Ohren Anhang

[Phatak]

EARS; behind; tumour: Berb.

EARS; external; boils,on: Merc.

EARS; external; veins distended: Dig.

EARS; lobules; herpes, on: Sepia.

EARS; ossicles, sclerosis, of: Thyroidinum.

EARS; tympanum, drum burning; injury to: Tellurium.

EARS; aching with hiccough: Tarent.

EARS; aching < writing: Phytolacca.

EARS; “As if blood hot”: Lycopodium.

EARS; bubble, bursting, in: Nat-c.

EARS; itching intern with sneezing: Cyclamen.

EARS; open and close, as if; ear to ear: Alet.

EARS; “As if stopped” > swallowing: Silicea.

EARS; wax, blackish; hardened; black: Elaps

[hr]

Aml-n.: Throbbing in ears, bursting sensation, as if membrane would be forced out with each beat of the heart. Burning of ear

Arundo.: Burning and itching in canals of ears. Inflammation commences with shooting pains/finally discharge of blood; purulent discharge from ears. “As if insects crawling over body

Benz-ac.: Sensation in ears like a sound of confused voices; <: swallowing/walking in the open air; throbbing and hissing in ears, synchronous with beats of heart; swelling behind ears

Chen.: Roaring in ears; deafness; ringing in ears; sensitive to external noises (China), although deaf to voices

Com.: Left ear cracked and desquamating, like powdered starch; heat and fullness in right ear

Eryn.: Inflamed eustachian tube; left ear swollen in and out; tender to pressure, bleeds easily, thick, bloody, foul smelling pus; bruised, tearing pain about ears, as if being torn of

Lith-c.: Earache left side, from throat, with prosopalgia; pain behind left ear in bone, extending toward neck

Merc-d.: Catarrhal inflammation of middle ear; eustachian tube and mucous membrane of pharynx affected; otitis media; closure of eustachian tube; membranum tympani retracted, thickened, and immovable

Onos.: Roaring and whizzing in ears. Vertigo from chronic catarrhal inflammation of middle ear; vertigo, with ringing in ears

Plant.: Pain in ear, with pain in teeth and face; pains sharp. Neuralgia; earache, associated with toothache

Teucr-marum-verum:. When blowing the nose, a fine singing in the ears, and sounds like the passing of air through mucus. Accumulation of mucus in middle ear

[Richard Moskowitz]

Otitis media has become the commonest pediatric diagnosis made by physicians caring for children in the U.S., its annual budget reaching $2 billion in 1982,2 and growing

ever since, with no relief in sight. After decades of punishing warfare against the resident nasopharyngeal bacteria, several medical journal articles have recently begun to admit defeat

and have questioned not only the safety and effectiveness of antibiotics and tympanostomy, but also the wisdom of prolonging the essentially military strategy based on them.

For those pursuing more holistic approaches, the present stalemate confers both the opportunity and the obligation to come forward and present our experience to the medical community and the public at large. Nobody need just take my word for it that homeopathic remedies are inexpensive, non-toxic, and can help even the most advanced cases, or that parents, children, and their pediatricians alike will come to appreciate the non-invasive philosophy governing their use. I will feel amply rewarded if more professionals and lay people will simply try them and see for themselves.

The following cases are intended to show how the homeopathic viewpoint can assist in our practices, in both diagnosis and treatment, and also in research, both theoretical and experimental, into the etiology and pathogenesis of these increasingly common and all-but ubiquitous ailments.

Calc-s.: Girl of 3, had had recurrent ear infections since the age of 5 or 6 months, typically associated with colds and the production of thick, green mucus in the nose, throat, and sinuses, and treated with antibiotics each time, often for months without interruption. With no fever and perhaps a slight earache, she often became irritable and cranky as the cold ended, when her physician would make the diagnosis by otoscope. Apart from mild eczema, the child was seldom ill otherwise, and rarely had the fevers or acute illnesses to be expected at her age. A strapping 8 lb. at birth, she weighed only 16 lb. at one year, and had remained small for her age ever since. Teething was late and difficult. She had had all the usual vaccines, with no obvious reaction.

I chose Calc-s. C 200, one dose, and 2 months later her mother reported “the best winter ever,” with no ear infections and two mild colds that soon cleared up with the help of Calc-s.

C 12. I next saw her a year later, several weeks after an episode of wheezing in the middle of a cold, for which 2 doses of Pulsatilla 30X prescribed over the phone had worked splendidly. Despite no more ear infections in all that time, she had had a fever or two, and was still plagued by quantities of thick, greenish-yellow phlegm in her nose and throat. After one dose of Sulphur 200, she never came back. When I called recently, some 5 years later, in preparation for this talk, her mother told me that she had never had another ear infection, and that there was no need to bring her back, since her general health had remained very good, and the usual remedies had proved quite effective for the typical colds, fevers, and URI’s that had developed along the way.

I want to add a few other comments about this by no means unusual case. First, as I reread it now, I doubt that either Calc-s. or Sulph. was the true simillimum for this patient, since she was actually on the chilly side, and since even after the treatment she continued to produce large amounts of thick green phlegm and be subject to frequent colds. Indeed, I can’t really defend or even explain either prescription at this point. Yet her mother was more than satisfied: the ear infections disappeared, and never came back; the main constitutional issues stayed quietly in the background; and the remedies that she herself came up with continued to help without needing further assistance.

Not withstanding all the small remedies and “cured” cases that we like to parade at our conferences, I suspect that by far the larger share of our practices and reputations are built upon stories as generic and unspectacular as this one, and am deeply grateful for a method that adds feathers to my cap even when I bumble or fall short. Second, my own experience amply confirms numerous reports in the European literature that most kids eventually outgrow their er infections anyway, if simply allowed to do so without too much allopathic interference.

Case 2. K. G.-S., a boy of 16 months, had already had 5 ear infections and 5 rounds of Antibiotics when I first saw him. The first episode at 6 months of age was the only one associated

with fever (T. 102.8°F.) and acute earache, both of which subsided soon after the eardrum burst and discharged the pus that had accumulated behind it. Although he weighed 7 lb. at birth and appeared normal, he was slow to nurse, fell behind in his gross motor development, had had considerable pain and discomfort with teething, and still weighed only 20 lb. His only other complaint was a persistent diarrhea that had begun under antibiotic treatment and had since become chronic. In spite of prolonged and intense crying after the first and second DPT’s, his third DPT and MMR provoked no obvious reaction at all.

I gave him Sulphur 10M, one dose, and one month later his mother reported that the diarrhea had worsened, becoming particularly acute the first week, but that, despite a fever of 103° F. on the third day, the highest in his life, he had had no symptoms of a cold or ear infection since. Because of the diarrhea, I gave him Calc: 10M, one dose, and by the next visit, two months hence, he was well and had made good progress developmentally, with no sign of an ear infection, one brief cold, for which Calc-S: 12C worked well, and no more diarrhea.

After that I didn’t see him again for more than a year, about 4 months after another acute otitis episode, with fever but no earache, that was diagnosed by otoscope, and continued for

a full week on antibiotics. Previously, apart from a few colds and the reappearance of diarrhea at such times, he had had no more ear infections and was continuing to develop normally.

Repeating the Sulphur 10M, I never had any further news of him until I had my receptionist call recently, more than 5 years later, and learned that he had been in good health the whole

time, with no ear infections and no antibiotics. After buying a kit and studying on her own, the mother had herself found Belladonna to be highly effective in the early stages of his colds

and acute illnesses, and no longer needed my help.

Again not for any elegant prescribing on my part, much less from any notion that the child was “cured,” I treasure cases like this, because our work together helped his mother to take charge of his health and to perform competently in that role. When my own learned prescriptions fail, as they not infrequently do, I feel if anything even prouder when the parents themselves find the remedies that work best for their child. By far the most precious gift that homeopaths can offer the medical community is our relationships with our patients, which can continue to grow and flourish even when the simillimum proves elusive.

Case 3. J. L., a girl of 6, had had ear infections repeatedly since the age of 5 months, particularly when exposed to other kids in crowded day care or classroom settings. With little fever and no earache, the individual episodes were quite mild, with red cheeks, loss of appetite, and grumpy, cross, or irritable behavior. While vulnerable to staying up late and sudden changes of weather, she seldom ran fevers of any kind, the highest being around 102˚F. once with a “Strep throat,” yet had already taken antibiotics over two dozen times. Although vaccinated

at the usual times without any obvious reaction, she developed an ear infection after her 5-year DPT booster that persisted for 4 months despite long-term maintenance on antibiotics, and had subsided only with regular chiropractic adjustments.

