Blog - Shilpa Bhouraskar

Prescribing in Children - Combining two approaches.

Struggling with Children's Cases

I received an interesting question by email the other day from an experienced homoeopath. She is a really good practitioner at Stage 4, but struggled with children cases. Especially because in many children there is less information to arrive at the sensation.

Her problem was that these kids do well on several basic medicines but they don't always hold. Many of these cases go around in circles.

At the same time she added that most the contemporary children's materia medicae were too limited in the remedies they covered and wanted to know other tools and books she could use for such children.

I thought this question could resonate with many practitioners so decided to share my experiences on this one.

Innovate And Implement

For me the key to success in any stuck homoeopathic case is about being able to constantly innovate and look outside the box when looking for tools and resources to find that breakthrough.

And some of my worst failures have been when I have been stuck with one specific approach or book or author and unable to look beyond.

And almost every breakthrough and aha I have had was when I could give myself the permission to look outside the conventional homoeopathic tool kit for solutions.

So in a way you are constantly growing and learning as a practitioner no matter how far you have travelled...

Children and Homoeopathy - Using Mother's Pregnancy History

In my past videos I had shared one such unconventional approach that continues to help me confirm prescriptions in children with great accuracy especially when the common children type such as Pulsatillas and Calcrea Carbonicums or Sulphurs and Naturm Muriaticums do not fit the picture completely.
That is using Mother's pregnancy history or Father's History during Conception.

This single approach has helped thousands of cases in not just my own practice but even my students practices And so it still remains a default strategy in my own practice when an unknown picture emerges in a little patient.

However as every other tool it has its own pros and cons and its own scope and application.

So what do you do in those children where -

1) The common children type remedies do not completely fit the whole picture.

2) But there is not enough information or pre-natal connection to find new unknown core remedies that resolve your cases!!

This is where I step back and ask my self the same question that has helped me in almost every stuck case -

What else can I do using the best of the existing resources, tools and remedies and still provide a good outcome for my patients?

Another Unconventional Approach

This is when I have found another unconventional homoeopathic approach that has been equally effective.
It combines two separate approaches and remedies to complement each other at the same time in a patient.

This amazingly simple yet unusual approach has helped innumerable cases in many acute clinics throughout my homoeopathic journey over the last 16 years.

Instead of going into the theory, let me share a case example to explain my protocol so it becomes practical for you through this video

Before I go

So again this case underlines the fact that every tool and resource in homoeopathy has a role to play in practice no matter how big or small.

And sometimes you need to use more than one tool and remedy...

But the bottomline is to ensure that we know exactly what we are doing and why. And more importantly where we are going using the tools so we can constantly remain on track to provide the best outcome for our patients.

If you are new to this concept I will encourage you to read my ebook - When your favourite approach does not work to find more insight to enrich your homoeopathy. It's completely free and you can download it on the left side of this page.

And if you have already read it, I want to know whether you use any unconventional homoeopathic approaches that work for you? I would love to hear about them. Simply share your experiences below.


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As per the Verspoor and Decker's Dynamic Legacy, dual remedies were addressed by Dr. Hahnemann, Aegidi and Boenninghausen as early as 1823.

It is truly effective - and logical, depending on dia-gnosis (seeing through) of the case. It is refreshing to hear others applying it!

In this case, Tub (miasm), Lyc (constitutional) proved appropriate. I would have added Hyos with some confirmation questions to address the realm of deep fears, causation want of love, manifestation in this case jealousy and bed-picking. I would have further considered clearing any lingering negative effects from his various trauma (teacher, family, medical intervention and meds).

Best regards and may you continue your appreciated efforts.

Hello i really liked the case information.I wanted to ask as my son also have allergic bronchitis often he got cal carb in different dose in last 3years ,my sons case is similar he has narrow chestand i can count his ribs with finger he shares i think tubucular misam with childs cases as u r explaning in the my son is 6 he had milk,cold air question here is that can give him tuberculinium 1m as intercurrent remedy?......we have family history of diabetes and asthma.

Thanks Bhanu,
I am glad the case offered you some insight into your son's condition.

However a miasmatic analysis needs a more deeper understanding of the case and it cannot be decided on one or two symptoms.

