1. ADHD:
HOMOEOPATHI
C
PERSPECTIVE
PRESENTED BY:
Dr. BIPIN JETHANI
ASSISTANT PROF.,
DEPT. OF ORGANON OF MEDICINE
NEHRU HOMOEOPATHIC MEDICAL COLLEGE
& HOSPITAL
EMAIL: drbipin.jethani@gmail.com

2. It is thought that many great people such a Winston Churchill,
Leonardo De Vinci, Einstein, and Benjamin Franklin had the classic
characteristics of ADHD. This suggests ADHD people have some
exceptional qualities with exhausting side effects.

3. Attention deficit hyperactivity disorder (ADHD) and
attention deficit disorder (ADD) refer to a range
of problem behaviours associated with poor
attention span.
These may include impulsiveness, restlessness
and hyperactivity, as well as inattentiveness,
and often prevent children from learning and
socialising well.

4. Attention Deficit Disorder
(ADD) is the most
commonly diagnosed
behavioral disorder of
childhood, affecting an
estimated 2 - 4% of
school aged children.
Boys are more likely to
be affected than girls.
What is important for our understanding is that for these
problems to be diagnosed as ADHD, they must be out of
the normal range for the child's age and development.

5. Clinical features and criteria for
diagnosis
The Diagnostic and
Statistical Manual
(DSM-IV) divides the
symptoms of ADHD
into those of
INATTENTIVENESS
and those of
HYPERACTIVITY
AND IMPULSIVITY.

7. SUBTYPES OF A.D.D. SPECTRUM OF
DISORDER
Some children with ADHD primarily
have the Inattentive Type, some the
Hyperactive-Impulsive Type, and
some the Combined Type. Those with
the Inattentive type are less
disruptive and are easier to miss
being diagnosed with ADHD

9. ADHD often occurs alongside other difficulties
and is not the sole cause of problem
behaviour. Children may exhibit temper
tantrums, sleep disorders, and be clumsy.

10. ETIOPATHOGENESIS OF ADHD
The wholistic perception of ADHD
demands proper understanding of the
multifactorial nature of this disorder

11. ETIOLOGICAL BASIS OF ADHD:
HOST ENVIRONMENT AXIS
HOST FACTORS
ENVIRONMENTAL
FACTORS

ORGANIC BASIS
FAMILIAL
INHERITANCE


PERSONALITY
TYPE
PRENATAL & POST
NATAL INFLUENCES

12. ODE TO HAHNEMANN:
UNDERSTANDING
HOST ENVIRONMENT AXIS
……For as two things are required for the production
of these as well as all other morbid alterations in
the health of man - to wit., the inherent power of
the influencing substance, and the capability of
the vital force that animates the organism to be
influenced by it - the obvious derangements of
health in the so-called idiosyncrasies cannot be laid
to the account of these peculiar constitutions alone,
but they must also be ascribed to these things that
produce them, in which must lie the power of
making the same impressions on all human bodies.
….........
(§ 117 of Organon of Medicine, 6th edition)

13. ORGANIC BASIS OF
ADHD
Neuroimaging studies
suggest that the
brains of children
with ADHD are
different from those
of other children.

14. In ADHD children, the
frontal lobes are
immature or sluggish,
so they
appear to act without
thinking.
The judgement
and control of their
action is seen as
limited, much like a
child half their age.

15. FUNCTION OF FRONTAL LOBE
This is the executive management part
of the brain that forms a judgement from all of
the information that has been sent from around
the brain.

16. FAMILIAL
INHERITANCE
Studies of twins suggest a genetic link to
ADHD . In 80-90 per cent of identical twins
where one has ADHD so does the other.
Recent research also suggests there is a greater
chance of inheriting the condition from male
relatives such as grandfathers.

