Phobic Disorders in Children and its Miasmatic Manifestations

Dr Jitendra Kumar Srivastava BHMS CEN
Sushila Homoeopathic Health Care and Research Center. Kanpur

Cognitive behavioral and medication treatments for  phobia hold much promise for attenuating this serious and disabling condition in youth. Research is necessary to develop and test methods for identifying youth at risk of developing  phobia, and initiating efforts towards the primary prevention of this serious disorder. At present, the field is open to investigators in clinical research settings, research and primary care settings,  and public health programs to turn serious attention to understanding the impact and course of  phobia in children and adolescents. In addition to research efforts , ongoing education is needed to alert physicians,  school personnel, and the general public, to the significance of this disorder. Moreover, lobbyists and others in the position of impacting health care policy must become accustomed to recognizing the empirical evidence supporting cognitive behavioral treatments either alone or inappropriate combination with psychopharmacology. 

MIASMATIC CONSIDERATION

It is a well-known fact that the Master, after erecting the doctrinal monument of homoeopathy together with its corresponding curative technique, observed in his own practice (which surely followed the principles of his method) that the results, while relatively satisfactory and clearly preferable and superior to those of old-school medicine, still left a large question mark with respect to relapses or the emergence of new diseased states in the apparently cured patient. That is, the matter persisted in a condition of relatively good health but had a tendency to manifest periodic or successive syndromes or pathological states with a certain similarity or relationship with one another. In other words, the really sick patients were seen to pass through periodic or states of illness which appeared distinct to the superficial observer but in which careful examination disclosed a nexus of identity, a characteristic connecting link; thus, the apparently different illnesses presented by the same sick person, as judged by his bio-pathology, were in fact linked by a background which constituted a predisposition to a characteristic form in respect both to dysfunctions and to the lesions themselves. This predisposition, whether constitutional or merely a constant aspect of organic man which persists in the form of its expression, was called by Hahnemann; MIASM OR CHRONIC DISEASE. 

Para 78 (organon of medicine)

The true natural chronic diseases are those that arise from a chronic miasm, which when left to themselves, and unchecked by the employment of those remedies that are specific for them, always go on increasing and growing worse, notwithstanding the best mental and corporeal regimen, and

torment the patient to the end of his life with ever aggravated sufferings.These, excepting those produced by medical malpractice (Aph 74), are the most numerous and greatest scourges of the human race; for the most robust constitution, the best regulated mode of living and the most vigorous energy of the vital force are insufficient for their eradication. 

We know that the first step towards achieving  proper miasmatic interpretation of a case is to record every detail faithfully with all symptoms complete as to location, sensation, modalities, possible causation and concomitants, as well as past history, family history, personal history including mental and physical generals, and a history of various treatments pursued. All this must then be interpreted in terms of the evolution of the symptoms with respect to time. 

An interesting parallel observation here is that the artificial drug disease we see developing during a proving could have actually have been interpreted in terms of an evolving drug disease, if proving information had been recorded in such a manner in the source books of our Materia Medica. Unfortunately, Hahnemann opted for the regional schema in his Materia Medica Pura which takes away the possibility of applying this concept to the earliest provings.

We begin with the Constitution (Normality) and move through the following miasmatic progression: > Diathesis –> Prodrome –> Psora [Primary –> Secondary] –> Sycosis –> Tubercule –> Syphilis. 

Each and every individual receives a number of inputs through out his/her  life  & every one reacts differently to  each  of  these inputs.  The  reactions  are mainly dependant  on:

1] Heredity, 

2] Genetic pattern  and  

3] The environmental influences that one experiences in every stage of one’s life .

The  life-cycle of a human being is broadly  divided   into  four stages  viz. 

a] childhood, 

b] adolescence, 

c] adulthood and  

d] old age.  

Each  period  & transition has its own  characteristic  problems  and disorders.Childhood is the basic step for the beginning of life  and its disorders can cause great impact on the life pattern of remaining stages of life.

