change and reconvalescence treatment. . . . . . . . . . . . . . . . . . . . . . . . . 474

6.4.3.3 External treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476

6.4.3.3.1 Acute exudative eczema (weeping or wet eczema). . . . . . . . . . . . . . . . . . . . . . 476

6.4.3.3.2 Dry eczema. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479

6.4.3.4 Superinfected eczema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 482

6.4.3.5 Steps towards individualized treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 484

6.4.3.5.1 Acute exacerbation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 484

6.4.3.5.2 Vegetabilized silver: acute and primary treatment for atopicdermatitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 486

6.5.3.5.3 Introductory primary therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 488

6.4.3.5.4 Viewpoints on categorization of substance choice: neurasthenicand hystericae constitutional types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 488

6.4.3.6 Individualized treatment with single-substance medicines . . . . . . . . . . 490

6.4.3.6.1 Medicines for the neurasthenic constitution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 490

6.4.3.6.2 Medicines for the hysterical constitution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497

6.4.3.6.3 Medicines for the child with a predominantly ambivalent souldisposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 502

6.4.3.6.4 Medicines of metal origin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 506

6.4.3.6.5 Other single-substance medicines for treating atopic dermatitis . . . . 507

6.5 Bronchial asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 511

6.5.1 Towards a clinical picture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 511

6.5.2 Observations in practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513

6.5.3 Pathogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 518

6.5.4 From pathology to treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 522

6.5.5 Treatment basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525

6.5.5.1 Obstructive bronchitis and asthmatic bronchitis . . . . . . . . . . . . . . . . . . . . . . . . 525

6.5.5.2 Acute, interval and constitutional treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 526

6.5.5.3 Conventional and anthroposophic-homoeopathic treatment . . . . . . . . 527

6.5.5.4 Fears and expectations – asthma “training”. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528

6.5.6 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 530

6.5.6.1 Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 530

6.5.6.2 External treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 532

6.5.6.3 Treatment with metals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534

6.5.6.3.1 Antimony. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534

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6.5.6.3.2 Iron. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 535

6.5.6.3.3 Copper . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 540

6.5.6.3.4 Lead . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 542

6.5.6.4 Basic plant-based medicines for treating asthmatic bronchitis . . . . . . 543

6.5.6.4.1 Citrus and Cydonia: primary medicines for allergic asthma andpollinosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543

6.5.6.4.2 Nicotiana tabacum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 547

6.5.6.4.3 Prunus spinosa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548

6.5.6.5 Animal or insect-based medicines for treating asthma . . . . . . . . . . . . . . . . 549

6.5.6.5.1 Organ preparations for treating asthmatic bronchitis. . . . . . . . . . . . . . . . . . . 549

6.5.6.5.2 Apis mellifica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 551

6.5.6.6 Acute treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 552

6.5.6.6.1 Use of medicine compositions for acute treatment . . . . . . . . . . . . . . . . . . . . . 552

6.5.6.6.2 Other medicines for acute treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 553

6.5.6.7 Inhalation therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555

6.5.6.8 Interval treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 557

6.5.6.8.1 External treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 557

6.5.6.8.2 Continuing medication during treatment pauses . . . . . . . . . . . . . . . . . . . . . . . 558

6.5.6.8.3 Triggers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 558

6.5.6.9 Redressing imbalances – strengthening the centre. . . . . . . . . . . . . . . . . . . . . 561

6.5.6.10 Eurythmy therapy and art therapy for asthmatic bronchitissufferers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 563

6.5.6.11 Constitutional treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 564

6.6 Pollinosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573

6.6.1 Insight into the illness and relevant organs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 574

6.6.2 From pathology to treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576

6.6.3 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 578

6.6.3.1 General treatment options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 578

6.6.3.1.1 Bitter substances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 578

6.6.3.1.2 Citrus and Cydonia for acute and maintenance treatment ofpollinosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 580

6.6.3.2 Interval treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 582

6.6.3.3 Individualized treatment with single-substance medicines . . . . . . . . . . 583

6.7 Perennial allergic rhinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 587

6.8 Urticaria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 590

7 Psychosomatic disorders ............................................. 600

7.1 Sleep disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 601

7.1.1 Function of sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 602

7.1.2 Development of sleep during childhood . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 605

7.1.3 History and diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 606

7.1.4 Consultation with parents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 608

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7.1.5 Medicinal treatment options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611