Two days after a single dose of Sulphur 10M, she developed a generalized rash that lasted 3 or 4 days, followed by a more “bouncy” mood and livelier energy than she had displayed

in a very long time. At the time of her first follow-up, she had a mild cold, with the usual red cheeks, runny eye, temporary hearing loss, and the dreaded positive Strep culture.

It required a considerable leap of faith for her mother to allow even this minor illness to run its course without antibiotics, using only Puls: C 30 as needed, but soon after she bought

a kit of remedies and a book to learn how to use them. Two months later, her pediatrician was happy to report and even take credit for the fact that her ears were uninfected for the first time that anyone could recall.

The following winter, she was back with her usual symptoms , a low fever, and a weakly-positive Strep culture. As it subsided, I repeated the Sulphur 10M, and at her next visit the picture had changed to one of recurrent sore throats, foul breath, enlarged tonsils, dark circles under the eyes, and a loose, productive cough. This time I chose Merc-v. 1M, followed by the 10M one month later, with good results until yet another cold several months later, accompanied by the same swollen tonsils and loose cough as before. This time I repeated Sulphur 10M, and I never saw her again, but her mother reported a few years later that she had remained very well the whole time, with no major colds, no ear infections since the first visit, and for the first time a perfect attendance record for the school year just completed. Calling her back recently, we learned she was doing very well in high school, with no ear infections at all in the nine years since she had begun using remedies.

Once again leaving aside my rather crude prescribing in this case, I want to point out a few of the methodological issues it exemplifies, issues so obvious and so fundamental as to be readily overlooked or forgotten. First, the official policy of equating fluid behind the drum with a full-blown “ear infection” calling for antibiotic treatment ignores what every family doctor or pediatrician knows, that most colds or URI’s, especially + swelling of the tonsils +/o. adenoids, can be expected to produce secondary congestion of the middle ear and some degree of temporary hearing loss as a result. The girl in this case was subject primarily to tonsillitis, and could be said to have ear infections only to the extent that the pneumatic otoscope can detect even minute amounts of fluid, and that years of war against the resident ear bacteria have culminated in this failed Vietnam-like strategy of killing everything in the vicinity.

Secondly, her longest period of ear involvement followed soon after a DPT booster, a connection that I have verified numberless times in my practice for a number of different vaccines, but that is rarely suspected by most doctors and parents alike, because vaccines are widely regarded as almost risk-free and indeed sacrosanct, except for a few comparatively rare life-threatening events developing within the first hours or days.7 Finally, like most of my patients with chronic otitis media, this child seldom ran fevers throughout the time she had received conventional treatment, and indeed began to do so only when her general condition improved. Useful prognostically for reassuring the family, this simple fact also carries major implications for the natural history of the disease and its evolution in recent times.

Case 4. L. P., a girl of 10 months, had already had 4 acute ear infections and received antibiotics for each one. They began at 2 months of age, when her mother was forced to wean her to go back to work, and the baby developed a rash and unusually cranky behavior on a milk-based formula. These early symptoms were all greatly intensified for a full week after her first DPT shot, followed suddenly and not long after by an acute ear infection, with a high fever and violent earache, much like all of the others.

With Calc. 1M at the onset and Cham. C 30 as needed acutely, she did quite well, with fewer colds and none of her typical acute episodes, but mild symptoms persisted and < teething, when the remedies had to be repeated. The following spring, 6 months later, she started all over, with 3 of her typically rip-snorting ear infections and as many rounds of antibiotics in the 3 months since her father had insisted on her long-overdue MMR vaccination. At this point I gave her Lyc. 10M, followed by Sulphur 10M a month later, and was about to change the again, until I learned that the parents had recently separated and were angrily vying over the child. From then on, she continued to do very well on infrequent doses of Sulph. despite a violent bout of gastroenteritis after a DT and polio booster, and a tendency to relapse when she stayed with her father, who let her eat her fill of dairy products and took her to the pediatrician for her regular quota of antibiotics and vaccines.

I have continued to follow this child at irregular intervals for more than nine years, and although she has long since outgrown her ear infections, her underlying health issues have not changed all that much. Already evident in the acute, vigorous responses of her infancy, her basically strong constitution and immune system have matured over the years, enabling her

to bounce back more quickly than ever when she does fall ill. While both allergic and mildly addicted to milk and cheese, she has continued to grow and develop relatively normally

in the face of a conflicted heritage that she can not as yet understand or change.

In short, this is a child of strong vitality who exemplifies the opposite side of the same issues already discussed:

1) the innate tendency to respond acutely and vigorously to infection, and to recover quickly from it;

2) the tendency to relapse following any vaccination, and to milk allergy which is often associated with it; and

3) the tendency to develop the classic signs and symptoms of acute otitis media that were the rule in the pre-vaccine and pre-antibiotic era, but have since become the exception.

Overview.

With these few representative cases in mind, I will try to summarize my experience with the general phenomenon of otitis media in children, giving special emphasis to the practical issues of diagnosis, treatment, prognosis, and long-term case management.

1. as with my allopathic colleagues, middle-ear infection is one of the commonest presenting complaints of children in my practice, although I do mostly chronic work and provide

well-baby and well-child visits only when the parents explicitly ask for them. In an average week, I may triage four or five acute cases over the phone, and see one new and two or three established patients with chronic or recurrent otitis that has been diagnosed and treated repeatedly or on a long-term basis with antibiotics or tympanostomy, or both.

What most of these patients have in common is the absence or relative paucity of strong symptoms, such as high fever or violent earache, that would indicate an acute, vigorous response

to their illness. With a few exceptions, like the last case I presented, even when they do “flare up,” their symptoms are much more likely to be vague and nondescript in character, such as “fussy” or “cranky” behavior, whining or picking at the ear, mild hearing loss, poor appetite, and the like. In quite a few instances, there are no symptoms whatsoever, and the child behaves and functions perfectly normally, but at the well-baby visit the pediatrician detected some fluid behind the drum, signed it off as an “ear infection,” and began the cycle of antibiotic treatment that may prove quite difficult to break.

Similarly, although the symptoms often recede to some extent during conventional treatment, relapse is common afterwards, and even when the child appears clinically well, the presence of fluid is generally interpreted as a persistence of the infection, or in any case as a mandate for continuation of antimicrobial therapy. In this way, a child who may never have been that sick also never gets entirely well, and continues to relapse until the pediatrician recommends maintenance doses of antibiotics for months at a time, or indefinitely, as well as surgical insertion of tubes and artificial drainage if the condition persists despite these measures, as indeed it often does. In short, the most striking and disturbing features that such cases have

in common is simply their chronicity, their tendency to develop smoldering or persistent responses to illness, to relapse more and more easily, and their failure to heal or resolve

themselves in a clearcut or timely fashion.

In treating such a case, the physician needs only to break this cycle of chronicity, which is accomplished fairly easily if the parents are willing to co-operate. But here too lies the major obstacle, our own cultural belief and professional indoctrination that reduces the art of diagnosis to the specialized detection of abnormalities and the goal of treatment to the killing or decimation of our resident bacteria. Even more than finding the correct remedy, the most difficult and important requirement for success in treating these kids lies in re-educating the parents and developing an alternative model that works and makes sense for them.

First, I try to redefine the nature of the illness and the best way to detect and diagnose it, beginning with some basic anatomy of the ear, nose, and throat, and the typical clinical and pathological features of a URI with ear involvement (congestion, earache, etc.), contrasting it with that of full-blown acute otitis media. Always my emphasis is focused on the signs and symptoms that they are already well aware of, that is, how the child feels and functions, or what we homeopaths like to call “the totality of symptoms.”

If we’ve made a good connection and feel pretty much “in synch” so far, I may go a step further and propose that we not look in the ear just yet, unless the clinical picture is especially intense, or hasn’t resolved after giving remedies, or either of us is so panicked that we just have to know. Since almost any URI can produce detectable fluid congestion behind the drum, and it is not necessary or even desirable to treat the illness all the way to the end, the totality of symptoms is what best defines the illness, and what we can see through the otoscope adds really useful information only in the rarest and most difficult cases.