Miasmatic consideration in phobic disorders in children is very interesting topic as it can give remedy for the treatment.

PSORIC MANIFESTATIONS:-

• In psoric phase,  the children are quick to grasp what is being taught to them or even even pick up facts from the world around them easily.
• They have an excellent memory for names, numbers, roads, places, important dates and people they have met, etc. They remember minutest details of not only the recent but also the past events.
• Their concentration levels  and moral values are very high. 
• Reaction to success and failure is quite positive. Thus, they  do not accept defeat easily  and always make an attempt to  succeed or to improve.  
• The images and perceptions are very clear in the psoric phase, the child  has a good photographic memory, he remembers everything very distinctly as if it had just happened yesterday. Perceptions are clear,  acute  and clairvoyant  in nature. Because of their clairvoyance they are able to judge other peoples conditions &  situations very easily.
• Psoric  children  have  a  lot  of   positive  imagination    and creativity  &  these are the children  who usually carry on  their imaginations to reality and practicality.
• A child   who  is  in   psoric  phase,  is   born   much   more healthy, positive and constructive than any of the other phases. 
• These  children  are born to healthy parents,  their  growth  and developmental milestones are usually normal.
• Their laughter and smile is beautiful and divine like that of  an angel.  They  even  smile  when they are sleeping  and  it  is  a pleasure  watching such children .
• Sensitivity  level of children belonging to this phase  is  high, their reaction to any stimulus is quick, the input and the output is relatively proportionate.  
• A psoric child would easily admit his mistakes very easily.  If their  parents  scold  them,  these  children  will  listen   and understand  their parents and try not to commit the  same  mistakes again.  They are very well mannered and immediately respond  to  their  parent’s.
•  If they fail, they strive again to either correct their mistake or improve upon their performance. They are always on the look out for growth and improvement.
• Psoric children are very sentimental, loving, content and happy by nature. .
• These children love comfort and they develop attachment at mental and physical level.
• They are very lively and affectionate. They have an intense desire to be magnetized.
• Very sensitive and emotional children , these children are easily moved  to  tears, anger or any emotions, but there is  a  genuine cause to these emotional outbursts.
• Anger  in  psoric children is sudden, lasting for a  short  while till the event is  over, handled or expressed. They  forgive  and forget  easily  once the event is over. Hatred feeling  does  not come  naturally to them and if they do hate somebody then it  for some  genuine reason. However they do not keep any hard  feelings for  the persons they don’t like. Revengeful attitude is not seen in these children.
• The  children  are intelligent with clear and acute perceptions. They  are  almost  clairvoyant  they are  able  to  judge  people conditions and situations very easily.
• They  have a lot of intuition because their sensitivity range is very high.
• These children have curiosity, like they will usually go close to flowers,  to butterflies, to see and observe their  movement, etc. Their curiosity is just out of the need to learn more. 
• They  appreciate good things in life & they  love  their play, study, hobbies etc. involve themselves completely in  every tasks. These  are the children who are in touch with time and  realities of life, they don’t succumb to external pressures easily.
• Whether  at  nursery or in school they learn  very  easily. *They usually do well academically and are the favorites of teachers. They  can  remember and reproduce the subjects  very  easily  and logically. These are the children who get double promotions. These  are  the children who even when sick will   prefer  to  go school  !! [same attitude is reflected in adults who are  in  the psoric phase, they go to work in all circumstances]. 
• At  school these children will take active participation in  all Events.  They  play with a very healthy attitude  and  will  have positive approach towards the game. *Children  love painting or drawing. Paintings of a  psoric  child are  clear, constructive with vibrant natural  colors.   Painting will show actual shapes without much of distortion, and a lot  of positivity. Their paintings would be related to nature &  natural colors.
• They like to listen to stories of adventure, bravery, good deeds, of  angels, heroes, etc.  They watch good movies or  cartoons and are easily moved to tears or laugher watching them.   