17. IN UTERO INFLUENCES
PREDISPOSE TO
DEVELOPMENT OF
ADHD
Intra-uterine life is the earliest phase
of life spent by an infant in the quiet,
dark atmosphere of mother’s womb
(from the moment of conception uptil
its exposure to the outside world)

18. ‘ wITHIN THE wOMb’
DEVELOPMENT IS A
PHENOMENON OF RAPID
PROLIFERATION AND
DIFFERENTIATION
It is the stage at which the enormous potential
of an individual to grow and evolve is realized
and therefore is extremely susceptible to
varied environmental influences especially
mother’s feelings, attitudes and intra-natal
exposures.

19. INSIGHT OF
HAHNEMANN
Much ahead of his time, he epitomized the
importance of intra-uterine life in
ontogenesis as well as utilized it as basis
of prescribing. A philanthropist, a man
of truth and courage …..
Samuel Christian Friedrich Hahnemann.

20. PRESCRIBING IN
PREGNANCY
Hahnemann has lucidly explained this in
'The Chronic Diseases - Their Peculiar Nature
and Their Homoeopathic Cure' where he states
that: 'Pregnancy in all its stages offers so
little obstruction to an anti-psoric
treatment that this treatment is often most
necessary and useful in that condition'

21. He emphasises upon this fact in footnote of
§284 of 6th edition of ‘Organon of Medicine’ as
‘…………But the case of mothers in their
(first) pregnancy, by means of a mild
antipsoric treatment,……..is indispensable
in order to destroy the psora – that
producer of most chronic diseases –
which is given to them hereditarily; destroy
it both within themselves and in the foetus,
thereby
protecting
posterity
in
advance………..’

22. EMBRYOLOGICAL ONTOGENESIS

23. DOCUMENTED INTRA-UTERINE
INFLUENCES PREDISPOSING TO ADHD
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ALCOHOL
MENTAL STRESS
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SMOKING
ULTRASOUND
EXPOSURES
MOBILE PHONES

24. EFFECT OF SMOKING
Smoking during pregnancy is an
independent risk factor in the
etiopathogenesis of ADHD

25. The University of California have found that using mobile phone while
pregnant could cause behavioural and emotional problems in children
The study of more than
13,000 children found that
pregnant women using the
handsets just two or three
times a day was enough to
raise the risk of their
babies
developing
hyperactivity and difficulties
with conduct, emotions and
relationships by the time
they reached school age.

26. A new study warns that exposure to
repeated ultrasound can affect
fetal brain development. The
study, funded by the National
Institute
of
Neurological
Disorders and Stroke revealed
that when pregnant mice were
exposed to ultrasound, a small
number of nerve cells in the
developing brains of their fetuses
failed to extend correctly in the
cerebral cortex and led to
development of hypersensitive
mice.
EffEct of
ultrasonic
wavEs
Most importantly, it was assessed that damage was
analogous to the neurophysiological changes in
children with ADHD.

27. Research shows that the
ultrasounded population
have
a
quadrupled
perinatal
death
rate,
increased rates of brain
damage, dyslexia, speech
delays, epilepsy, learning
difficulties, and a 32%
increase
in
left
handedness (which is
thought to be caused by
brain damage).

28. MENTAL STRESS DURING
PREGNANCY
D.H. Stott in a series of papers has
showed that psychological stress during
pregnancy may predispose the child to
react in an undesirable way to
subsequent adverse environment and so
predispose to behavioral problems and in
particular to juvenile delinquency.
Stott, D.H. “Evidence for a congenital factor in maladjustment and
delinquency”, American Journal of Psychiatry

29. BIRTH PROCESS:
natural transition of a
neonate from the darkness of
the in-utero environment to
the illumination of the
external world
HIStoRY of BIRtH tRAumA , AS duE to
foRCEPS dElIvERY oR PRoloNGEd
lABouR, IS A mAjoR fACtoR tHAt
REquIRES ExPloRAtIoN IN CASES wItH
AdHd. tHE BRAIN StRuCtuRES BElIEvEd
to BE lINkEd to tHE dEvEloPmENt of
AdHd ARE vulNERABlE to HYPoxIC
dAmAGE duRING BIRtH.

