Case of Varicose Ulcer treated with LACHESIS

Cases

A patient of mine consulted for a relative, a contractor (construction) 54 yrs, who had developed a non-healing varicose ulcer in the left leg and was advised a skin graft as all treatment failed. The patient had no comorbidity. Since his job included long-standing, he had suffered from varicose veins bilaterally for years. 2-3 years back he developed this ulcer near the left medial ankle which refused to heal despite conventional treatment, hence the advice of skin grafting. The only information I got was that he had severe burning pain in the lesion and it prevented sleep. Lachesis 200 one dose was given. A local wash with calendula Q was also advised regularly. The next day the pain reduced and the patient was more comfortable. Nothing else was given (not even a placebo) and patient kept reporting every week. There was a remarkable change in the appearance of the lesion within 10 days, with granulation tissue appearing and ulcer becoming shallower. Slowly the ulcer started healing and after 3 months of the only dose, it healed completely.

Explanation

As this case was not under my direct observation that is why I decided to go with a moderate potency. It was a left-sided varicose ulcer and had marked burning as a symptom. There are many other medicines having varicose ulcers but none have such burning (it was the sensation voluntarily given by the patient) as Lachesis. Based on this a single dose was given (Lachesis- left-sided, varicose ulcer, burning pain). And since the patient kept improving the dose was not repeated (had the progress stopped, I would have had to think about a second prescription).

This case is also interesting as I did not give a placebo to the patient (I could not, as the medicine was prescribed over the phone). Improvement in the first few days convinced the patient that his treatment was on the correct path and he followed every instruction that was given to him, diligently. Aude Sapere

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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Clubbing of fingers and Lauroceracus

Internal Medicine/Knowledge of Disease

Clubbing is a physical sign, seen as knotting at the end of fingers and loss of normal nail curvature.

There are various causes of clubbing of fingers, commonest of which are enumerated below:

  • Cyanotic Congenital heart diseases
  • Subacute bacterial endocarditis (SBE)
  • Lung abscess
  • Bronchiectasis
  • Empyema
  • Bronchial CA
  • Inflammatory bowel diseases- ulcerative colitis/ crohn’s disease
  • Some cancers

Lauroceracus can either be curative (when chosen on basis of characteristics or peculiarities) or palliative (if given purely on a pathological basis in those with anatomical defects.) in the above conditions. Let us now discuss these conditions and symptoms that indicate the remedy pathologically in these diseases.

  • Children born with cyanotic heart disease (blue babies (Boger synoptic key)), often show signs of distress and cynosis on exertion. Their skin may have a bluish discolouration. Clubbing of fingers is a well-known sign in such patients (Toe and finger nails become knotty. Clubbing of fingers (Boericke materia medica))
  • Apart from clubbing SBE may present with neurological symptoms such as seizures and twitching also present in lauroceracus symptomatology. (Convulsive twitching. Epileptic convulsions, with foam from the clenched mouth ( BBCR)
  • Bronchiectasis/ lung absecss – (Cough, with copious, jelly-like, or bloody expectoration (Boericke materia medica))
  • I could not find any overt symptoms (pathologically) of inflammatory bowel diseases in Lauroceracus, though it could come as remedy in individualization of the case.
  • Lauroceracus is known to have some cancers in its pathologically and may be helpful in these conditions if clubbing of fingers is found to be an associated symptom.

Complete repertory states two other medicines in clubbing of fingers viz cal iod and beryllium. In Cal Iod the suppurative pathology could probably explain the clubbing. I do not know much about beryllium as medicine, so would refrain from commenting on it.

Knowledge of disease helps us in diagnosis, prognosis, management, and its prevention. It is not possible to always cure a disease due to a variety of factors. Though we generally use characteristics and individualistic features for the selection of remedy, knowledge of pathology (of both disease and medicine) also helps in remedy selection in such cases.

References

  • Boericke materia medica
  • Boger synptic key
  • Boger Boenninghausen materia medica and repertory.
  • French diagnostic index
  • Harrison’s principles of internal medicine

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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SOURCES OF MICRONUTRIENTS IN THE BODY

Patient Management/Removal of maintaining cause

Our body is a dynamic system that is constantly exchanging matter with its surroundings: taking in something and giving out something else. To function and maintain itself properly it needs substances of different types in large or small quantities.