SYCOTIC MANIFESTATIONS

• A child may have Sycotic traits right from birth [without going through the psoric phase] when there is parental inheritance [for e.g.. history of gonorrhea in parents] OR
  The child may slide from the psoric to sycotic phase depending on the external influences or any suppressive line of treatment taken. as explained in the psoric miasm.
• A child in the Sycotic phase is confused mentally and physically. He, thus, reacts in 4 different ways :-

1. Reacts after a long time with a pause between action and reaction
2. Reacts in a way which is harmful to himself [eg. internalizing of the emotions or of the disease]
3. No reaction at all
4. Repression of emotions

• Sycotic children are those who are sensitive but are confused because of fatigue.
  In Sycotic phase, the children have a poor memory. They forget everything very easily, they do not remember even the most common names, numbers, etc. Their memory is weak for both recent and past events, more so for recent events. Their concentration levels are low and hence they have difficulty in concentrating on one task.
  There is always a state of predominant confusion because the child does not know how to handle the inputs. In spite of all the slowness and dullness, the child who is in the sycotic phase, always desires more for less effort. 
• In the sycotic phase, the images that are stored are full of altered perception, confusion and negativity. Their perceptions are unclear and the children find it difficult to judge or perceive any condition or make mistakes in perceiving the realities of life, at both, the mental and physical level. 
• Sycotic children have a lot of non-constructive, negative or fixed ideas. They keep building up ideas & ideas in their mind; they plan a lot of big things, but never carry on these imaginations / ideas to reality or practicality. Even if they do try to implement on these, they cannot pursue it their final destination which often leaves them sad and depressed.
• Suppression at the physical [e.g. suppressive line of treatment] or at the mental level [emotional suppression] is a very important causative factor for all problems in sycotic children.
• Whether there is suppression at the physical or the mental level, the formative years of sycotic children are not well organized. Usually one of the developmental milestones in these children is delayed, either head holding, walking, talking, teething, etc. 
• Sycotic children are dull, lazy, sluggish and slow to act. They are slow to assimilate or receive any inputs & also slow to respond, or to react to any stimuli.
  These are the children who are not in touch with time and reality of life, and they succumb to external pressures easily.
• Sycotic children usually do not enjoy playing because of their laziness and sluggishness.
  They play games which involve sitting at one place. They are especially disinclined to play outdoor games. You will often observe that sycotic children will love watching sports but if you ask them to take an active part in any of the sports, they will not do so.
  They always desire to win, by whichever means, and usually by crooked means which comes naturally to them.
  Paintings of sycotic children are shabby, disorganized and with dark colors. Their paintings are usually half done, even their completed paintings have no meaning, which clearly reflects their confusion.
  Stories which sycotic children prefer to listen are those of jealously, corruption, evil, cheating, stealing etc. [In real life also they portray these kind of personalities. Young children who resort to stealing, lying, anti-social behaviors to the extent of homicide are strongly sycotic responses]
• Academically, sycotic children are poor to average in studies. Basically these children have no interest in studies. They do not want to study or put any efforts and yet they cannot accept failure. In order to pass their exams these children will resort to copying, snatching other children’s paper, taking chits to examination halls, etc.
  They forget what to write in the exams out of confusion or anxiety as to how they will perform. Their memory is weak, for words, alphabets, reading etc. They have a difficulty in remembering what they have studied, and make mistakes all the time. There is marked poverty of thoughts, logic, rationality, etc. Their mind just does not seem to work and hence these children like doing home work which is repetitive [more mechanical rather than intelligent work]
• Sycotic children bring a lot of complaints from school regarding studies, behavior, attention, play, etc.
• Sycotic children are easily moved to negative emotions like anger, irritability, rage, hurt, jealousy, suspiciousness etc. 
• Anger and irritability is a very strong quality in sycotic children. Children are easily angered or irritated without any reason, but they find it very difficult to express these emotions. Instead, they keep on thinking about such incidences constantly, and build up hard feelings against all those who have hurt them or troubled them in any way. 