30. The brain structures believed to be linked to the
development of ADHD are vulnerable to
hypoxic damage during birth. The damage is
caused by inadequate oxygen reaching parts of
the brain while blood flow is reduced.
A
Good
NumBER
of
BEHAvIouRAl PRoBlEmS IN
CHIldREN CAN BE lINkEd to
BIRtH tRAumA, EmotIoNAl
dIStRESS of tHE motHER
duRING PREGNANCY

31. ‘Attention Deficit
Disorder – A Different Perspective’
Hartmann (1999) in his book ‘Attention
Deficit Disorder – A Different Perspective’
argued that ADHD is the original hunter’s
genes.
He reframes the characteristics of ADHD as
positive qualities for hunting.

32. The symptoms of Attention Deficit
Hyperactivity Disorder principally evolved
as adaptive behaviors.
It has been suggested that the behaviors of
ADHD evolved to serve a functional
purpose in the distant past but may not fit
well
within
current
culture
and
expectation (Hartmann, 1993; ShelleyTremblay & Rosen, 1996).

33. ADHD: ANTHROPOLOGICAL
PERSPECTIVE
‘Attention deficit’ he redefines as ‘noticing
everything’. As a hunter heads off across
the savannah, he is constantly looking
out for what might eat him and what he
could catch and eat. In the classroom
ADHD child is seen as being distracted
by noises and activities instead of
focusing on the student’s own work

34. When the hunter sees prey, they become
single minded, focussed on pursuit and
capture. This characteristic in ADHD
people shows up in their mono-focus on
those things that interest them. Hunters will
take some personal risks to catch their prey,
while those with peasant farmer genes
would prefer to stop for a strategic plan.
This behaviour is seen as impulsiveness and
risk taking.

35. ADHD: MALADATIVE
DISEASE OF CIVILISATION
The ADHD needs to be considered as
maladaptative disorder in children rather than
as an isolated psychiatric illness. In the
background of the fact that ADHD is
ontogenically malprogrammed disorder; the
evolutionary history of each and every child
with ADHD assumes utmost importance,
especially from the most initial stage of
development i.e. INTRA-UTERINE LIFE.

36. PERSONALITY PROFILE OF ADHD
ADHD should instead be called
Latent Entrepreneur Personality
Type (LEPT)
The name LEPT conveys the idea that
this is a personality type at one end of a
spectrum rather than a brain disorder.

37. CHARACTERISTICS that drives
entrepreneurs to pursue their business
when others would have given up
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INSATIABLE CURIOSITY , bored by mundane tasks but
enthusiastic to explore new ideas.
MODERATE RISK TAKING , disregarding the obstacles that
prevent others from Starting.
ADAPTABILITY AND RESILIENCE TO SETBACKS,
learning as they go to overcome difficulties.
INTENSE BURSTS OF ENERGY
INDEPENDENT - needing autonomy and often preferring to be a
leader or a loner than a cog in a large wheel.
ACTION ORIENTATION

38. CLINICAL EXPERIENCES
A 6 year old male child with fair complexion
and red lips presented with combined type
of ADHD.
Features s/o ADHD were noticed around 2-3
years of age with marked restlessness,
very easy distractibility and striking lack of
perceptions of impending dangers.

39. INTRA-UTERINE HISTORY
 The
INTRA-UTERINE history revealed
marked hyperemesis during entire 9
months. Had developed severe cough for
which she took only home remedies.
Cough
subsided
immediately
after
delivery.
 It also revealed H/o constant stress of
mother which started during early months
of pregnancy – feeling of anger due lack
of moral support and unco-operative
attitude of inlaws.

40.  The child was born full term LSCS with
mild IUGR.
 H/o chicken pox (well erupted) at age of 2
years.
 Developmental milestones normal
 Desire salty foods and paneer
 DESIRE SLEEP ON ABDOMEN
 Family history of CAD, DM and
Hypertension

41. CASE ANALYSIS
The case analysis underlined the fact that
that mental stress during early months of
pregnancy would have had enormous
dynamic influence on the organ-system
which begins developing in the most initial
period of organogenesis – the Central
Nervous System, as can be deciphered
from the presenting complaints (ADHD) of
the patient. Hence the mental trauma
during pregnancy needed to be especially
taken into consideration.

