If a child has had any one of these reactions, a skin test for the serum that has caused the reaction is unnecessary and dangerous. However, if a previous injection went by without a reaction, a skin test for the serum is necessary before giving it again.

In case a child must take a tetanus shot and he is known to be allergic to horse serum, then a human serum which is rich in the same kind of antibodies has to be given to him instead. This serum is to be injected intramuscularly as one single dose. Although human serum has never caused an allergic reaction, this remains a possibility. To avoid it, active ‘immunization against tetanus with toxoids is mandatory to eliminate the need for any tetanus immune serum.

Special precautions are necessary to immunize an egg-sensitive atopic child against influenza, measles, rubella, and mumps vaccines because these vaccines contain egg. (However, if the child has hives or asthma after eating eggs, then no egg vaccine is to be given to him).

Flu vaccination must be given in three doses—the second one two weeks after the first, and the third two months after the second, starting in September and going into December. The vaccine used has to be free from alum, be polyvalent, contain the Asian flu virus, and be given intracutaneously in one-tenth of the regular dose.

While giving the atopic child any kind of immunization, a pediatrician should have adrenalin on hand for unforeseen reactions.

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A diagnosis of psychosomatic illness or hypochondria is very largely a diagnosis of exclusion – it requires all other possibilities to be excluded first. With many patients suffering vague, multiple symptoms, food intolerance must be regarded as one of those possibilities. Unless steps are taken to ‘eliminate it from the enquiry’ – and that must mean a diagnostic diet – then there is no sound basis for saying that a patient’s symptoms are psychosomatic.

Things are not necessarily done in this order, however, and for good reason. Many of those attending the doctor’s surgery with physical symptoms, such as headache or diarrhoea, actually have serious emotional, sexual or family problems that they want to discuss with the doctor, but find it difficult to start on such sensitive topics. Family doctors are trained in the art of discovering what the patient has really come to see them about. If you have symptoms that you think may be caused by food intolerance you should not feel affronted if the doctor’s initial questions seem rather personal and irrelevant to the aches and pains being suffered. Answering the questions calmly and reasonably will do much to convince the doctor that your problems are not psychosomatic.

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