• If somebody scolds them, they will not weep or show any emotions [like most children do]. Instead, they start thinking about the incidence over and over again, and develop hatred towards the person [be it his parents or closest friends] who has hurt them, they will then keep making plans and schemes as to how they will take revenge, etc. Forgive and forget is not the policy of sycotic children. 
• Thus, sycotic children keep on internalizing their emotions all the time. There is a constant bottling up of negative emotions within them, which keep on troubling them all the time. They keep brooding over such instances +++ which is a very important feature of this miasm.
• In extremely young children, the anxiety is seen in form of restlessness, sudden weeping, getting up frightened at night [because of anxious and frightful dreams], enuresis etc.
  In slightly older children, the anxiety is manifested either in their studies or at play.
  Anxiety is often seen in their reluctance to appear in the exams without any reason. Their anxiety is so marked that they may develop physical symptoms like sweating, palpitations, diarrhoea, etc. whenever they are appearing for an exam or participating in any event. Once they finish the exams, they will develop anxiety about whether they will pass or fail in their exams.These children will also show a marked anxiety +++ about their health, they constantly feel they will fall sick or that they are suffering from some grave illness. [You will often observe sycotic children coming to a physician for a mild trifling ailment of cold, and they will exaggerate their complaints as if they are suffering from a very long illness like pneumonia!!!].
  They are true hypochondriacs who in the later stages of illness , develop all sorts of fixed ideas about their body and health .[for e.g.: they think their body is made of glass – a typical Thuja state]
  This anxious state often makes them fearful of everything around them; they develop marked fear of being alone, of dark, of failures, of performance, of meeting people, etc.
  Even their dreams manifest their anxious state; they dream as if something would happen, of death, of missing a train, of failing in exams, of missing achievement, failures, etc.
• Sycotic children are extremely obstinate and headstrong. They will do whatever they desire to do, they are very demanding and once they want something they want it at any cost. They cannot bear the slightest contradiction for anything. Everyone must listen to them and keep them happy but they will not listen to anybody be it their parents or friends. When their demands are not met with, they feel extremely sad, depressed and frustrated. 
• Another most important factor in sycotic children is ” Love of thyself ”
  Sycotic children are extremely self centered and selfish in nature. They only think about themselves and will go to any extent to accomplish their goals or wishes. Hence, these children often turn out to be sly, crafty, and malicious in their manners.
  Right from a very young age, the sycotic children are jealous and selfish. They are very possessive about their parents. The children in this phase will not allow their parents to love their younger siblings. If the parents cuddle and love the other child, they become jealous, rageful and will harm the younger ones when they are alone.
  They will attract attention of their parents and others, by creating self-pity or by attention seeking behaviors. 
• Sycotic children are very greedy; they don’t part with their things easily. They are never satisfied with what they have; they always want more of everything. 
• They will never share their toys / books etc. with anyone. They will keep their belongings to themselves and also want to acquire what other children have. These children are often termed as miserly. 
• They have fixed ideas and manifestation of their fixed ideas is their belief in lucky and unlucky numbers; inauspiciousness, black cats etc. and they rely on these things for all that they want to do.
  Thus, it is evident that in the later stages of disease, the sycotic children develop a lot of fixed ideas; it could be either related to their health / their greedy nature / belief in lucky and unlucky numbers, etc. These ideas are so strongly grilled in the mind of sycotic children that no amount of reasoning or explanation will change them.
  As the disease progresses further, the child develops a lot of delusions, illusions and hallucinations which is a very important feature of this miasm. The different types of delusions, hallucinations, illusions may be those of animals, of ugly faces, delusions that he /she is very ill, or that she will become insane, as if everything is unreal, of distant voices, etc. 