Those minerals and chemicals needed in smaller quantities are called micronutrients. They play a vital role in metabolism and their deficiency in the body can lead to various diseased states. Therefore, it is of paramount importance for a physician to know these nutrients and their deficiency diseases, as a simple substitution in diet can correct the disorder without any medication (as they are mainly because of errors of diet and act as maintaining causes in treatment of chronic illnesses).   The physician can effect a ‘cure’ even without any medicine. Below is a comprehensive but not exhaustive list of various micronutrients and their dietary sources that a physician can advise to her/his patients and prevent deficiency diseases, by simply advising a nutritious healthy diet.

(§4
He is likewise a preserver of health if he knows the things that derange health and causes disease, and how to remove them from persons in health)

To know more download the below PDF file

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VIPERA AND TRIAD OF ABDO PAIN, FEVER, AND JAUNDICE

Internal Medicine/Knowledge of Disease

Today while studying Vipera I came across this symptom in Boerick Materia Medica.

“Violent pain in enlarged liver, with jaundice and fever; extends to shoulder and hip”

I would like to show here, another way materia can be studied and applied.
Here we are assuming a more pathological approach and would apply knowledge of medicine to study materia medica.

This symptom mentioned above is a triad of pain fever and jaundice. Which is a charcot’ s triad of cholangitis (if the pain is right hypochondrial pain).

Let us now see a differential diagnosis of conditions where this triad of fever, jaundice, and abdomen pain can be present (in all of these conditions vipera can then be thought of based on patient presentation and pathological symptom similarity):

  • Cholangitis- this inflammation of the bile duct causes the classical triad of charcot. It Can be diagnosed on ultrasound and blood picture will generally show neutrophilia. Primary or secondary, it can be associated with ulcerative colitis. The picture is very similar to that present in vipera.
  • viral haemorrhagic fevers- contracted from rodents, bats or insects, these fevers can present with all the features of pain fever, jaundice, coagulopathies, renal involvement etc. Vipera can be a very useful medicine in these fevers.
  • Scrub typhus- caused by bite of an infected mite with eschar formation at bite site, this presents as fever myalgias, enlarged spleen, pain abdomen. Rash, injected eyes and hepatomegaly may or may not be present.
  • Leptospirosis- contracted from infected rats, it presents with fever, pain and jaundice. It also affects kidney function and may cause haematuria.
  • Enteric fevers- caused by salmonella typhi from contaminated water or food, this will present with diarrhoea, constipation, fever with lower pulse rate than expected, low WBC counts. Bilirubin will however may not be raised.
  • Malaria- chills and fevers present in intermittent way depending on type of malarial parasite. There may be enlarged liver and abdomen pain.  The bilirubin doesn’t rise unless haemolysis occurs, causing black water fever.
  • liver abscess- fever, chills and painful hypochondria(rt) are common findings, however jaundice is not a common presentation. It can be easily diagnosed on USG.
  • viral hepatitis- these can present with fever, pain and jaundice. However it is the liver enzymes that are raised markedly in comparison to raised bilirubin.
  • Other acute abdomens such as pancreatitis appendicitis, diverticulitis etc can present with fever and pain abdomen though each will have their own characteristic and jaundice may or may not be present.

(Please note that this similarity is found only while studying the medicine from a pathological point of view. The confirmation can only be done by applying this knowledge in such a clinical condition in a patient.

This kind of approach is especially helpful when:

  • one is not able to find any characteristic symptom or
  • the attendants are not able to give one,
  • there is time constraint or
  • the physician has not seen the patient but has received a diagnosis from attendants.

The results in such prescriptions would nonetheless depend on the accuracy of diagnosis and its pathological similarity to chosen medicine.

References
www.medscape.com
Harrison’s Principles and Practice of Internal Medicine, 12th edition.
Pocket Manual of Homeopathic Materia Medica & Repertory by William Boericke

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com

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CONCOMITANTS WITH PAINS

Materia medica/ knowledge of medicinal powers

(compiled from N M CHOIDHRY MATERIA MEDICA and NASH LEADERS)

Pains with desire to take deep breath- xantho

Pains with chilliness- puls

Pains with delirium- veart alb

Pains with fainting- hepar sulph

Pains with irritability- cham, nux v

Pains with numbness- aco, plat, cham

Pains with salivation- plantago

Pains with sleepiness- nux mos

Pains with sweat- cham

Pains with frequent micturition- thuja

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Differential diagnosis of NAUSEA remedies

Materia medica/ knowledge of medicinal powers

In an acute case sometimes, it is important to relieve the most troubling symptom. It can however lead us to the right remedy if carefully individualized. These quick tips of differentiating between closely associated remedies aspire to do the same. 

