Perhaps you would prefer our homeopathic sublingual snake venom in the event of snakebite. This has been prepared in keeping with our belief that "like cures like". (We also treat arsenic poisoning with more arsenic, but diluted many times.) This wonderful snakebite elixir is "potentiated by succession" where we strike the bottle 100 times against a felt pad before doing repeated 1:100 dilutions. We dilute our snake venom until there will likely be less than a single snake toxin molecule in each bottle. Doesn’t everyone know that the weaker the dilution, the stronger the effect? Even if there is less than one molecule of the original substance in the final dilution, perhaps the water molecules maintain a "memory" of the original substance. If the English royal family uses our services, we must know what we are doing. (No, we do not provide marriage counseling to them.)

OK, what am I getting to? Do I really believe the above, or am I against "alternative" techniques of healing? First, I would substitute "unproven" for the word "alternative". Second, why should remedies pushed by homeopaths, naturopaths, herbalists, and mail order degree "nutritionists" not be required to pass the same tests of safety and efficacy required of any other pharmaceutical product that enters the market? For instance, law from FDA scrutiny excludes most homeopathic nostrums.

The "health" food industry, with congressional assistance, is attempting to block the FDA’s efforts to regulate the sales and promotion of vitamins and supplements. This is a multi-billion dollar business, and they want to continue doing that business, without governmental interference.

This does affect our patients and us. I am sure I am not the only pediatrician in our chapter who has been asked by a parent, "Doctor, what do you think about homeopathic (or herbal or holistic or naturopathic) remedies?" I try to explain about the placebo effect and the fact that every dose-response study ever done refutes the basic tenets of homeopathy, but I am sure this frequently falls upon deaf ears. Although most homeopathic remedies are not likely to be harmful; they may keep patients from receiving more effective treatment.

On the other hand, I also disagree with the practice of many pediatricians who prescribe antihistamine-decongestant combinations for the treatment of serous otitis. Such treatment has repeatedly been shown to be useless or worse than useless if it triggers central nervous system irritability. Here, a homeopathic remedy (water) would have fewer side effects with likely the same cure rate.

Pediatricians should ask what treatments have been prescribed when parents bring up the topic of non-traditional medicine. One mother in my practice mentioned that she had taken her young sons to a local "holistic physician" for treatment of their recurrent ear infections. The boys had been prescribed vitamin A, 130,000 units per day, several times over the toxic level, in addition to coffee enemas for their ear infections!

Parents grieve for a young white male, top of his high school class, loved by everyone. He ended his life with a bullet from his parents’ gun. At his funeral, not only were his parents grieving, but his friends, neighbors, and teachers also. He did not live in "the ghetto"; he did not sell drugs. An entire school mourned the death of a young black junior high school student, shot to death by accident. His close friend had brought a gun to school to show it off to his teammates during basketball practice. He did live in the ghetto. Who knows if he ever sold drugs...it doesn’t matter. The end was still the same.

Violence is the leading cause of death in all teens. All of us are probably familiar with teen violence in the African-American community, but when we think of the mainstream white community, we are blind to the impact of teen violence on this portion of our pediatric practice. When we look at perpetrators of violence in the United States, white teen rates are 72/1,000 (ages 12-15), excluding murder and manslaughter. This number is not far behind rates for African-American teens (ages 16-19), which is 89/1,000.

This is the first article in a series of three to address teen violence in pediatric practice. This piece has illustrated the ubiquity of teen violence and its effects on all aspects of our community.

The second article will address how we can, as pediatricians, address teen violence everyday within our own practice. The third article will provide the pediatrician with referral guidelines and references. The reader is referred to the October 1994 Pediatrics Supplement on "The Role of the Pediatrician in Violence Prevention" for a more global perspective. These articles were written as part of our District’s campaign for violence prevention.

Violence is the major disease of our times. We need to come together with the entire community at large to ensure a safe future for our children and ourselves.

Behavioral/Developmental Pediatrics Lawrence Diller, MD, Chair

The committee met on September 21. The chief item was the announcement of the 2^nd Annual Update in Behavioral/Developmental Pediatrics to be presented by UCSF on February 4, 1995. Speakers will include Tom Boyce on stress, Byna Siegel on autistic children and Ashberger’s syndrome, and Glenn Elliott on Desipramine and the heterocyclics. The afternoon will be devoted to therapies. General pediatricians are invited to attend.

Dr. Diller is anxious to talk to interested groups on the social and ethical considerations involving the use of Ritalin. The committee expressed interest in a new pediatric HMO being developed by Children’s Hospital Oakland, called "Children First Network". This will be a paneled HMO with primary care pediatricians as gatekeepers. Behavioral Pediatrics will be included as part of the package of this plan.

Over the next year, members of the Committee will have the opportunity to participate in one of several projects with statewide importance. We will revise and distribute health education materials on environmental hazards for use in pediatric practices throughout California, and contribute our pediatric expertise to the statewide Childhood Lead Poisoning Prevention Program. In addition, we will evaluate the impact of reduced funding for anti-tobacco health education activities through Proposition 99. We meet approximately once a quarter, and are actively seeking new members. If you have any interest in joining this exciting group, please contact CoChairs Mark Miller (916) 342-1831 or Susan Cummins (415) 476-4883. We look forward to hearing from you.

As pediatricians we promote prevention. Prevention comes through education. But in order to educate we have to find an audience: the children, parents and others we want to teach.

The role of the Public Relations Committee is to set up a network to disperse information. The Academy constantly produces posters, slide shows, pamphlets, videotapes and press releases among its many forms of outreach. For instance, did you know that October was Child Health Month? Some current campaigns include Guns and Violence, TV Watching, SIDS Prevention, Universal Health Care and Immunization. In coming months I will use this column to inform you of the latest Academy offerings available for distribution.

We need people who have contacts in the media, who will hang a poster in their office, who will organize a health fair, who work in the PTA. All the various materials we receive will sit unused unless people like you help get the message out.

Please take a moment to think about your community and how you can encourage prevention beyond your one-on-one discussions with individual parents and patients at well child visits.

If you know someone at Channel Z, or the Daily Review, or your daughter’s fifth grade teacher, or the child care center down the street (for example), or (better yet) you would like to know what is currently available, please call Executive Director Beverly Busher at (415) 459-4775.

If you tell two friends and they tell two friends, and so on and so on...

Please fax this information to me at: (510) 581-1805