SYPHILITIC MANIFESTATIONS

• A child may reach the syphilitic phase through one of the following ways

1. The child may acquire syphilitic traits right from birth when there is parental inheritance [eg. History of syphilis or a STD in parents OR When the child is born to parents after a very long time of marriage]
2. A child may directly slide from the psoric to syphilitic phase depending on the external influences [when these symptoms are treated with suppressive line of treatment or if present for a long time] OR
3. Children may slide into this stage from psoric, to sycotic to tubercular and finally the syphilitic stage [when inappropriate treatment is carried out or any suppressive line of treatment is given]

• In either case, the formative years of syphilitic children are not organized at all, and are in a big mess.
  These children may have severe delayed developmental milestones, either head holding or walking, talking, teething, etc. All forms of mental retardation fall into this miasm.
  The resistance of these children is extremely poor, and thus they are usually in the last and the final stage of any disease. 
• This miasm is full of Destruction  Violence Negativism and  Degeneration
• Every input in this phase is handled in a different manner, but the output is usually destructive in nature, to self or to others.
  The response to every stimulus is negative; it is the other extreme of psoric phase.
  It is a phase in which all controls are lost : 

1. There is loss of value in life 
2. Lack of perception 
3. Lack of thinking
4. Lack of power to take decision
5. Paucity of thoughts
6. Lack of feelings
7. Improper behavior and 
8. Actions are full of negativity, violence and destruction. 

• A child in the syphilitic miasm has a very poor memory.
  These children forget everything very easily, and cannot remember both recent and past events.
  Their concentration levels are extremely poor and sometimes there is a complete absence from reality.
• Images stored in a syphilitic child are full of negativity, without any logic, reasoning or rationality. 
• Their perceptions are dull, and these children are always in a state of confusion and irritability.
  Even what they perceive is a distorted, incomplete image of reality.
• The syphilitic child is full of negative and destructive imaginations. 
• They think of negative aspects all the time. 
• They hardly ever put any of their imaginations or ideas into actions. 
• They thrive in talking about calamities, disaster, cyclones, etc.
• In this phase, the children are :4 Dull4 Stupid 4 Stubborn and 4 Morose
• They show disinterest/ little interest or aversion to everything whether it is at play, study or any         kind of hobbies, etc. 
• They have an extremely low intelligence and cannot correlate many things in life. 
• They always behave in an idiotic, imbecile and unacceptable manner as if they have gone insane. 
• A syphilitic child is usually worse at night. Their sleep is disturbed and unrefreshing. 
• They have plenty of dreams which reflect their negativity and destructiveness like dreams of death, dead bodies, killing, mutilation etc. 
• These children are destructive even at play.
  Their only way of playing with toys is breaking them and they will not rest in peace until they break their toys part by part. 
• They also destroy other children’s belongings. Games which these children enjoy are bow and arrow, guns and arms, etc.
  Whatever they play, they must win at any cost and will resort to any unfair means for that. They justify all their actions as being fair.
  They like to listen to stories of murder, horror and those depicting evil, violence and destruction, etc. 
• Syphilitic children are extremely poor performers. They are very slow to grasp or learn anything. They have an aversion to all kind of studies.
  These are the children who will repeatedly fail in one class and will never pursue their studies till the final day of exams. They, then, copy from books/ neighbors and try to achieve success in their exams [Sycosis]. They take a lot of pride in such a success.