If there is significant ear involvement, I like to reassure parents that giving antibiotics is no more effective than placebo,8,9,10 and that in fact it produces more frequent relapses than giving analgesics and simply allowing the children to recover on their own.11 Only at that point will I add the punch line, that homeopathic remedies are wonderfully effective, both as needed for the acute episodes, and “constitutionally,” to prevent them or minimize their number and severity.

Finally, I will take a careful vaccine history and look for any other underlying chronic or constitutional influences that may contribute to the problem, such as a difficult pregnancy, traumatic birth, or other established illness, food allergy, emotional upset, and the like. Quite often, the first episode can be traced to shortly after the time of a DPT, MMR, or some other vaccination, even when no acute or obvious reaction was noted at the time,12 or the old pattern of chronic or recurrent otitis is reactivated by a booster after a long period of remission.13 Quite often a relapse following this or that booster after a long period of good health is what first convinces the parent of the connection, which has also been independently corroborated by the curative effect of homeopathic nosodes prepared from the vaccine or natural disease in such cases.14 Citing these experiences, I will ask the parents not to vaccinate the child at least until the condition has been resolved, and refer them to my various writings on the subject for further study.

While they are by no means the only important factor in the background of such cases, and I have certainly seen my share of chronic otitis even in unvaccinated kids, vaccines stand alone in being legally mandatory for every child, and in being regarded as so uniformly safe and beneficial that the mere possibility of chronic, long-term sequelæ is seldom if ever taken seriously.

With this important preparatory work done, I am ready to proceed with homeopathic remedies. The guidelines I follow and the remedies I use are no different from the ones that we use

in general pediatric practice, and I see no need to elaborate on them here. If the child is not acutely ill at the time of the first visit, I usually begin with a single dose of the indicated preventive or “constitutional” remedy in perhaps a 200 potency, often a typical polychrest, such as one of the Calcareas or Kalium salts, or Sulph., or sometimes with a so-called “acute” remedy like Acon., Bell. or Cham. if it is indicated for the acute episode but clearly discernible in the chronic pattern as well.

I also find it very helpful to suggest the C 12 or D 30 of a remedy to have on hand for acute flare-ups, often the same one as the 200, or perhaps another complementary to it, and to see the child or at least coach the parents through the episode with words of encouragement, changing the remedy if necessary. Once remedies have helped them through an acute episode without antibiotics, the remainder of the treatment is apt to proceed quite smoothly. If the child has never had a fever or responded acutely or intensely before, it is prudent and even reassuring to prepare the family for such an eventuality beforehand.

By no means grounds for discouragement, relapses many months or even years later are even simpler to treat, since the precipitating factors will be much more obvious after a period of good health, and the remedies that worked well before will most likely perform even better the next time, as the children often know by asking for it themselves. This uncanny ordering and clarification of the case over time is the predictable legacy of effective treatment, and the awe and wonder that they inspire in doctors, patients, and family members are among the most treasured perks and lasting rewards of every homeopathic practice.

Chronicity.

What is most mysterious and problematic about ear infections in children is therefore not in the manner of their treatment, which is not especially difficult, and typically involves the

same remedies as are indicated for many other chronic ailments, but rather, as we have seen, in the nature, causes, and effects of that chronicity itself.

When I was a medical student in New York City in the early 1960’s, otitis media was pre-eminently an acute disease, often presenting in the Emergency Room with a high fever and

a piercing scream, both of which ended abruptly as soon as the eardrum burst and discharged its purulent contents. While certainly not a pleasant experience for doctor or patient, it seldom lasted very long, indeed had often taken care of itself before we had the chance to interfere with it, and was unlikely to come back for a long time to come. In short, it closely resembles the type of acute flare-up which, when I see it in one of my patients today, I have learned to interpret as a favorable prognostic sign.

When I moved to Boston in 1982, stopped doing births and primary care, and limited my practice to classical homeopathy, I started to see large numbers of chronic otitis patients

such as I have just described. Why the occasional acute ear infection I knew in medical school had mushroomed into a chronic disease of epic proportions was also precisely the question with which I began this article. Both my clinical experience and the research I have conducted to support it have amply confirmed my intuitive sense that the modern pandemic of chronic otitis media is largely attributed to two cruel, fanatical, and ultimately self-defeating wars that carry on the same militaristic philosophy:

1) the war on the nasopharyngeal bacteria, fought with antibiotics, tympanostomy tubes, and the systematic cultivation of fear of communicable disease; and

2) the vaccination of entire populations against a growing list of acute diseases, more or less on principle, with no end in sight, and no inclination to consider the possible long-term consequences of doing so.

Based on Koch’s postulates and their considerable predictive value, the war on our own resident bacterial flora is undesirable, to begin with, and in fact unwinnable, even in thought.

It is unwinnable, in the first place, because as this planet’s most basic life forms, bacteria can reproduce themselves in an average of six hours, and through natural selection rapidly become resistant to even the most lethal antibiotics. In clinical medicine, some important examples include nosocomial or hospital-borne outbreaks of resistant Staphylococci and E. coli, and the emergence of infections with new, mutant organisms such as Mycoplasma, and PPLO, which lack cell walls, obvious adaptations to penicillin-rich environments. In a recent Newsweek article, the propagation of resistant strains made hospitals into veritable centers of germ warfare, from which virulent organisms are widely disseminated out into a general population more or less powerless to stop them.16

In the case of childhood ear infections, resistant strains have similarly been implicated in the weakened primary immune responses and high relapse rates associated with antibiotic treatment. 17 Other common sequelæ include superinfection with yeasts and other common fungi, as well as the food and environmental allergies that often accompany them.

Other studies of the fluid isolated from kids’ infected ears have shown that the predominant organisms are simply the common pathogens of the tonsils and nasopharynx, such as the “pneumococcus,” or Streptococcus pneumoniæ, ß-hemolytic Streptococcus (Group A), the main culprit of “Strep throats,” Hemophilus influenzæ type B (HiB), and Staphylococcus aureus, all of which are commonly found in healthy throats as well.

Indeed, in 20% of the children with acute otitis media, and 80% of those with the chronic serous variety that is now most prevalent, the effusions are sterile and no longer contain any organisms whatsoever.19,20 In other words, once the resident bacteria are destroyed, the common result is “glue ear,” an important cause of chronic and sometimes permanent deafness. Thus even more injurious than the drugs themselves is the fanatical strategy of attacking and killing everything in sight that makes such imagery seem attractive.

A further application of the same military strategy has been the development of the pneumatic otoscope, its tight seal permitting the detection of even minute amounts of fluid and thus facilitating both early diagnosis and even more minute surveillance. Yet diagnosing more infection has only unleashed still more firepower, with the same ruinous results as described above. With tympanostomy, the war against otitis media attains its final dead end, looking like an obvious practical solution to the mechanical problem, yet itself recently found to be a major cause of otosclerosis and permanent hearing loss, ironically the same spectre used to browbeat reluctant parents into accepting it in the first place.21 Even more ironic is the fact that such ear tubes merely substitute a fixed, artificial conduit for the natural process of perforation and drainage that the acutely infected ear heals so well by itself and with so few complications.

In any case, it makes no sense to search out and destroy the mostly friendly bacteria that have already established residence in our bodies and police them so effectively for our benefit,

or to suppose that monkeying around with them could ever produce anything but more war, more devastation, and the emergence of still other and for the most part more hostile types

of bacteria capable of surviving it.

As for vaccine-related illness, comparatively little of my experience is of the kind that Harris Coulter and Barbara Fisher described in their book, Shot in the Dark, which like most of

the anti-vaccination literature is limited to what appear to be specific effects of specific vaccines, in their case, different types of encephalopathy or brain damage from the DPT.

While such reactions are likely to be the most dramatic and severe, as well as those for which the corresponding homeopathic nosodes would probably be most useful, most of my own clinical experience has to do with subtler, more generic reactions of what I would describe as a non-specific type. By that I mean that they appear to represent exacerbations of a pre-existing chronic state, as is evident from the fact that they appear more or less the same in a given individual, regardless of which vaccine is given, and are benefited by the same group

of remedies that we already use for the general population, whether vaccinated or not. While such reactions are rather more difficult to recognize and verify, they are also much more common and, I suspect, considerably more important.