I would encourage you to consult a good local homoeopathic practitioner who can work with you and your son on a one on one basis and look at his state in total before confirming the miasmatic remedy.

Even if you are a practitioner, it is really hard to treat our family especially kids ourselves at Stage 3. So its best to have another practitioner provide that unprejudiced observation and diagnosis.


I loved hearing your dual remedy approach. It makes sense to use one for the miasmatic totality and another for the consttutional case. I have just started using this approach recently in children and it would seem to me that each one needs the other to open and resolve the case. Kind of like one opens the door and allows the other one in to do the work that needs to be done and if you use just one the door gets opens but nothing happens with a well indicated remedy.

For me at least I have to be careful with a nosode as it seems there has been some provings of them when given so I am surprised you went high with Tub...but is was infrequent. I have not yet hit upon right potency/frequency of nosode an secondary remedy but I will.

Thanks for sharing your case and experience it helps me with my cases.

Hello Shilpa, it is really good approach,dual remedy sometimes works very well,because we are giving both way miasmatic and contitutional remedy according to the totality of the symptoms.Lycopodium, in Wilkinsons materia medica in mind,"Talks with an air of command manner stiff and pretentious"perfect choice and Tuber. according to family history, very well repertorise.
Thanks Shilpa.

Hi Shilpa, thanks for the interesting case. I can understand the logic of using the miasmatic nosode as an intercurrent when a well-indicated constitutional remedy is not having the desired effect, but in this case I am curious why you gave the Tub without first testing the Lyc. The Lyc was a good constitutional prescription, and it does cover all the rubrics that you felt were missing: restlessness, emaciation, ravenous appetite, weak chest, nosebleeds. Lyc had not been given before, and for all we know the good result may be entirely due to this remedy.

Great case Shilpa. I have given the miasmatic remedy with what I think is the constitutional in kids cases or cases where the acute repeats for the person.

Thanks Peter,
There are a number of ways of using the miasmatic nosode, and you are right one way is when the constitutional is not having the desired effect.

However in this case there were few more stronger reasons that made me decide to give Tuberculinum without waiting and continue for 6-7 months.
Tuberculinum in this case was used -

1) As an anti miasmatic remedy to remove that obstacle to cure - Due to a very Strong Tubercular Fundamental Miasm with past and family history
2) As a Constitutional remedy to work at baseline due to a Tubercular Diathesis or Constitution.
3)As an Clearing remedy to open the case - He had a history of many well indicated remedies that did not work in the past.
4) As a clinically indicated remedy - Now this was personal clinical experience of seeing hundreds of Tuberculinum prescriptions singly and as a dual remedy in the last 16 years, I felt there were subtle differentiating aspects that Lycopodium did not cover. Eg The type of emaciation - Lyco has this upper body thin neck and a sort of withered look in emaciation and Tub has emaciation especially in the chest. The narrow chest with protruding ribs.
The Restlessness of Lyco and Tub are also different. Having seen Tubercular patients with past and family history there is this intense internal and external restlessness where they just cannot sit still. Plus the high metabolism and the inability to put on weight no matter how much they eat etc.

So for me Tuberculinum was strongly necessary in this case to complete the process inspite of Lyco.

But as a dual remedy I have seen it can generally reduce the recovery period greatly.

Thanks for the comprehensive response, Shilpa. You really are an excellent teacher!

I am so grateful for this lecture. I have a son with similar symptoms, not entirely the same but I gave many remedies including Lycopodium. It took me some time to give tuberculinim in a 30c and bowel nosodes, but I did not give it in a 1M and perhaps that is why he continues to have problems. I have been hesitant to use 1M and higher remedies after some aggravations in other patients especially if it was from diseased tissue like tuberculinum. I think, it is time to forgive my past mistakes and trust that some times it is necessary. Now, I make sure that I know the antidote to remedies and consider if any new symptoms are coming from the perscription given.

Hi Shilpa,
Nice case and I enjoyed hearing how you approached it. I am mostly familiar with using miasms when the case is stuck so this was a good learning for me. I have a question concerning the triple split dose. Can you please tell me how/what the triple split dose is? I know you gave the Tuberculinum in a 1M but I do not know what the triple split dose it. Thank you in advance.

Thanks Christine. The triple split dose is three dry doses of the remedy on a single day at spaced intervals ( morning afternoon evening).