  Paintings of a syphilitic child are usually with dark colors, those depicting violence and destruction like themes of war, bridges being broken down, of bombarding, death, etc.
  In extreme cases, the child cannot remember, read, write or comprehend anything. Quickness of thought and perception is diminished and there is a gradual incapacity for understanding things and this makes him morose. The mind grows slow-as if paralyzed. 
• Children in this phase are very unemotional and hard hearted by nature.
  Syphilitic Children are slow to react to any emotions or sometimes do not react at all. Hence, these children are often labeled as “unemotional”. They have little or no emotions left in them. These are the children who will always treat other children and people as objects, love and affection for others are as good as nil.
• Syphilitic children are extremely obstinate and headstrong. They will always do what they want to do. They cannot bear contradiction from anyone and in any form. They must have their own way in everything that they say, do or desire. 
• Their verdict is final and if you dare to go against or contradict it, they resort to irritability and even violent means.
• Violence and destruction are the hallmark features of the syphilitic miasm and run throughout this miasm very strongly.
  All the emotional outbursts of syphilitic children are in the form of violence and destruction.
• They get angry on trifle matters, and the anger is always expressed in form of violence and destruction. These children bang their heads till they bleed or they will beat up other children or throw things or break glasses or even harm anyone who dares to contradict. 
•  These children are extremely cunning, vindictive and malicious in their manners. They are cruel in their behaviors and have no love or respect for anybody. They plot or plan against people and instigate other people, too, to resort to destruction.
• They are extremely cruel towards animals, you will often observe these children throwing stones at cats and dogs, or they will kill birds and butterflies. 
• They will resort to all sorts of cunning and mean plans to get their work done. Cheating, lying, beating, stealing, etc. are a part of their lives and they hardly have any guilt feelings after doing such things. 
• They are overtly courageous and perform dangerous or illegal acts. Even as young children, they resort to homicidal or suicidal acts without even thinking once about the consequences.
• As in tubercular phase, these children also, resort to sexual activity at a young age. There are a lot of sexual perversions. They resort to inappropriate practices at a very young age. Dreams of syphilitic children often depict lewd / lascivious events, destruction, war, death, disaster, calamity, etc.
  Thus one can conclude that most of the conduct disorders and anti-social behaviors in young children are strongly syphilitic responses. 
• In later stages of the disease the child may have:
• Religious insanity or they perform repetitive actions like washing mania, etc. They also develop a lot of illusions, hallucinations or delusions as the syphilitic phase progresses.
• The child has a lot of fixed ideas which could be either for persons, or for objects, or of religion and no amount of explanations or reasoning will change this. [for eg. Young children who become extremely religious, keep reading the Geeta / Bible / Quran etc. all the time, and have certain rigid or fanatic ideas about his/her religion are syphilitic responses]
• Feeling of dissatisfaction is the most prominent feature in this miasm. 
• Children are not content with anything in life. They feel that everything they do, or everything that happens to them is worthless and that they have no reason to live.
  Children always think about death and dying. They feel they have very little time to live and that they will die soon. Time passes very quickly or too slowly for them [Syc]. They are usually depressed children who will keep the depression to themselves, and the first thing you know is that they have committed suicide / or attempted suicide.
  Depression in young children is a Syphilitic trait.