7.1.5.1 Sleep disorders related to specific triggers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 612

7.1.5.2 Disorders of initating sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 615

7.1.5.3 Disorders of maintaining sleep, combined sleep disorders. . . . . . . . . . . . 623

7.1.5.4 Brief remarks on differential therapeutics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 625

7.1.5.4.1 Normal initiation of sleep with frequent waking during the night: 625

7.1.5.4.2 Children who wake at night and turn night into day: . . . . . . . . . . . . . . . . . . 626

7.1.5.4.3 Sleepwalking (somnambulism) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 626

7.1.5.4.4 Rhythmic movement disorder (jactatio capititis) . . . . . . . . . . . . . . . . . . . . . . . . 626

7.1.5.4.5 Children who sleep in the “knee-elbow position” . . . . . . . . . . . . . . . . . . . . . 626

7.1.5.4.6 Sweating during sleep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 626

7.2 Anxiety and phobic anxiety disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627

7.2.1 Considerations for parent consultation regarding children’sanxieties, fears and phobias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 631

7.2.2 Counselling and non-medicinal therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 634

7.2.2.1 Anxiety: birth to age 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 634

7.2.2.2 Anxiety: age 7–14 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 636

7.2.2.2.1 Typical anxiety disorders in the second seven year period:School phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 638

7.2.2.3 Anxiety: age 14–21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 639

7.2.2.4 Eurythmy therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 642

7.2.3 Medicinal treatment options for childhood anxiety disorders . . . . . . . . 642

7.2.3.1 Basis for individualized treatment with single-substancemedicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 642

7.2.3.1.1 Quiet, reticent behaviour with fear of unfamiliar people . . . . . . . . . . . . . . 642

7.2.3.1.2 Loud or restless-anxious behaviour. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 646

7.2.3.2 Medicinal treatment for specific forms of childhood anxiety. . . . . . . . . . 648

7.2.3.2.1 Fears of being alone and of the dark . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649

7.2.3.2.2 Fear of illness and death . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649

7.2.3.2.3 Abnormal lack of fear . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 649

7.2.3.2.4 Exams and anticipation anxiety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 650

7.2.3.2.5 School anxieties, school phobia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651

7.2.3.3 Anxieties related to developmental crises from age 7–14 andage 14–21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 652

7.2.4 Children with poor self-image and low self-esteem . . . . . . . . . . . . . . . . . . . 656

7.3 Depressive disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 658

7.3.1 Aspects of diagnosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 658

7.3.2 Options for medicinal treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 660

7.3.3 Eurythmy therapy and non-medicinal therapies. . . . . . . . . . . . . . . . . . . . . . . . 667

7.4 Aggressive behaviour disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669

7.4.1 Towards an understanding of aggressive and hyperkineticbehaviour disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 669

Table of contents XXV

7.4.2 Differential diagnosis indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 670

7.4.3 General treatment indications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 671

7.4.4 Options for medicinal treatment with potentized single-substance medicines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 672

7.5 Attention deficit disorder with and without hyperactivity(ADHD/ADD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 676

7.5.1 Who is hyperactive? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 676

7.5.1.1 ADHD and adaptation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 677

7.5.1.2 ADHD – A Sign of Talent?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 680

7.5.1.3 Age, gender, relationships, social class: genetic or epigenetic? . . . . . . 682

7.5.2 Diagnostic aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686

7.5.2.1 Case history . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 686

7.5.2.2 Examination and differential diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 691

7.5.3 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 694

7.5.3.1 Constitutional, social and situational factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 694

7.5.3.2 Stimulants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 695

7.5.3.3 General views on treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 697

7.5.3.4 Medication for attention deficit and hyperactivity disorder (ADHD). . 701

7.5.3.4.1 Strengthening the centre – composite aurum medicines for ADHDand ADD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 702

7.5.3.4.2 Single-substance medicines for children with ADHD and ADD . . . . . . . . 705

7.5.3.5 Eurythmy therapy for children with attention-deficit disorderswith hyperactivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 715

7.5.3.6 Medication for attention and concentration disorders without hyper-activity (ADD), diminished performance and learning difficulties. . . . 716

7.5.3.6.1 Definition and basic treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 716

7.5.3.6.2 Individually indicated medicines for attention deficit disorders(ADD), diminished performance and learning difficulties . . . . . . . . . . . . . 718