42. CASE ANALYSIS
 Besides
this, her intra-uterine tendency to
‘THROW UP’ in form of hyperemesis and
cough was interpreted as somatic
manifestation of her deep subtle desire to
‘THROW UP’ the foetus. The emotional
drain on the system with lack of catharsis
and resultant suppressed anger was
manifested by the child in his misdirected
bursts of energy.

43. CASE ANALYSIS
The understanding of case in terms of intra-uterine
effect of deep seated emotional trauma resulting in
affection of Central Nervous system with
concomitance of red lips and desire to sleep on
abdomen pointed to the remedy
THYROIDINUM
as mentioned by Clarke, Boericke, S.K.Ghosh and
L.M. Khan in their respective works on Materia
Medica.

44. In Boger’s ‘Synoptic Key of Materia
Medica’, Central Nervous System is one
of the principal areas of affection in the
pathogenesis of drug Thyroidinum.
Thyroidinum was prescribed in LM potency
and patient has become more settled and
most importantly now involves himself in
more constructive daily activities.

45. CASE STUDY
Case of 8 year old male child, lean
thin, sharp nose presented with
Inattentive predominance ADHD.

46. PRENATAL & POST NATAL HISTORY
Patient had h/o grief during pregnancy due to
detection of cancer of mother some time after her
conception and her death 1 month just 2 weeks
before delivery of child. Intra-uterine history
revealed gestational hypertension with development
of pedal edema in the last trimester.
Forceps delivery due to obstruction of head. Birth cry
delayed

47. PRESCRIBING CLUE {§ 153} –
‘PECULIAR’
Tendency to cough and cold with every
change of weather with hyperpyrexia but
playful even in this state
NON COMPLAINING ATTITUDE

48. A very practical tip by Dr. L.M. Khan is that in
case of a child born of a prolonged labour
where he/she had to bear the undue stresses
and trauma of the birth passage, think of
Arnica montana as constitutional remedy
especially if there be history of delayed crying.
Absence of cry immediately after birth can be
analogically
considered
as
NONCOMPLAINING ATTITUDE OF CHILD, a
hallmark feature of Arnica Montana.

49. TRAUMA OF PREGNANCY IN FORM OF
GRIEF AND ITS EFFECT ON
CARDIOVASCULAR SYSTEM WITH
ATTITUDE OF ‘NO COMPLAIN’
ARNICA MONTANA
Arnica Montana 200 {9 doses} were prescribed.
As narrated by mother, patient has become more receptive to
command following. The tendency to cough and cold showed
significant improvement

50. CASE STUDY
A
stout looking 9 year old child presented
with ADHD with marked destructiveness
and hyperactivity. Intra-uterine history did
not provide any significant clue. FTND
with
no
immediate
post
natal
complications.
 Precocious developmental milestones.

51. SIGNIFICANT POINTS


H/o typhoid at 4 years of age.
Family history of alcoholism and Ulcerative colitis.
Recurrent tendency to coryza


Appetite decreased.
Desire for cold drink even in attacks of acute cold
which made it worse.

Chilly patient with dry deep cracked tongue.

52. Started with Phosphorous in LM potency on
the basis of:
 Tubercular diathesis
 Desire cold drinks
 Chilly patient
However there was not much improvement
even in 30th potency.

53. CASE ANALYSIS
 Keeping
in mind lack of further guiding
symptoms and strong SYPHILITIC TAINT
(Family
history
of
alcoholism,
DESTRUCTIVENESS in form of cold drink
even when it aggravated complaint and
deep cracked tongue); I prescribed
Syphilinum LM1/ OD

54. CASE STILL UNDER PROGRESS
but according to mother, appetite has
increased and patient is slightly better
with regards to his degree of
hyperactivity.

55. GENERAL
MANAGEMENT
Create a daily routine for the child,
eg homework schedules, bedtime
and mealtime routines. Plan
structured programmes aimed at
gradually lengthening the child's
concentration span and ability to
focus on tasks.