TUBERCULAR MANIFESTATIONS

• A child may reach the tubercular phase through one of the following ways : 

1. 4 A child may inherit the tubercular trait right from birth through his parents [for e.g. There may be a long lasting history of Tubercular infections in the parents OR a strong family history of tuberculosis]
2. 4 The child may slide from the Psoric to Sycotic to Tubercular phase. This depends on the external influences playing on him [especially when the symptoms experienced by the child are suppressed very strongly]
3. The child may directly transit from the Psoric to Tubercular phase [without passing through the sycotic phase]. This would be as a result of certain external factors or due to parental inheritance.
4. In either of the above cases, the formative years of tubercular children are not very well organized.

• The CORE of the Tubercular miasm is :4 Activity 4 Erratic and Changeability4 Hopefulness and 4 Weakness and Exhaustion
• The Sensitivity level of children belonging to this phase is HIGH, but their reaction to any stimulus is SUDDEN, ERRATIC and UNPREDICTABLE.
  Every stimulus received by the child in this phase has a different response in :
  4 Intensity
  4 Magnitude
  4 Time and
  4 Frequency of action 
• Let us now consider the behavior of the Tubercular child in the different worlds mentioned below :

In either of the above cases, the formative years of tubercular children are not very well organized.

• Erratic ‘ is the main theme of tubercular miasm.
  4 MEMORY : Children in this phase, at times, show a very sharp memory and other times there is complete lack of remembrance.
  4 CONCENTRATION : Their concentration levels may vary from high to low.
  4 RESPONSE : The response to any inputs is quite erratic, and hence the output is unpredictable.
• Tubercular children have a clear and acute perception, are very sensitive to external impressions and are almost clairvoyant in nature. Because of their clairvoyance, they are able to perceive threats very easily and hence they can decide the next line of action. If this clairvoyance is channelised in a proper way, these children can read the minds of other children or adults very easily.
• The children belonging to the tubercular miasm have a very active and creative world of imagination. 
• Children in this phase, have a very strong imaginative power. They create their own world of angels, imaginative characters, etc.
  They get many such ideas and then they try to implement these ideas in real life. For e.g. after seeing Superman or Batman they think, “If batman can fly, why I can’t”. They may even try to get similar costumes, collect their friends and may perform a heroic act.
  Result is : Can anybody guess……!!!
  In reality, I have seen / heard of these children performing these acts, some of them have died, some have succumbed to major injuries and some were lucky enough to survive without a scratch.
  They imagine and build on these ideas in a very constructive manner, but their natural resistance being poor, the body cannot meet the demands of their system and in turn succumbs to weakness, exhaustion or any major illness.
• The other aspects of these Tubercular children include :
  4 Hysteria
  4 Theorizing
  4 Resorting to Fancies
  E.g. A tubercular child may put his younger brother who may be dirty in a washing machine !!!
• Hyperactivity, Erraticity, Moodiness and Unpredictability – run through out the tubercular miasm.
  Tubercular children are tall, rapidly growing children [Tall children, growing well but emaciated belong to Phos.] with a tendency to repeated infections. 
• Tubercular children are sentimental, loving and friendly by nature. They love their play, studies, hobbies etc.
  These children have lots of inner desires and goals, but because of their poor resistance they succumb to external pressures very easily. They have no energy reserves. 
• As these children fall sick quite frequently, they cannot pursue anything to their final destination, which often leaves them sad, frustrated and depressed.
  Thus, Tubercular miasm is similar to Psora but with a more deepened response and because of its ‘erraticity’, it oscillates between :
  4The good and bad
  4The positive and the negative
  4Love and hate
  4Care and no care
  4Highly intellectual and dull
  4 Health and disease, etc.
• Tubercular children make a lot of friends because of their good, friendly and cosmopolitan nature. They share their things very easily and are always giving, helpful and sympathetic towards other children. They will always try to be in “good books” because they enjoy attention and attraction from everybody.
  A quiet, internal vexation followed by impulsiveness and violent reaction is a Tubercular, Schizoid personality. 
• These children are very playful and fun loving. However, again erraticity is the hallmark.
  These children may like certain toys or games at one moment and, at times, they have hatred towards the same at another time.
  At one moment, they are very enthusiastic about a particular game, at another moment; they are bored and want to change to something else.
  They will never stick to one game or activity because of their constant desire for change. They cannot pursue one action for a long time.
• They prefer listening to stories about traveling, of mischief or of some unusual characters 
• [Film ET by Steven Spielberg is a typical creation that is tubercular in nature since it required a lot of imagination and creativity].
  They actually perform acts of unusual characters [like Superman, Batman, Cowboys, etc.] and derive intense pleasure from it.