In particular, two of the four cases I presented exhibited prolonged, severe relapses of their chronic state after a vaccination; one patient suffered almost identical relapses after two different vaccines; and all four first developed their chief complaint during their first dose of the DPT series. In no case were their responses acute or obvious enough to be identified as

a repeatable symptom of that particular vaccine. Indeed, all that was repeatable in all cases, and with all the vaccines, was simply the chronicity of the responses, the fact that they occurred more frequently, persisted for longer periods of time, and showed less of a tendency to resolve themselves spontaneously.

It is precisely this congruence between vaccine-related responses and the original illnesses that they make worse, that suggests how vaccines act nonspecifically on the immune system

as a whole, and so implicated vaccines in the still more basic riddle of chronicity itself. As biotech firms are busily cranking out new genetically-engineered vaccines almost as fast as they can identify possible organisms to attack, the all-out war against identifiable acute diseases has already added to the pre-existing chronic disease burden a full complement of new DNA- and RNA-like fragments looking for chromosomes to recombine with, and thus inadvertently to engender new diseases of which as yet we know nothing. In short, I’m afraid that doctors, like politicians, are here to stay.

[Dr. Henry C. Houghton]

The two leading symptoms are the discharges and the deafness. Allow me to call your attention to a term found very frequently in our literature, which is used to designate a disease, -

otorrhoea.

This is the name, not of a disease, but simply of a symptom of a disease. The make- up of the word, as you understand, indicates its meaning, - ‘a flow from the ear‘. As regards the nature of this discharge, it may be said that it is marked by all the shades of difference between pure pus and a mucopurulent discharge which is more mucous than pus. The purulent discharge may also be laudable, bland, or ichorous, excoriating, sanguineous, and on these small points of difference is based the prescription of various remedies.

The deafness is in marked contrast to that in many cases of chronic catarrhal inflammation. There are certain facts touching the calibre and length of the canal, the appearance of the membrana tympani, and of the mucous membrane of the cavity of the tympanum, if the drum head be perforated, which will, as objective symptoms, help you to distinguish between

otitis externa and otitis media.

Until the eye is educated, you may not be able to determine whether the granulation, ulceration, pus, or mucus, which is seen, is located in the canal, upon its walls, or upon the walls of the cavity of the tympanum.

The prognosis is unfavorable if the disease is allowed to take its course. It is certainly favorable under the best instrumental and medical treatment of today. I may state here, not in any spirit of egotism, but to emphasize an important truth, - that for more than 17 years I can review the history of cases, and assert that where the parents, guardians, or others having the charge of patients, have persisted in maintaining the treatment year after year, in no instance have I failed to reach the desired result. In two cases, children who had suffered from

scarlet fever, barely escaping with their lives, both membranae tympanorum lost, the suppurative process has been brought to an end; and, by the use of a cotton pellet, these children,

now young ladies, are able, with but little difficulty, to understand all ordinary conversation. In one case, however, it required nine years, and in the other, eight, to reach this much-desired issue.

Patients who have themselves made attempts at cleansing the cavity of the tympanum, have at times experienced a loss of sensation and taste on one-half of the tongue, and have been seriously alarmed at the results so produced. You will understand how this has been caused, when you consider the relation of the chorda tympani nerve to the branch of the facial,

which passes through the upper portion of the tympanum. In cleansing the cavity, the surgeon may produce this symptom but it is usually of short duration, and need cause no special alarm. Vertigo may be produced in the same manner, or by the forcible use of the syringe. This is due to direct pressure, either upon the disarticulated stapes or the exposed fenestra rotunda, thereby causing change of the tension of the labyrinthine fluids.

This is not usually a serious symptom but you must not allow this fact to make you unmindful of persistent vertigo, associated with suppurative disease of the middle ear, as we shall

see that it is one of the symptoms of necrosis, or caries of the labyrinth.

Remedies: The indications for the remedies will be found considering the objective symptoms which present themselves in the meatus externus.

Calc-p.: of great importance in scrofulous patients with enlarged tonsils and a tendency to grossness of tissue, or to involution of the periosteum, and cancelled tissue of the temporal

bone. It is frequently prescribed for the poorly nourished children who present themselves at the clinic, those with large heads, large bones, and flabby tissues.

Chin.: hemorrhage from the mucous membrane of the middle ear. This is a matter of clinical experience, rather than pathogenetic etc and failing of satisfactory results in a particular case,

I gave Chin. in a low potency, on general principles, for the anaemic condition of the patient. To my great satisfaction, the patient’s condition not only improved, but the hemorrhage

from the ear ceased and, from the exhibition of this remedy, an improved condition of the tissues began, which was carried to a successful issue by the administration of other remedies. This I believe to be the scope of Cinchona and I use it intercurrent with Calc-p. Kali-m. Psor. Sil. Tell-met. Thuj.

Elaps.: a valuable remedy in children. The naso-pharynx is characterized by dryness of secretion. The mucous membrane of the posterior wall of the pharynx cracks, or is covered with

dry crusts. The nares are obstructed, crusty, so that the child has what the old nurse calls “snuffles,” and, when sleeping, breathes with the mouth open. The discharge from the ear is thin, somewhat irritating, staining the bedclothes on which it chances to fall, a clear green color.

Hep.: ulcerations, perforations + sensitiveness of the tissues.

Hydr.: bland discharge, more mucus than pus + dropping, in the posterior nares, of a yellowish catarrhal secretion. Kali-bi. analogous to Hydr., has the muco-purulent nature of the secretion, but the tissues are more irritable, tending to bleeding or to crusts and the naso-pharyngeal tract manifests the same disposition.

Kali-m.: excessive granulations, and I have had more satisfaction from its use than from any other single remedy. In repeatedly occurring granulations on the inner third of the canal,

about the edges of the perforations, or on the tympanic wall, I always expect improvement under this remedy, in conjunction with the local treatment which I have already laid down.

Merc.: indicated by this characteristic: a coppery or metallic odor of the secretion, as well as by the well known naso-pharyngeal symptoms.

Psor.: extremely fetid discharge + eczematous conditions about the ear, or in other parts of the body. Compare with Tell-met. and Thuj.

Sulph.: intercurrent remedy, and may be used when other remedies apparently fail to overcome the conditions for which they are clearly indicated, and its administration often serves

to bring out, and render clear, conditions which were before obscure. The general symptoms of the integument should be noted carefully, to guide in the administration of this remedy.

Tell-met.: conditions of the drum head similar to phlyctaenular conjunctivitis, the whole drum head appearing dark purple, with elevated spots at various points, which form vesicles, break, oozing a watery discharge, having the odor of fish-pickle, extremely acrid, excoriating the canal, and often the cheek.

The late Professor Carroll Dunham, M.D., made a heroic proving of this remedy, and called my attention to this effect on his own person, some years afterwards. Inspection of the drum head showed it to have been perforated, and afterwards repaired, the cicatrical tissue being quite extensive. This would argue that the remedy had much deeper action than merely upon the external surface of the drum-head. In fact, this has so proven in long standing cases, particularly in children.

Thuj.: discharge is bland, thick, the odor being that of putrid meat.

‡ Cavum tympani wa

Akute, schmerzhafte Otitis media

+ Silicea comp. wa

Wirkung: Prompt

Akute, schmerzhafte Otitis media

Beugt zudem dem schwieriger zu behandelnden Paukenerguss vor.

Chronischer Tubenkatarrh, Seromucotympanon (Glue-ear)

Tuba auditiva D12 wa und Sylvin D6 (Rezepturpräparat, z.B. Apotheke an der WELEDA).

Rezidivierend perforierende Otitiden

Diese Standard-Therapie hat sich seit vielen Jahren bei vielen Patienten bewährt und erübrigt im unkomplizierten Fall die Antibiose. Beugt dem schwieriger zu behandelnden Paukenerguss vor.

Paukenerguss: eine Ansammlung von Flüssigkeit im Mittelohr (Tympanon). Die Konsistenz des Ergusses: dünnflüssig (Serotympanon) über zähflüssig (Mukotympanon) bis hin zu leimartig (glue ear), der zeitliche Verlauf kann von akut im Rahmen eines Erkältungsinfektes oder nach erheblichen Druckschwankungen (Tubenkatarrh, Barotrauma) bis hin zu chronisch bei dauerhafter Funktionsstörung der Eustachi-Röhre z.B. durch Gewebewachstum im Nasenrachen oder Nase variieren.