56. IMPORTANCE OF ACCESSORY
CIRCUMSTANCES (§5)
Remove disturbing or disruptive elements from their
daily routine. For example, remove siblings from
the room when they are doing homework or turn
off the TV. Ensure environment is friendly and
conducive to better concentration. Communicate
with the child on a one-to-one basis and avoid
addressing other children at the same time.

57. BEHAVIOUR THERAPY
 POSITIVE
RE-INFORCEMENT
Use rewards consistently and frequently to
reinforce appropriate behaviour such as
listening to adults and concentrating so as
to ensure reinforcement of positive traits.

58. HOLISTIC PRESCRIBING WITH GOOD GENERAL
MANAGEMENT CAN MAKE THE
BEHAVIOURAL DISORDER BEHAVE.

59. THANKS FOR YOUR PATIENT LISTENING

65. 
Attention Deficit Hyperactivity Disorder, more commonly known as ADHD, is a medical condition that has observable symptoms such as
uncontrollable hyperactivity or inattention and impulsivity that causes disruption to the daily functioning of a person in a number of settings
such as home, school, work or in the community .
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There are three types of ADHD, each with their own distinctive behaviours.
Inattentative type, with signs that include:
unable to focus on details or a tendency to make thoughtless errors in schoolwork and other activities
trouble with continuous attention in play activities or tasks
obvious listening difficulties
difficulty following instructions
trouble with organization
avoidance or dislike of tasks that requires thinking or focus
tendency to misplace belongings such as toys, notebooks, or homework
easily distracted and distracting
forgetfulness in daily activities
Hyperactive and impulsive type, with signs that include:
squirming or fidgeting
trouble remaining still and seated
constant running and climbing
find it hard to play quietly
seem to be constantly "on the go"
continuous talking
blurting answers out
find it hard to wait in turn
tendency to interrupt or intrude
Combined type, which is made up of a combination of the other types and is the most common form .
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66. 
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How is it diagnosed?
Diagnosis is dependent on a full evaluation as there isn't a test that
detects the presence of ADHD. Diagnosis can be a difficult process,
as factors such as Tourette syndrome, depression or a learning
difficulty may influence the results. Referral to a specialist such as a
psychologist, neurologist or psychiatrist can help dismiss alternative
diagnosis .
To be considered for a diagnosis of ADHD there are four boxes that
need to be ticked:
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a child must display behaviours from one of the three types of ADHD before age
7
behaviours must be more severe than in other children of the same age
behaviours must be evident for at least 6 months
behaviours must take place in and have negative affects on at least two areas of
the child's life (such as school, home, day-care settings, or friendships)

68. 
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When the brain hears a loud bang, the sound
comes in through the ears to the hearing part of
the brain that acknowledges sounds. The
information is then split for processing. About
10% of the signal goes to the amygdala in the
limbic system, and 90% to the cerebral cortex.

69. 
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The limbic system is the primitive processing
part of the brain that holds some memories and
assesses threats. The bang may trigger the
amygdala to send a signal to the neighbouring
© Deb Gilbertson, 2003
cells to release adrenalin for fight or flight.
This process is very fast.

70.  This inability to put adrenalin away again
leads
 to high levels of adrenalin in the system. In
 my view this explains some of the
 hyperactivity in ADHD people.

72. ‘Attention
deficit’ he redefines as ‘noticing everything’.
As a hunter heads off across the savannah, he
is constantly looking out for what might eat
him and what he could catch and eat. In the
classroom this is seen as being distracted by
noises and activities instead of focussing on the
student’s own work.

73. 
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The hunter may get hurt when they pull down
the prey, yet the next day they will do it again.
Consequences lead to awareness of the risks
but do little to stop them from taking those
risks. For ADHD children this means that the
normal behavioural modification technique of
applying natural and logical consequences has
little effect. This characteristic can also been
seen as resilience to setbacks, a critical quality
in entrepreneurship.

74.  Hunters need high levels of energy for the
 hunt. This is seen in the classroom as
 hyperactivity, with energetic children
 struggling to sit quietly. For the
entrepreneur
 high energy is an essential quality for
business
 success.