• At school, these children are either poor learners or they perform very well. In one semester, you will see these children doing extremely well, while just in another semester their performance is so poor that the parents start wondering as to what has gone wrong with the child. His grades may vary from “A to F”.
  They enjoy participating in all kinds of activities. They are extremely creative, and hence always take part in all sorts of drawing or art competitions.
• Paintings of a tubercular child are with vibrant and live colors. Their paintings depict modern art and they are able to explain exactly what they have painted. Each and every object or colors used in the paintings have some significance and these paintings very strongly depict their inner world. 
• They love going for picnics, school tours and will not miss any of them. [But again, when a tubercular child has to go for a picnic, he will organize every detail, pack everything and once he sits in the bus, he so tired that he goes to sleep]
• Erraticity and Moodiness
  The most important factor of the emotional pattern in these children is ” erraticity “.At one moment, these children are extremely sensitive and loving and at other times you will see them being indifferent to everything. These children are often related to as “MOODY” children.
• Fear and anxiety are strong features of this miasm. These children are anxious and fearful in nature without an appropriate cause, they have numerous fears. For e.g. Fear of dark, of being alone, of ghosts, of animals, of robbers etc. [Both fear and anxiety in a tubercular child are usually present because of ESP or clairvoyance]
• Tubercular children get angry and irritated at trifles easily, they become full of rage, may use bad or abusive language, and sometimes become violent and cause harm to themselves or others. 
• Another important feature of this miasm is the desire and love to travel and wander everywhere.
  In younger children, you can see this quality in the form of extreme restlessness; children will wander from here to there and will never sit quietly in one place. 
• In older children, you will observe that these children love to go for all kinds of outings with their friends and family, they have visited several places, have been to all the school tours, picnics, etc.
  [A clear tubercular response is typically expressed by the story of Red Riding Hood who was told not to go anywhere, but yet, she went here and there and then landed up in a mess]
• Tubercular Children are very hopeful by nature.
  They are always hopeful of good things, hopeful that will always succeed in life, that they will be able to perform well in the exams, when sick, they will be hopeful of recovery very quickly, etc. [Even with their grave illness, tubercular children will keep on enjoying themselves as if nothing has happened to them]
• One of the negative qualities that a tubercular child may possess is that, they are not comfortable with norms of the society.
  For eg. Very young children will get involved in playing the game of family and indulging in inappropriate acts. These are children who like to be touched, caressed, hugged or kissed. You will observe these children kissing many around them in the garden or at other public places. The act of children getting into the act of masturbation at a very young age is strongly a tubercular response.
• Tubercular children fall in love easily at a very young age. An 8-10 year old child will have a boy friend or a girl friend. They desire a lot of physical touch, caressing etc.
  Their mind is always occupied with sexual thoughts. Even their dreams depict these qualities, they often dream of lewdness, lasciviousness etc. [This tendency is even carried out to the adult stage]. Homosexuality and obscene behaviors are truly a tubercular response. [Platina is one important remedy for such behavior]. All kinds of sexual perversions belong to the tubercular miasm.
• They are complete spend thrifts, i.e. if they have 5 $ they plan to spend 10, borrow it from people and then spend it and not even feel bad about it. They become careless in their money matters, and will always spend more than they ever have.
• Tubercular children develop addictions at a very young age. These include intake of drugs, alcohol etc. 
• Thus, one can conclude from all of these above Eg. That these are the children who will want to defy the normal value system and morals of the society in various ways. [These negative qualities are seen in them because they are always in need of some change, something that is charging and something which is not usual]. 

Paira 210 (organon of medicine)

Of psoric origin are almost all those diseases that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease sharply separated from all others, since in all other so – called corporeal diseases the condition of the disposition and mind is always altered; and in all cases of disease we are called on to cure the state of  the patient’s disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homoeopathically with success.

Paira 214 (organon of medicine)

The instructions I have to give relative to the cure of mental diseases may be confined to a very few remarks, as they are to be cured in the same way as all other diseases, namely, by a remedy which shows, by the symptoms it causes in the body and mind of a healthy individual, a power of producing a morbid state as similar as possible to the case of disease before us, and in no other way can they be cured.

 Reference 

• Organon of medicine fifth edition 
• Chronic diseases by Samuel Hahnemann
• A short text book of psychiatry by neeraj Ahuja
• Miasma the road less travelled by dr harsh nigam
• Notes on the miasms by Ortega
• Practice of internal medicine by Harison