Rezidivierend perforierende Otitiden ‡

‡ Cochlea wa

Akuter Hörsturz, neu aufgetretener Tinnitus

Apis D30, Cuprum metallicum praeparatum D6 w

Wirkung: Rasch.

Weitere Empfehlungen: Wärmflasche an die Füße – wichtig! Nackenverspannungen lösen, z.B. mit rhythmischer Massage oder Osteopathie.

Ggf. medikamentöse Ko-medikation mit Magnesium phosphoricum comp. wa

Sonstiges: Auf Störungen der Harnwege (z.B. asymptomatische Bakteriurie) achten!

R.S.: „Das Ohrensausen beruht auf einem Schwachwerden des Astralleibes gegenüber dem Ätherleib im Blasengebiet.“

Auf diesem Hintergrund findet in dieser Region eine zu geringe Gestaltung mit Ausbreitungsmöglichkeit von Fremdleben und dessen mangelnder Wahrnehmung statt. Polar dazu liegt im Kopf eine übersteigerte astralische Aktivität mit pathologischer Eigenwahrnehmung vor.

Bemerkungen: Dieses Vorgehen hilft in 80 % der Fälle und ist der Standardtherapie mit HAES, Pentoxifyllin und Steroiden i.d.R. überlegen.

Die Erfolgswahrscheinlichkeit sinkt, sobald die Symptomatik länger als 4 Wo. besteht. ‡

Repertory Hearing:

ACUTE more than usual: Lyss.

DEAFNESS < weather

WHERE one ear: Ambr.

l.: left ear: Pitu-gl.

WITH cachexia: Syph.

coldness in abdomen: Ambr.

in general: Med: Syc-co. Syph. Vario.

catarrhal: Bac 7. Morg-p. Syph.

intermittent: Ergot.

nerve: Syph.

partial (hard of hearing): Med. Psor.

progressive, slowly: Syph.

stopped-up sensation: Carc.

syphilitic, congenital: Lac-c.

total: Psor. Syph.

transient: Lac-d. Med.

Some Remedies in Deafness

[Joseph D. Laurie]

From suppressed eruption: Sulph. Ant-c.

From measles: Puls. Carb-v.

From Scarlatina: Bell. Hep.

From abuse of mercury: Nit-ac. Carb-v. Sulph.

Nervous deafness: Chin. Ars. Gels.

From enlarged tonsils: Bell. Merc. Calc.

From suppressed discharge from ears or nose: Hep. Lach. Bell.

DIMINISHED WITH coldness in abdomen: Ambr.

in general: Ambr. Cortico. Morg-p. Oscill. Psor. Syc-co. X-ray. Variol

cholera, after: Sec.

distant, sounds seem: Lac-c.

voices of persons around him, does not hear: Lyss.

EXAGGERATED

< night: Lac-c.

menses: Lac-c.

With: convulsions from a drum beating: Psor.

pain: Psor.

trembling from a bell ringing: Psor.

convulsions from a drum beating: Psor.

in general: Ambr. Lac-d. Med. Psor.

booming, speech is: Lac-c.

echoes, hears (double sounds): Lac-c. Med.

ILLUSIONS

When: eating: Fed

whistling: Ped

strangeness and fright, a feeling of: Thai

cries for help: Strep

in general: Thai

cracking

r. ear: Ped.

roaring: Ped. whizzing:

SENSATIONS AS IF

deafness went from one ear to the other: Med. deaf in both ears, but can hear as before: Lac-vac. ears, he did not hear with his own but someone else's: Psor.

parchment were drawn over ear on which he is lying: Med.

SENSITIVE to noise: Lac-ac. Op.

TINNITUS AGG. at night: Pyrog.

WHEN afternoon: Ambr.

evening: Psor.

at night: Lyss.

during fever: Tub.

WITH headache: Tub

pulse, coinciding with: Maland

stupefied feeling: Psor

in general: Ergot. Morg-p. Psor. Thyr. Tub

buzzing: Ergot. Hipp-X. Lac-c. Lyss. Morg-p. Penic. Pitu-gl. Psor. Thai. Tub. X-ray

itching, followed by: Psor.

crackling: Psor.

WHERE left side: Ambr.

hissing

right ear: Ped.

TINNITUS frying, like: Med.

mastoid bones: Med.

steam escaping, like: Pyrog.

hooting, foghorn, like a: Thai.

humming: Psor.

puffing: Pyrog.

ringing: Anthr. Cortiso. Hist. Lac-c. Lac-hum. Maland. Psor. Pyrog. Thai

left ear: Psor

externally to the head: X-ray

roaring: Psor. Pyrog.

left: Lac-ac.

rushing like water: Lyss.

singing: Morg-g. Psor.

left: Lac-ac.

pulsing: Med. Psor: Pyrog.

purring: Pyrog.

snapping

left: Lac-ac.

thundering: Psor.

tinkling: Hippoz.

various sounds: Psor.

Whistling siren, like a ship's: X-ray.

[Uwe Stave]

Disease Promoting Environment

John's mother tells me that, since his second year of life, he has had occasional temper tantrums and bouts of aggressive behavior. Also, he has suffered from a string of upper airway infections, sometimes with fever and earaches. I asked about the home "atmosphere" and learned that the parents frequently had arguments using harsh language. After some years the parents separated and got a divorce. John's ear infections required several treatments with antibiotics. At age four he was given ventilation tubes into his ear drums. His hearing was compromised for many years which also affected his learning.

In my years of pediatric work I have seen a great number of young children with similar histories. Many were referred by colleagues and hospitals after several courses of treatment with antibiotics. Some had ventilation tubes in their eardrums. Usually it was reported that the antibiotics had reduced or eliminated the fever but did not prevent a new attack of ear infections. It was often not easy to obtain an exact history of events, especially not information about the "hearing space" at home. I talked with parents who even rejected the idea that four letter- or F-words represented abnormal language usage in the presence of young children. It was referred to as "modern language".

Some Factors Contributing to the Child's Hearing Space

1. Conversations and singing, occasionally running the vacuum cleaner, dishwasher or other appliances.

Most natural situations in a household and most human activities are accepted by babies. If they cannot tolerate the sounds, they will protest by crying. Depending on age, the child will try to communicate his/her feelings; trying to participate in the life around. Most mothers consciously protect their children from excessive noise. Therefore, exposure to loud noise or continuous background noises remains the exception.

2. Background Noise; the continuous sound of a TV, radio or tape; in some places noisy traffic; or the noise from a construction site. This noise is usually created intentionally by adults (who often argue that they need the constant sound to not feel lonesome). Occasionally, people turn rock music on, which makes the chest and abdomen vibrate. Since infants and small children are more often shocked and stunned by such sounds their lack. of response can be mistaken as approval or tolerance. The sense perception of infants and small children can easily be overwhelmed and even be paralyzed. Some fall asleep in spite of loud sounds. Such behavior might seem to justify continuing with the noise, but falling asleep must here be seen as withdrawal from exposure and thus a healthy protective response.

3. Shouting and the Use of Nasty, Dirty Words; swearing, often in anger, hate and mood swings.

When I had the chance to observe an infant in a room with shouting adults, I saw an inner vibration in the infant, best visible in fine respiratory irregularities. It is not rare for a young child to begin crying

if exposed to harsh adult language. This kind of response is rather normal and may express confusion or even compassion for the involved parent. Crying can also be a defense, an attempt to protect the soul. Does the use of angry words affect a young child who does not even know the meaning of these words or expressions?

Careful observation of small children shows that their reactions and perceptions are not really tied to the meaning of such words, but are obviously enhanced by the speaker's mood, soul condition and body language.

Today we are dealing with a constant flow of weakening influences on the child's life body. The attacks and the drain on life forces certainly have multiple causes. Furthermore, the damaging effects from the environment are quite different in young children and adults. A child with weakened life forces will over time compromise its biological defense system and the ability to produce sufficient amounts of antibodies will diminish. The susceptibility of the upper airways to infection in young children makes it obvious that the middle ear can frequently become involved and chronically inflamed. Often it comes to my mind that the resulting hearing deficit may actually protect the individual child from a malevolent environment. Nature knows best.