7.5.3.7 Children with craniocervical junction abnormalities . . . . . . . . . . . . . . . . . . . 724

7.5.3.7.1 Pathogenetic connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 724

7.5.3.7.2 Treatment options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 726

7.5.3.8 Children with autonomic lability and labile hypotonic circulation . . 727

7.5.3.9 Food intolerances. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 730

7.6 Affective respiratory spasms. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 731

7.6.1 Symptoms and pathogenesis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 731

7.6.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 733

7.7 Treatment indications for childhood jealousy . . . . . . . . . . . . . . . . . . . . . . . . . 734

7.8 Stuttering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 735

7.8.1 Insight into the disorder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 735

7.8.2 Medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 736

7.8.2.1 Shock. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 736

7.8.2.2 Delayed speech development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 736

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7.8.2.3 Disturbance of self-consciousness, development of the neuroticpersonality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 737

7.8.3 Non-medicinal therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 738

7.9 Tic disorders, nail biting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 738

7.9.1 Tics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 738

7.9.2 Nail biting (onychophagia) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 740

7.10 Treatment perspectives on childhood migraines and tensionheadaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 740

7.10.1 Parameters for medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 740

7.10.1.1 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 740

7.10.1.2 Rhythm . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 740

7.10.1.3 Sleeping place. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 741

7.10.2 Medication options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 741

7.11 Enuresis nocturna . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 743

7.11.1 Pathogenesis as the starting point for treatment. . . . . . . . . . . . . . . . . . . . . . . . 743

7.11.1.1 Delayed maturing process. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 744

7.11.1.2 Hormonal aspect. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 744

7.11.1.3 Delayed pneumatization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745

7.11.1.4 Soul-psychological disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745

7.11.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745

7.11.2.1 External applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 747

7.11.2.2 Internal medication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 747

7.11.2.2.1 Initial treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 747

7.11.2.2.2 Further treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 748

7.12 Diurnal enuresis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 750

8 Neurological disorders................................................ 759

8.1 Epilepsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 759

8.1.1 General insight into the illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 759

8.1.2 Diagnostic aspects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763

8.1.2.1 Triggers, accompanying circumstances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763

8.1.2.2 Rhythm in daily life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 764

8.1.2.3 Nutritional habits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 764

8.1.3 Extending treatment options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 765

8.1.4 Eurythmy therapy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 768

8.1.5 Anthroposophic and homoeopathic medicines for childhoodepilepsy – an overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 769

8.1.5.1 Metals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 769

8.1.5.2 Single-substance mineral medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 773

8.1.5.3 Animal medicines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 775

8.1.5.3.1 Apis regina . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 775

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8.1.5.3.2 Apis mellifica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 776

8.1.5.3.3 Vespa crabro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777

8.1.5.3.4 Bufo rana. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777

8.1.5.4 Plant-based medicines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 778

8.1.6 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785

8.1.6.1 Epilepsy: birth to age 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785

8.1.6.2 Epilepsy: age 7 to 14. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 787

8.1.6.3 Epilepsy: age 14 to 21 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 789

8.1.6.4 Considering the organs in epilepsy treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . 790

8.2 Movement and sensory development disorders . . . . . . . . . . . . . . . . . . . . . . . 793

8.2.1 Infantile cerebral palsy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 795

8.2.1.1 Differentiation of levels of disease manifestation . . . . . . . . . . . . . . . . . . . . . . . 795

8.2.1.2 Medicinal treatment options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 797

8.2.1.2.1 Standard treatment for cerebral palsy-related muscular spasticityand muscular disbalance: Plantago Primula cum Hyoscyamo . . . . . . . . 797

8.2.1.2.2 Therapeutic accompaniment of children with cerebral palsy . . . . . . . . . 797

8.2.2 Treatment indications for constitutional motor developmentdisorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 801

8.2.3 Sight disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802

8.2.4 Hyperopia and myopia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 802

8.2.5 Esotropia (convergent strabismus) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 804

8.2.6 Hearing disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 804

9 Disorders and constitutional aspects of growth andmorphogenesis ......................................................... 808

9.1 Growth, stature and proportion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 810

9.1.1 Shape of the head and constitution . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 810

9.1.2 The threefold organization of the face as an expression ofconstitution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 812

9.1.3 Short stature and tall stature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 813

9.1.4 Connective tissue and joints. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 816

9.2 Skeletal deformities of lower extremities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 816

9.2.1 Foot deformities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 816

9.2.2 Malalignment of the knee joint. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 817

9.2.3 Congenital hip joint dysplasia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 817

9.3 Disorders of the spinal region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 818

9.3.1 Hyperlordosis (“Hollow back”) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 818

9.3.2 Postural weakness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 818

9.3.3 Idiopathic scoliosis and Scheuermann’s disease (osteochondrosis) . 820

9.4 Aseptic bone necroses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 825

9.4.1 Perthe’s disease (juvenile osteochondrosis of femure head). . . . . . . . . . 825

9.4.2 Excursus: transient synovitis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 827

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9.4.3 Köhler’s disease I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 828