Here you will find how to differentiate nausea of different remedies. The characteristic symptoms which differentiate these remedies are also mentioned for easy understanding.

  • Nux vom- has more of retching than vomiting. Chilliness and irritability.
  • Ant tart- nausea is associated with sleepiness. Rattling in chest.
  • Ipecac- nausea is associated with clean tongue and thirstlessness. Rattling chest.
  • Tobaccum- severe nausea with sweating and sinking in stomach > by uncovering the abdomen.
  • Lobelia- very similar to tobaccum (except the modality), it has however more action on respiratory sphere, rattling chest. Salivation with complaints. Pricking and itching of skin Is a useful concomitant to differentiate it from other drugs. Urine with deep red colour/ sediment with aSbove complaints.

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FEVER TREATED WITH BELLADONNA in a k/c/o Gaucher’s disease

Cases

With this case, I want to demonstrate treatment of an acute during treatment for chronic disease. This child around 6 yrs of age was a k/c/o Gaucher’s disease. She frequently suffered from infections for which she had to be admitted and given intravenous antibiotics (she would not respond to oral ones). After each such episode, she took a couple of weeks to recover and regain her strength, only to be battered by the next one. She was under treatment of a senior homeopath who was out of the station and had entrusted me to look after her in his absence. During this period, the child developed an acute episode of severe tonsillitis with high-grade fever. Her parents called late at night (they were not willing to admit her); when I saw her, she had a 103F fever, red lips, thirstless. She was not able to swallow anything on account of the pain. An examination of the throat showed very red tonsils (though no focus of suppuration could be seen).  Belladonna 200 was given and was asked to be repeated hourly with instructions to stop as soon as fever comes down. The parents were advised to admit the child if the fever does not come down or goes further up.

The morning brought good news. The child’s fever came down after just one dose and there was no need for repetition.

Explanation

During the acute episode, consideration was given only to the newly developed symptoms and not to the pre-existing ones. The case became a very straightforward one. Redness (sp. red lips), congestion, thirstlessness, and high fever. These are key indications of bell. The surprise was in the fact that no other dose was needed. This shows that a single dose of similimum can ride the tides (in this case it aborted acute episode). We can either achieve results in a zig-zag way or in the shortest possible way, the latter achieved only by similimum (similar medicine in suitable potency).

Aude Sapere

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

Download the .pdf version of the case here

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DIETARY RECOMMENDATIONS FOR PATIENTS WITH RENAL/ KIDNEY STONES

Patient Management/Removal of maintaining cause

Kidney stones are a very common occurrence among the general population. Low intake of water and a tendency to form stones is one of the commonest causes of their formation.

Depending on the underlying pathology the kidney stones can be of various varieties such as calcium oxalate (most common type), uric acid, struvite, cystine, or fibrin deposit type (the last two are a rarer variety), etc.

They might be either symptomatic or asymptomatic depending on size, speed of formation, location (a smaller stone in the ureter would become symptomatic faster than a bigger one in the pelvis of kidney), or type (c oxalate stones have a tendency to cause haematuria while struvite stones are ass with chronic infection), etc.

Experience has shown that these are most easily amenable to homeopathic treatment. However along with treatment during acute and then constitutional treatment, these cases need to be advised in relation to diet and lifestyle, as the patient’s lifestyle also plays a major role in the formation of these stones.

Following is an easily comprehensible list of advice that patients can follow to walk towards a goal of stone-free life.

Download the pdf now

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Case of pansinusitis treated with HEPAR SULPH

Cases

A 50 yr old male came with a complaint of chronic pansinusitis. He had been suffering for years with the problem and nothing helped him. He repeatedly took antibiotics to clear up the infection, only to return again. He could not smell anything, could not bear airconditioned environment, and had not slept properly according to his own account for years due to a blocked nose at night. The only time he felt better was when it was warm. He was given a dose of hepar sulph 10m. He returned after 3 months, extremely happy and satisfied, and thanked profusely for the medicine had helped him smell something literally after decades. He slept without any problem and did not need any antibiotics for the past 3 months.

Explanation

An extremely chilly person (he was only ameliorated by warmth) who has pansinusitis (and yellowish discharge) and has taken repeated antibiotics needs nothing but Hepar sulph. I thought that given the chronicity of the trouble he might need some other medicine later on, but it has not been the case till now, even after 4 yrs.

Aude sapere

Shivangi Jain
BHMS, MD, PGDMLE, PGDHHM
drshivangijain79@gmail.com
https://drshivangihomoeopathy.com/

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