[Richard Moscowitz]

Childhood Ear Infections

Adapted from a lecture presented at the 150th Anniversary of the foundation of the American Institute of Homeopathy, St. Moritz Hotel, New York, April 9, 1994, and published in the Journal of the American Institute of Homeopathy 87:137, Autumn 1994.

Otitis media has become the commonest pediatric diagnosis made by physicians who care for children in the U.S. with an annual budget topping $2 billion in 1982, [note 2] and no relief in sight.

After decades of punishing warfare against the nasopharyngeal bacteria, several medical journal articles have recently begun to question the safety and effectiveness of antibiotics and tympanostomy and the wisdom of continuing the purely military strategy based on them.

The present impasse creates the opportunity and the obligation for anyone with a better idea to share it with the medical community and the general public. Nobody need take my word for it that homeopathic remedies are inexpensive, nontoxic, and effective even in advanced cases, or that parents, children, and their caregivers deeply appreciate the non-invasive philosophy governing their use.

I will feel generously rewarded if more laypeople and professionals will only try them and see for them-selves.

The following cases of childhood ear infections are intended to show how the homeopathic viewpoint can assist both clinically, in the diagnosis and treatment of these all-too-common ailments, and in the design of experimental research into the causal factors that promote and influence them.

The cases that I have chosen are noteworthy not for any particular skill in choosing the correct medicine, but in precisely the opposite sense, that excellent results are regularly attainable with common remedies and case-taking methods already well known to the serious student. Indeed, the exemplary success of homeopathic remedies in treating such children is itself an important clue to the mystery of pediatric otitis media in our time.

Case 1. C. Z., a girl of 3, had had recurrent ear infections since the age of 5 or 6 months, typically associated with colds and the production of thick, green mucus, and requiring antibiotics more or less continuously for several months at a time. With no fever and at most a slight earache, she often became irritable and cranky as the cold ended, when the pediatrician often made the diagnosis by otoscope. Apart from mild eczema, the child was seldom ill other-wise, and rarely had the fevers or acute illnesses to be expected at her age. 8 lb. at birth, she fell short of 16 lb. at 1 year and had remained small

for her age. Teething was late, painful, and difficult. She had had all the usual vaccines with no acute reaction.

I chose Calc-s. 200, and two months later her mother reported the best winter ever, with no ear infections and two light colds that were quickly aborted with Calc-s. C 12. I next saw her a year later, several weeks after an acute episode of wheezing in the middle of a cold, for which Puls. C 30 prescribed over the phone had worked splendidly. But though she had been free of ear infections in all that time,

she had had a fever or two and was still plagued by quantities of thick greenish-yellow phlegm in her nose and throat. After one dose of Sulph. C 200, she never came back. When I called recently, over five years later, in preparation for this talk, her mother told me that she had had no more ear infections, and there was no need to bring her back, since her general health had remained good, and the usual first-aid remedies had been very effective for the usual colds, fevers, and URI's that had developed along the way.

I want to add a few comments about this rather typical case. First, as I reread it now, I doubt that either Calc. Sulph. or Sulphur was the best remedy for this patient, since she was on the chilly side, and even after treatment she continued to produce thick green phlegm and be subject to rather frequent colds. I can't really defend or explain either prescription at this point. Yet her mother was more than satisfied. The ear infections disappeared and never came back, the long-term or constitutional issues stayed in the background, and the remedies she herself came up with continued to help without further assistance.

Notwithstanding the small remedies and "cured" cases that we like to parade at our conferences, I must admit that the bulk of my reputation is built on stories as generic and unspectacular as this one.

I feel deeply grateful to a method that adds feathers to my cap even when I bumble or fall short.

Second, my experience confirms numerous reports in the European literature that most kids eventually outgrow their ear infections anyway, if simply allowed to do so without further allopathic interference.

Case 2. K. G.-S., a boy of 16 months, had already had five ear infections and five rounds of antibiotics when I first saw him. Only the first episode at six months was associated with fever (102.8° F.)

and acute earache, which subsided promptly once the eardrum had perforated and discharged the pus that had accumulated behind it. Although weighing 7 lb. and appearing normal and healthy at birth,

he was slow to nurse, fell behind in his gross motor development, had considerable discomfort with teething, and weighed only 20 lb. by the time I first saw him. His only other complaint was a chronic diarrhea that began on antibiotic treatment and had never gone away. Despite intense, prolonged crying after the first and second DPT's, the third was uneventful, as was the MMR.

One month after Sulphur 10M, his mother reported that the diarrhea had worsened, becoming acute the first week after the remedy, but that, ever since a fever of 103° F. on the 3rd day, his highest so far, he had had no symptoms of a cold or ear infection at all. Because of the diarrhea, I gave him Calc. Carb. 10M, and by the next visit, two months later, he was well, and had made good progress developmentally, with no ear infections, one brief cold for which Calc. Sulph. 12C worked well, and no more diarrhea.

I did not see him again for more than a year, four months after an episode of acute otitis with no earache but a fever of 103° F. that had lasted a full week on antibiotics. Apart from a few colds and a reappearance of diarrhea at these times, he had had no more ear infections and was continuing to grow and develop normally. Repeating Sulphur 10M, I had no further news of him until I asked my receptionist to call recently, more than five years later, and learned that he had been healthy, had had no ear infections, and needed no antibiotics throughout that time. After buying a remedy kit and studying on her own, the mother had found Belladonna to be highly effective for his various colds and acute illnesses, and no longer needed my help.

Once again, not for any elegant prescribing on my part, much less from any notion that the child was "cured," I treasure cases like this one, because our work together helped the mother to take charge

of her son's health, and to perform competently in that role. When my own learned prescriptions fail, as they not seldom do, I have good reason to feel proud when the parents themselves find the

remedies that work best for their child. Perhaps the most precious gift that homeopaths can offer is our relationships with our patients, which can continue to grow and flourish even when the search for the ideal remedy proves elusive.

Case 3. J. L., a girl of 6, had had frequent ear infections since the age of five months, especially when exposed to other kids in crowded day care or classroom settings. With little fever and no earache,

the acute episodes were typically mild, with red cheeks, loss of appetite, and grumpy or irritable behavior. Also vulnerable to staying up late and to sudden changes of weather, she seldom ran fevers of

any degree, the highest being around 102° F. with a "Strep throat," but she had already taken antibiotics over two dozen times. Although vaccinated at the usual times without any obvious reaction, she developed an ear infection soon after her last DPT shot that had lasted for four months despite continuous antibiotics, and had subsided only after chiropractic treatment.

Soon after Sulph.10M, she developed a generalized rash that lasted several days, followed by a buoyant mood and more lively energy than she had shown in a long time. At her first follow-up, she had a cold, with the usual red cheeks, runny eye, temporary hearing loss, and the dreaded positive Strep culture. It required a considerable leap of faith for her mother to let this tiny cold run its course without antibiotics, using only Puls. 30X as needed, and later buying a kit of remedies and a book to show her how to use them. Two months later, her pediatrician was happy to report and even take credit for the fact that her ears were uninfected for the first time that anyone could remember.

The following winter she returned with mild symptoms, a low fever, and a weakly positive Strep culture. As the illness subsided, I repeated Sulph. 10M, and by her next visit two months later the picture had changed to recurrent sore throats, foul breath, enlarged tonsils, dark circles under the eyes, and a loose, productive cough. This time I gave her Mercurius 1M, followed by the 10M a month later, with excellent results until her next cold many months later, when she developed the same swollen tonsils and loose cough as before. After the third dose of Sulphur 10M, I lost track of her for a few years, but the mother eventually called to report that she had been well the whole time, with no major colds and no ear infections, and a perfect attendance record at school for the year just finished. A few months ago, I called to check up and learned that she was doing splendidly in high school, with no more ear infections in the nine years since she had begun using remedies.

"Equating fluid behind the drum with infection requiring treatment ignores what all pediatricians know, that URI's with swelling of the tonsils and adenoids produce congestion of the middle ear and temporary hearing loss as a result. Decades of warfare against the nasopharyngeal bacteria have culminated in a Vietnam-like strategy of killing everything in the vicinity."

