To Children and Parents
Topics of interest about family and children, education, health and subjects of complementary Paediatrics such as Natural medicine, Homoeopathy and Chinese medicine for children will be discussed. Readers' questions and comments are welcome.
Wednesday 10 May 2017
Tuesday 9 May 2017
History of vaccinations
Some infectious diseases leave behind a natural immunity. The knowledge of this led to attempts to acquire this protection artificially through a controlled amount of contact with the illness at a favourable time and under favourable conditions. Such trials have been known over a thousand years in chinese medicine and later also in arabic medicine, the most important historical example being that of developing the vaccination against smallpox. These attempts were associated with risks of actually contracting the disease and dangers of the consequences.
The enlgish doctor Edward Jenner carried out the first vaccination against smallpox on 14. May 1796, using the crusts of skin lesions from an infected cow. What followed showed the characteristics typical of the development also of other vaccinations later, i.e. an initial partial success, recognizable adverse effects and the suppression of the disease to smaller outbreaks at a later stage. According to Jenner's judgement, his own son suffered from serious damages from the vaccination. The next milestone was the discovery of microorganisms by Louis Pasteur (1822-1895). The contemporary German doctor and Nobel prize winner Robert Koch (1843-1910) discovered the tubercle bacillus and developed the tuberculin vaccine. A series of vaccinations was developed against the big "killer epidemics": Smallpox (1798), Rabies (1885), Pest (Black Death) (1897), Diphtherie (1925), Tuberculosis (1927), Tetanus (1927). After the second world war, scientific progress enabled the development of more vaccinations also against virus diseases: Polio (dead vaccine 1955, live vaccine 1962), Measles ( 1964), Mumps (1967), German Measles (1970) and Hepatitis B (1981).
A critical review of history shows that well earned progresses often go hand in hand with set backs and sacrifices, which is also characteristic of the advances of humanity. On 8th April 1874, the German government declared vaccination against smallpox to be legally compulsory. At the same time, vaccinated citizens suffering from adverse effects were eligible for compensation. It has been documented, that under the WHO vaccination programme with the oral Polio vaccine and the simultaneous injection of DPT (Diptherie-Whooping cough-Tetanus)- vaccine the cases of Polio in India around 1980 actually increased rather than decreased. The problems associated with the wild polio virus under tropical conditions were not yet recognized. Now and again, vaccines had to be withdrawn from application due to unforeseen problems. The previous whooping cough vaccine was discontinued from 1974 to 1991 in Germany because of causing brain damage and fatal cases. It was only in 1997 when the neurological adverse effects of vaccines containing mercury (Thiomersal) especially affecting infants were officially acknowledged. Thereafter, all such vaccines concerned were removed from the market in Germany. Instead of Thiomersal, the conservation material used nowadays is mostly Phenoxyethanol.
Such collective experiences in the past justify an initially reserved attitude towads a newly introduced vaccine, e.g. the HPV.vaccine for teeange girls.
The interested reader is referred to the numerous publications on this issue. Among these, the book by the German paediatrician Dr. Martin Hirte "Impfen, Pro & Contra" is probably the most well known. In the current up-dated edition of March 2015 are many quotations from recent studies and documentations.
Such collective experiences in the past justify an initially reserved attitude towads a newly introduced vaccine, e.g. the HPV.vaccine for teeange girls.
The interested reader is referred to the numerous publications on this issue. Among these, the book by the German paediatrician Dr. Martin Hirte "Impfen, Pro & Contra" is probably the most well known. In the current up-dated edition of March 2015 are many quotations from recent studies and documentations.
Saturday 22 April 2017
Vaccinations - general comments
In Germany, there has been a very active, sometimes heated, debate
about the necessity and complications of vaccinations for a long
time. The official vaccination scheme is laid down by
the "STIKO" (Continuous Commission on
Immunization), a commission of 16 experts within the Robert Koch
Institute in Berlin. It is known that individual members of the
commission work closely with industrial firms producing vaccinations,
and that doctors get paid for each vaccination they carry out. The
list of the recommended vaccinations has become longer and longer
over the past years. At present, the official vaccination scheme
for children up to 17 years, starting at the age of 9
weeks, covers 14 diseases (13 for boys). By the time a
child is 15 months old, he would have received 27 individual
vaccinations (several of these are combined in a single
injection). What a heavy demand on the response from the immune
system of a young and tender body!
I appeal to parents and readers not to be polarized into the two
camps of "fans for" or "opponents against"
vaccinations. It is not a simple question of "Vaccination - yes
or no?", rather it should be a neutral and factual discussion on
"Vaccinations - why for and why against which vaccination?"