9.4.4 Schlatter-Osgood disease (juvenile osteochondrosis of tibialtubercle). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 828

9.5 Retropatellar pain syndrome (“Chondropathia patellae”) . . . . . . . . . . 828

9.6 Osteogenesis imperfecta (brittle bone disease). . . . . . . . . . . . . . . . . . . . . . . . 828

9.7 Epilogue: specifics of human morphogenesis in comparison toanimal morphogenesis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831

10 Extending treatment options for specific diseases .......... 836

10.1 Childhood cardiac disease – complementary treatment . . . . . . . . . . . . 836

10.1.1 Congential heart defects – options for and value of complementarymedical treatment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 836

10.1.2 Medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 840

10.1.2.1 Medicines and trace element substitution for supportingmyocardial function. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 840

10.1.2.2 Medicines to stimulate the rhythmic system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 842

10.1.2.3 Medicines for tempering anxiety and stress and failure to thrivein children with chronic cardiac disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 843

10.2 Idiopathic thrombocytopenic purpura (ITP) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 845

10.3 Henoch-Schoenlein purpura . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 848

10.3.1 Clinical picture and constitutional illness disposition . . . . . . . . . . . . . . . . . . 848

10.3.2 Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 852

10.3.2.1 Phosphorus and formica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 852

10.3.2.2 Pulsatilla and Apis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 853

10.4 Cystic fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 855

10.5 Undescended testicle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 858

10.6 Phimosis, penile adhesion, labial adhesion . . . . . . . . . . . . . . . . . . . . . . . . . . . 859

10.7 Acne vulgaris . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 860

10.7.1 Acne from an anthroposophical perspective, problems related toconventional treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 860

10.7.2 Anthroposophical and homoeopathic treatment of acne vulgaris . . . 861

10.7.2.1 Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 863

10.7.2.2 Medicinal treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 865

10.8 Skin, hair and nails – further disorders and clinical pictures . . . . . . 867

10.8.1 Warts, verrucae, molluscum contagiosum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 867

10.8.1.1 Verrucae . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 867

10.8.1.2 Verrucae vulgaris (common warts) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 868

10.8.1.3 Molluscum contagiosum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 869

10.8.2 Onychia (nail bed inflammation, panaritium) . . . . . . . . . . . . . . . . . . . . . . . . . . . 870

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10.8.3 Head lice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 871

10.8.4 Disorders of nail and hair growth disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 872

10.9 Rheumatoid arthritis during childhood and rheumatic spectrumdisorders. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 873

10.9.1 Individualized paediatrics and rheumatic spectrum disorders . . . . . . . 873

10.9.2 Anthroposophical perspective on juvenile rheumatoid arthritis . . . . . 876

10.9.3 Disease type as mirrored by the case history – case reports . . . . . . . . . . . 879

10.9.3.1 Systemic course of illness, Still’s syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 879

10.9.3.1.1 11-year-old boy with Still’s disease (Systemic Juvenile Arthritis) . . . . 880

10.9.3.1.2 17-year-old-girl with Still’s disease. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 882

10.9.3.2 ANA-positive oligoarthritis and extended oligoarthritis . . . . . . . . . . . . . . . 885

10.9.3.2.1 2-year-old girl with oligoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 885

10.9.3.2.2 4-yearold boy with Polyarthritis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 886

10.9.3.2.3 2-year-old girl with oligoarthritis and iridocyclits. . . . . . . . . . . . . . . . . . . . . . 889

10.9.3.2.4 3-year-old girl with extended oligoarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 890

10.9.3.3 9-year-old girl with seronegative polyarthritis . . . . . . . . . . . . . . . . . . . . . . . . . 892

10.9.3.4 10-year-old girl with seropositive polyarthritis . . . . . . . . . . . . . . . . . . . . . . . . 893

10.9.3.5 16-year-old girl with juvenile polyarthritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 894

10.9.3.6 6-year-old girl with Polymyositis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 895

10.9.3.7 Case reports in brief . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 896

10.9.4 Extended therapies for children with rheumatic diseases . . . . . . . . . . . . . 897

10.9.5 Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 899

10.10 Postoperative treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 900

11 Eurythmy therapy: principles of effectiveness, areas ofapplication ............................................................... 904

12 Epilogue ................................................................... 907

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 909

Index of Medical products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 939