Again leaving aside my rather crude prescribing in this case, I want to point out a few of the methodological issues it poses, issues so obvious and fundamental as to be easily overlooked. First, equating fluid behind the eardrum with an ear infection requiring antibiotic treatment ignores what every pediatrician knows, that most colds or URI's with swelling of the tonsils or adenoids produce secondary congestion of the middle ear and temporary hearing loss as a result. The girl in this case was prone mainly to tonsillitis, and could be said to have ear infections only to the extent that pneumatic otoscopes can detect even minute amounts of fluid, and that years of deadly warfare against the nasopharyngeal bacteria have culminated in a Vietnam-like strategy of killing every living thing in the vicinity.

Second, her longest period of ear involvement followed a DPT shot, a connection that I have often verified in practice, but is rarely suspected by pediatricians, because vaccines are regarded as sacrosanct and almost risk-free, except for negligibly rare acute reactions developing within the first hours or days.

Third, like most of my chronic otitis patients, this child seldom ran fevers during the time she received conventional treatment, and began to do so only as her general condition improved. Useful both for reassuring the family and for making a simple prognosis, this humble fact carries a profound implication for the natural history of the disease and its recent evolution.

Case 4. L. P., a girl of ten months, had already had four acute ear infections and received antibiotics for each one. The first began at two months, when her mother weaned her to go back to work, and the child developed a rash and unusually cranky behavior on a milk-based formula. These symptoms were also intensified for the week following her first DPT shot. A few weeks after that, the ear infection developed suddenly, with high fever and violent earache, like all the others. With the help of Calcarea Carb. 1M initially and Chamomilla 30X as needed acutely, she did quite well, with fewer colds and no acute episodes, but mild symptoms persisted and were aggravated by teething, when the remedies had to be repeated. She relapsed the following spring, six months later, with three acute ear infections and three rounds of antibiotics in the three months since her father had insisted on her long-overdue MMR shot.

At this point I gave Lyc. 10M, Sulph. 10M a month later, and almost a third remedy after that, but I heard that the parents had separated and were vying angrily over the child. From then on, she did very well on infrequent doses of Sulphur, despite a violent gastroenteritis following a DT-polio booster, and a tendency to relapse when she stayed with her father, who let her eat her fill of dairy products and took her to the doctor for her regular quota of vaccines and antibiotics. I have continued to see this child at long intervals for more than nine years, and although she has long since outgrown her ear infections, her underlying health issues have not changed very much. Since the acute, vigorous responses of her infancy, her basically strong constitution and maturing immune system have enabled her to bounce back more quickly when she does fall ill. While very fond of milk and cheese and somewhat allergic to them as well, she continues to grow and develop normally in the face of her conflicted heritage that she can as yet neither understand nor change.

In short, this is a child of strong vitality, representing the opposite side of the same issues already discussed: 1) an innate ability to respond acutely and vigorously, and rebound quickly from illness; 2) a tendency to relapse following vaccination (and milk allergy, often associated with it); and 3) the classic signs and symptoms of acute otitis media that were the rule in the pre-vaccine era.

With these representative cases in mind, I will try to summarize my experience with otitis media in children, giving special emphasis to the practical issues of diagnosis, treatment, prognosis, and long-term case management. As with my allopathic colleagues, middle-ear infection is one of the commonest presenting complaints of children in my practice. In an average week I will triage several acute episodes over the phone, and see at least one new and probably two or three established patients with chronic or recurrent otitis that has been diagnosed and treated on a long-term basis or repeatedly with antibiotics or tympanostomy or both.

"In the 1960's, otitis media was an acute disease, with high fever and pain, which subsided dramatically once the eardrum burst and discharged its contents. It didn't last long, had often taken care of itself before we could do anything about it, and was unlikely to come back for a long time. It was just what I have come to recognize as a favorable sign when I see it today."

What most of these patients have in common is the absence or paucity of strong symptoms like high fever or violent earache that would indicate an acute, vigorous response to their illness. With a few notable exceptions, like the last case I presented, their symptoms even during acute flareups are typically vague or nondescript in character, e. g., fussy or cranky behavior, whining or picking at the ear, congestive hearing loss, poor appetite, and the like. In quite a few cases, there are no symptoms whatsoever, and the child behaves and functions normally, but at the well-baby visit the pediatrician detects fluid in the ear, signs it off as an "ear infection," and begins or continues the cycle of antibiotics that often proves so difficult to break.

"The most striking and disturbing feature of these cases is precisely their chronicity, their tendency to develop smoldering or persistent responses to illness and to relapse more and more easily, resulting in a failure to heal or resolve them in a clearcut or timely fashion."

Similarly, although the symptoms often recede during treatment, relapse is common, and even when the child appears clinically well, the presence of fluid is regularly interpreted as continuing infection and cited as a mandate for further treatment. In this way, a child who may never have been that sick never gets entirely well, and continues to relapse until the doctor recommends antibiotics for months at a time and later surgical drainage as well, if the condition persists despite these lesser measures, as indeed it often does. In short, the most striking and disturbing feature of these cases is precisely their chronicity, their tendency to develop smoldering or persistent responses to illness and to relapse more and more easily, resulting in a failure to heal or resolve them in a clearcut or timely fashion.

Breaking this cycle of chronicity proves quite easy if parents and caregivers can suspend the conventional wisdom that reduces the art of diagnosis to the specialized detection of abnormalities and the goal of treatment to the killing of our resident bacteria. As much as finding the correct remedy, the critical requirement for success in treating these kids is to re-educate the parents and develop an alternative model that works and makes sense to everyone.

1st it is necessary to redefine the illness and how best to detect it, beginning with basic anatomy and the clinical and pathological features of a URI with ear involvement (congestion, earache, etc.), in contrast with classic acute otitis media. In my own practice I emphasize the signs and symptoms that parents themselves are aware of, i. e., how each child feels and functions in his or her own special world, or what homeopaths like to call the "totality of symptoms." If they are willing to trust me thus far, I'll take the next step and propose that we

not look in the ear unless the illness is acute and intense, or hasn't resolved after giving remedies, or either of us is so panicked that we just have to know. Since any URI can produce detectable fluid or congestion behind the eardrum, and the homeopath does not need or even want to treat illness all the way to the end, the totality of symptoms is what best defines the illness, and the otoscope is useful primarily to confirm or qualify what the alert observer already knows.

With significant ear involvement, it is helpful to assure the parents that antibiotic treatment is no more effective than placebo, and that it produces more frequent relapses than giving symptomatic treatment or simply allowing the children to recover on their own. At that point it makes sense to offer homeopathic remedies, both as needed for the acute episodes, and preventively, to minimize their number and severity.

Finally, it is imperative to take a careful vaccine history, and to look for familial influences or other factors that may aggravate a pre-existing chronic state, such as traumatic birth, food allergy, emotional upset, and the like. Quite often, the first episode can be traced to the time of a DPT, MMR, or other vaccine, even though no acute or obvious reaction was noted at

the time, or an old pattern of chronic or recurrent otitis is activated by a booster after a long period of remission. Such apparent-ly speculative connections have also been verified by the successful use of homeopathic "nosodes" prepared from the vaccines themselves in re-solving difficult cases. Drawing on these experiences, I routinely ask parents not to vaccinate their children until they are cured, and refer them to my various publications on the subject for further study. While I have also seen chronic otitis in unvaccinated kids, the crucial importance

of vaccines lies in the fact that they are compulsory for all and regarded as so uniformly safe and beneficial that the possibility of chronic, long-term problems from them is seldom investigated or taken seriously.

With this educational work in progress, it is appropriate to proceed with homeopathic remedies. Both the procedure that I follow and the remedies I use are much the same as would be found in any homeopathic practice involving children, and I see no need to elaborate on them here. If the child is not acutely ill at the time of the first visit, I may begin with one dose of the indicated constitutional remedy, or perhaps three weekly doses. In addition, it is reassuring to give parents a strategy and a list of remedies to have on hand for acute flare-ups, and to see the child or at least coach the parents through these episodes with words of encourage-ment, changing the remedy as needed. Often these acute remedies will include the constitutional plus a few others that are complementary to it.

Once remedies help them through this critical phase of the illness without antibiotics, the rest of the treatment is likely to proceed very smoothly. But if the child has never responded so acutely or intensely before, it is useful to prepare the family for such an eventuality as the underlying condition improves. By no means cause for discouragement, relapses many months or even years later are much easier to treat, since precipitating factors are usually much more obvious after a long period of good health, and remedies that worked well before will most likely do so again, as the children often know and will ask for it themselves. Indeed, this uncanny clarification and ordering of cases over time is a major and predictable benefit of successful treatment, and the awe and wonder it inspires in doctor and patient alike are among our highest rewards.