Legally speaking, each vaccination involving an injection is a
physical assault and could only be carried out with the consent
of the client, in the case of a child, his parents. Many parents take
the responsibility to give this consent very seriously, making the
decision carefully after a lot of considerations which vaccination
the child should have and when. The doctor has the duty to explain
to the parents about the vaccination, the disease it is supposed to
prevent and the possible side effects and complications of the
vaccination, so that the parents are able to make an independent
decision (according to the "special instructions for carrying
out vaccinations" by the STIKO Commission).
Parents who are reluctant to have their children immunized according
to the scheme are often charged for being irresponsible. Criticism
against them is mostly based on the following arguments. Well meaning
relatives such as grandparents who have lived through times when
infectious diseases were often life threatening tend to think that
all vaccinations would keep the child away from illness and could
only be good for them. Another argument maintains that only if each
and every child is vaccinated without any exception could a disease
such as measles or hepatitis B be completely exterminated, which is
the aim of a vaccination campaign. These arguments are not equally
valid for all the 14 different diseases concerned. The tremendous
improvement in hygiene and living conditions have contributed as
significantly as the availability of vaccinations to the decrease of
dangerous infectious diseases. The possible side effects and
complications of the vaccinations have to be weighed against the
reduced risk of contracting the diseases.
As a paediatrician working with Homoeopathy I am often asked
whether there is any "homoeopathic vaccination". The answer
is No. If there was any assertion that the application of a
homoeopathic remedy has the effect of preventing certain diseases,
this has not been proven to my knowledge. Homoeopathy is a treatment
method for an existing illness and the observed symptoms are
necessary for the prescription of a remedy. Thus it is not a
preventive measure in the strictest sense. In the debate concerning
vaccinations we should leave out Homoeopathy.
I have written these comments following the last essay on Goethe's
ballad "The Erl-King" about a dying child and my thoughts
on children's mortality rates in the times of Franz Schubert.
Perhaps the child in the poem who was having hallucinations before
his death was suffering from measles encephalitis? Those were the
times when vaccinations would have been most needed. Times when a
seriously ill child had to be taken to the doctor on horseback in the
cold night. A colleague from the USA once told me about his memories
of childhood in Upstate New York, how during an illness he was taken
to the doctor on a sledge in the midst of winter. No mother in Europe
nowadays would dare to do that. The paediatrician would be asked to
do a house call. In 2001 I was doing voluntary work in the
Philippines as a member of the "German Doctors for the Third
World". There, where infectious diseases were frequent and life
threatening, we were vaccinating children conscientiously. There,
small children were also dying from severe diarrhea. Unfortunately,
no vaccination was available for that. Quite to the contrary I do not
think that the vaccination against Rotavirus (causing diarrhea) now
in Europe is at all necessary.
We shall go into the discussions about individual diseases and
vaccinations in the next articles.
Thursday 20 April 2017
Goethe's ballad “The Erl-king” from a paediatrician's point of view
“Der Erlkönig” is a well known classical song which depicts the death of a child assailed by a supernatural being, the Erl-King or “Erlkönig”, a ballad written by Goethe in 1782 and set to music by Franz Schubert in 1815. Goethe was supposedly inspired to write the poem by the news of a farmer from a nearby village riding desperately with his ill child in the night to look for the doctor.
Who
rides there so late through the night dark and drear?
He
holdeth the boy tightly clasp'd in his arm,
He
holdeth him safely, he keepeth him warm.
…...
“Father, do you
not see the Erl-king?
The Erl-king with crown and cape?"
The Erl-king with crown and cape?"
“My father, my father, and dost
thou not hear
The
words that the Erl-King now breathes in mine ear?”
“My
father, my father, he seizes me fast,
For
surely the Erl-King has hurt me at last.”
........
........
The
father now gallops, with terror half wild,
He
grasps in his arms the poor shuddering child;
he
reaches his courtyard with toil and with dread,
The
child in his arms finds he motionless, dead.
I never
liked the song as I find it oppressive with fear and sadness, in
spite of the beautiful music. There are many unanswered questions
about the poem itself and different interpretations in the
literature. I developed my thoughts about it from a paediatrician's
point of view last November when I listened to the song in Schubert's
birth house in Vienna, having just read his biography. Schubert was
one of the only four surviving children out of fourteen (!) births of
his mother. What a tremendously high mortality rate for children
at that time! (Schubert himself only lived to his beginning 30's.)
Being there in this house where the Schubert family had lived and
worked (his father ran a school in the same house) and listening to
this ballad about the fears of a sick child before his tragic death
suddenly brought home to me how precarious the life of a child was
200 years ago.