"In the 1960's, otitis media was an acute disease, with high fever and pain, which subsided dramatically once the eardrum burst and discharged its contents. It didn't last long, had often taken care of itself before we could do anything about it, and was unlikely to come back for a long time. It was just what I have come to recognize as a favorable sign when I see it today."

What is mysterious and problematic about ear infections in children thus lies not so much in their treatment, which is not particularly difficult and involves many of the same remedies as for other chronic ailments, as in the disturbing fact of that chronicity itself. As a medical student in the early 1960's, I encountered otitis media primarily as an acute disease, usually presenting in the Emergency Room with high fever and piercing screams of pain, both of which subsided dramatically once the eardrum burst and discharged its infected contents.

While certainly not a pleasant experience for doctor or patient, it didn't last very long, indeed had often taken care of itself before we had a chance to do anything about it, and was unlikely to come back for a long time to come. In every way it close-ly resembles the kind of flare-up which, when I see it in a patient today, I have learned to recognize as a favorable sign.

"The epidemic of chronic ear disease must be attributed to two colossal public health blunders: the war on the nasopharyngeal bacteria, fought with antibiotics, tubes, and the cultivation

of fear; and the vaccination of entire populations against a growing list of diseases with no end in sight, and no strategy or inclination to consider the long-term consequences."

After 1982, when I moved to Boston, stopped attending births, and limited my practice to homeopathy, I began to see large numbers of the sort of chronic otitis patient that I have just described. Why the sporadic acute infections I knew in medical school had mushroomed into a chronic disease of colossal proportions was also precisely the question with which I began this article. Both my clinical experience and the research I have conducted to try to make sense of it have strongly corroborated my "gut" feeling that the modern epidemic of chronic ear disease must largely be attributed to two colossal public health blunders that carry on the same outmoded militaristic philosophy:

1) the war on the nasopharyngeal bacteria, fought with antibiotics, tympanostomy tubes, and the systematic cultivation of fear;

2) the vaccination of entire populations against a growing list of diseases, with no end in sight, and no inclination or strategy to consider the possible long-term consequences.

Based on Koch's postulates and their immense predictive power, the war on bacteria is nevertheless unwinnable even in thought. As the most basic life form on the planet, bacteria reproduce themselves in about six hours, and through natural selection rapidly become resistant to even the most lethal antibiotics. In clinical medicine, some major examples include hospital-borne epidemics of resistant Staphylococci and E. coli, and the emergence of infections with L-forms, Mycoplasma, and PPLO organisms, all lacking cell walls, neat adaptations to penicillin-rich environments. In a recent Newsweek cover story, the spread of resistant strains made U. S. hospitals look like centers of germ warfare from which many types of virulent organisms are disseminated into a general population more or less helpless to stop them.

In the case of childhood ear infections, resistant strains have been similarly implicated in the weak primary immune responses and high relapse rates associated with antibiotic treatment. Other frequent complications include superinfection with yeast and other common fungi, as well as the food and environmental allergies that often accompany them.

Furthermore, numerous studies have shown that the supposedly causative organisms isolated from children with chronic ear infetions are simply the common pathogens of the tonsils

and nasopharynx, such as the "pneumococcus," or Streptococcus pneumoniae, Group A ß-hemolytic Streptococcus, Hemophilus influenzae type B, and Staphylococcus aureus, all of

which are regularly found in healthy throats as well. In 25% of children with acute otitis, and in 80% of those with the most prevalent chronic serous variety, the middle-ear discharges

and cultures are sterile and contain no organisms whatsoever. Once these resident bacteria are destroyed, the result could have been foreseen by ordinary common sense: chronic serous otitis, or "glue ear," an important cause of chronic and even permanent deafness. Thus even more destructive than these antibacterial weapons themselves is the fanatical strategy of attacking and killing that makes such imagery seem attractive.

A further application of the same approach has been the development of the pneumatic otoscope, its tight seal permitting the detection of even minute amounts of fluid and thus facilitating both early diagnosis and more minute surveillance. Yet diagnosing more infection has only unleashed more of the same firepower, and thus more of the same results already described. Indeed, with tympanostomy the war against chronic otitis media has reached its final dead end, since it looks like an obvious mechanical solution to the problem, yet has

itself recently been found to be a major cause of otosclerosis and permanent hearing loss, the same spectre used to browbeat reluctant parents into accepting it in the first place.

Still more ironic is the fact that it simply makes permanent and structural the natural perforation and drainage that the acutely infected ear heals so well by itself and with so few complications.

In any case, it makes little sense to search out and destroy the friendly bacteria that already live with us and police our bodies so effectively most of the time, or to imagine that making war on them could ever produce anything but more devastation, more war, and ultimately more resistant and less friendly bacteria.

Although I have previously written about vaccinations in some detail, relatively little of my experience with vaccine-related illness is of the kind that Harris Coulter and Barbara Fisher write about in “A Shot in the Dark”, or what might be termed the specific effects of a particular vaccine. While these reactions are apt to be the most severe and also the most useful in learning how to prescribe the nosodes that correspond to them, most of the complications I have seen in my practice have been limited to subtler reactions that I would describe as non-specific in type. By that I mean that they resemble exacerbations of the pre-existing chronic state, looking more or less the same in a given individual, regard-less of which vaccine is given, and are benefited by the same group of remedies are used to treat chronic illness in the general population, vaccinated or not. Although such reactions are more difficult to recognize and verify, they are also much more common, and I suspect much more important as well.

"Two of four cases suffered relapses of their chronic state after a vaccine, one suffered identical relapses after two different vaccines, and all four first developed their complaint during their initial series. In none were their responses acute enough to be identified as symptoms of the vaccine. What was repeatable was simply the chronicity of the responses."

Thus two of the four cases I presented suffered prolonged, severe relapses of their chronic state after a vaccination, one patient suffered almost identical relapses after two different vaccines, and all four first developed their chief complaint during their initial three-dose vaccine series. In no case were their responses acute or obvious enough to be identified as a repeatable symptom of the vaccine. Indeed, all that was repeatable in all cases and with all the vaccines was simply the chronicity of the responses, the fact that they occurred more frequently, persisted for longer periods of time, and were less likely to resolve spontaneously.

It is just this congruence between the vaccine-related responses and the original illness that suggests how vaccines act nonspecifically on the immune system as a whole, and so implicates vaccination in the basic riddle of chronicity itself. As new biotechnology companies produce new genetically-engineered vaccines as fast as possible, the unrestricted war against identifiable acute diseases has already added to the pre-existing chronic disease burden a considerable array of DNA and RNA fragments looking for chromosomes to recombine with and certain to engender new diseases of which as yet we know nothing. In short, I am afraid that doctors, like politicians, are here to stay.

Antibiotics linked to recurrent ear infections

[Michael Woodhead]

Young children with acute otitis media are almost 3x more likely to suffer from recurrent ear infections if they are treated with antibiotics, research published in the BMJ today suggests.

In one of the first prospective long term studies of children with acute otitis media, Dutch researchers followed up 168 children treated by GPs for an episode of acute otitis media.

Half were randomised to received amoxicillin in three doses and half to placebo.

While there was no difference in recurrence rates in the first year after treatment, after three years the rates of recurrent otitis media were 63% for the antibiotic group and 43% for the placebo group.

The researchers say this means a 20% higher risk of recurrent acute otitis media with antibiotics was seen even after adjusting the results for other factors, such as allergy and a previous tendency to have recurrent ear infections.

However, they note that 30% of children in the placebo group had to undergo ear, nose, and throat surgery on initial infection, compared with only 21% in the amoxicillin group. They say the difference in recurrence rates between the two groups could be due to antibiotic use causing an ‘unfavourable shift’ towards the growth of resistant bacteria. Early use of antibiotics might impair the natural immune response and weaken protection against further episodes they argue.

And whilst antibiotics may reduce the length and severity of the initial ear infection, their use may encourage doctors’ attendance in future episodes and antibiotic resistance.

“This is another argument for judicious use of antibiotics in children with acute otitis media,” they conclude.

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