Not long
thereafter I had a family of three generations in my consultation
room. The grandfather accompanied his daughter bringing the ill child
to the practice. Before they left, the discussion about immunizations
somehow became lively. The grandfather was full of anxieties from his
times when serious illness was often life threatening for children.
Vaccinations were to him undoubtedly a great savior of modern
medicine. To the daughter, in this day and age when children's
mortality is fortunately not any more imminent except in hospitals
whereas side effects from chemical drugs a real
concern, the necessity of vaccinations has become questionable.
I tried to
explain to both father and daughter that they have different points
of view because the issues and concerns about children's health of
their generation are so very different.
Next time,
we shall discuss on this hot topic, the vaccinations.
Saturday 8 April 2017
Greetings of spring with cough and snuffles
4. April 2017
Last Friday, Mrs. K.
registered her two sons for an acute appointment because of their
cough, snuffles and fever. Simon (13) and Elias (14)
first came to the practice a few years ago with complaints of
stomach pains and bowel problems. Mother is also a patient in our
family practice. She suffers from hay fever and food
allergies, the greatest problems being with cow's milk and
gluten.
The children's symptoms
were not quite so acute. They have been there for a few weeks since
the beginning of March, sometimes better and sometimes worse. Because
Simon's fever went up again and Mrs. K. was still anxious from the
experience with Elias' pneumonia some time before, she brought the
children for treatment before the weekend.
Simon has had a “barking”
cough since quite a while. I asked him to please cough a couple
of times. Indeed the cough sounded neither dry nor “wet” with
phlegm, but rather hoarse coming from the larynx (at the level of
the vocal cords) as though the airways there were narrowed. Some
mothers would describe such a cough as “like a little dog barking”.
This is the typical description of the cough of “croup”, a
frightening attack which could happen to small children in the night
with wheezing on inspiration (stridor) and shortness of breath.
Parents often seek help in the emergency department of hospitals
because of the fear that the child might suffocate. The episode is
less dramatic with older children. Many of these children have a
tendency to have repeated croup attacks or to have a croupy (barking)
cough when they catch a cold, especially in early spring and autumn.
From my experience, a
barking cough is not just a simple virus infection of the vocal cord
area. Especially if it tends to be repetitive, it speaks for an over
reactive basic state of the airways, which is what “allergy”
means. There are often other expressions of this allergic basis such
as hay fever or asthma like symptoms in the family. I always ask
about the child's previous history, the association with the seasons
and the family history.
The mother thought for a
long time and could not quite answer the question, whether Simon was
also coughing a lot during the same season last year. Simon, however,
could remember it well, “yes, I coughed a lot on my birthday and
before too.” His birthday is on the first of April. So, during the
same spring season, when mother has hay fever symptoms, Simon is also
susceptible to coughing. The homeopathic remedy for a barking cough
would be Spongia, D30, 3 times daily 5 pieces.
Simon also had a blocked
snuffle. The allergic reaction and the infection caused swelling
of the nasal mucosa. The nose is almost completely blocked, left and
right side alternating, and mucous secretions could not flow down.
This could lead to the danger of Sinusitis. His fever was a warning
signal. Nose drops to decrease the mucosal swelling and medicines to
dispel the phlegm (“expectorants”) would be necessary to avoid
further infection and inflammation of the sinuses.
The elder brother Elias
had a really dry cough. This irritant cough sounded
rough, was short and frequent, “staccato” without long stops. The
homeopathic remedy for it would be Sticta pulmonalia, D30, 3 times
daily 5 pieces. While listening to the chest I noticed reduced breath
sounds on expiration. The child could breathe out better if he
pressed his tummy with his hand. There is obstacle to breathing out
caused by narrowing of the small airways. This is the point on which
the diagnosis “asthma” or “obstructive bronchitis”
is based. I prescribed regular inhalation with physiological salt
solution first. If the difficulty with breathing got worse, it would
be necessary to use “bronchodilators” (medicines which act to
widen and relax the narrowed small airways again).
From a holistic point of
view, the two children and their mother show different symptoms of
the same allergic basis. The bowels, the middle of the human
organism, is the important centre of most of the immunological
events in the body. All three patients have problems with the
digestive system. The mother admitted, that since she has stayed away
from cow's milk products and cereals containing gluten, after blood
tests confirmed the intolerance of these, and went through treatment
of the intestinal flora, her hay fever this year has been
significantly better. Logically, I recommended that the children
follow the same measures and treatment.
Thursday 30 March 2017
Images of Childhood in History
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Memories of our childhood
Memories of our childhood: It is amazing! This theme „ childhood“ has crossed the minds of some of us in the past two days, traversing across time and space. This co...
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