Tag Archives: cases

A case of infection

Young female patient presented with left index finger very swollen, with localised redness and most of the swelling at side of finger. Examination showed entry wound and lodgement of a piece of wood from a few days earlier.

There was sponginess of the tissue surrounding the site with pus of a whitish cloudy, slightly thick nature with an unpleasant smell.

It was too painful to work on without anaesthetic, so I decided to give a medicine and wait a short while.

Causation was skin entry via splinter.

The skin was heavily inflamed

discharge was thick, white and odorous

 

As you can see from the Repertorisation, Silica fitted the presenting symptoms completely. I gave 0/1 repeated every 10 mins for 3 doses.

The pain increased on the 3rd dose. on examination, the swelling had increased around the entrance wound with the pressure internally of the skin showing whiter. I cleaned the area and applied light pressure. The pus exploded into the gauze giving instant relief to the patient, and exposed a piece of the splinter which was deep within. I was able to remove the splinter and clean the wound site. I left it open with sterile dressing.

Patient came the following day, after taking two more doses of Silica. The rapidly healing wound was cleaned and redressed. Patient was instructed to take one dose of Silica a day for 2 days. The next visit, after 5 days showed a 95% healed area and no infection or inflamation

The medicine that came to mind whilst examining the finger was hepar Sulph. Referencing the Materia Medica showed the symptoms produced in the disease state, were not produced in the provings. Only Silica matched the presentation.

A case of toothache..

This is a case that happened to me personally.

I had an upper molar develop a small caries which I had noticed, yet as it did not cause any distress, I put it on the ‘to do’ list. About a week later, I was in central London driving to an appointment when I was suddenly struck with intense pain in the tooth. It was very severe with nerve involvement and made worse by any pressure. I was driving with my mouth slightly open to make sure the upper and lower teeth did not touch.

As this was an important meeting and not one I could miss, I was considering taking codeine to relieve the pain temporarily so as to enable me to function for the next couple of hours, and perhaps for a day or two until I could get into a dentist.

My mind evaluated the symptoms, upper molar, nerve pain, even the pressure of normal jaw tension or biting was worse. I kept examining the sensation and realised that subconsciously, I was using my tongue to try and clear the hole of the caries because it felt that something was wedged in it. (There was nothing in there on observation, but the sensation would lead a person to believe otherwise)

I pulled over to the side of the road and opened my medicine case and removed a single tablet of 200c Staphisagria. I sucked on it. Within  2 minutes, a sensation of the pain ‘trickling’ away occurred. it felt like it just bubbled away, removing the feeling of something lodged in there and all discomfort was removed fully within 10 minutes.

That evening I repertorised the case to see if it matched my assessment of the remedy I had taken.

(Click to enlarge)

 

 

 

I did not attend to that tooth for about three weeks because frankly I forgot about it.

Presenting conditional symptoms represent the entirety of the disease at that moment. In my case, the Staphisagria was taken immediately and stopped the problem completely.

This repertorisation was made using the Therapeutic Pocket Book, and shows the accuracy of the symptoms both literal and interpreted. Please note: interpreted does not mean an analysis of a symptom, rather the use of a literal sensation, in the case of the tooth feeling of something stuck in the tooth, rather than a crumb or something present. Please remember that symptoms are produced in a healthy person when proving substances, and it is the sensation that matters.

 

Cases: Fever with gastric disturbance.

Cebu Philippines 2012 January.

Male White English patient visiting Cebu for 4 weeks, presented with typical symptoms of change of climate, air, food and environment.

This was manifested in a fever type state, fairly rapid onset. No discernible causation. Was staying in 4 star hotel with air conditioning and was a fairly frequent traveller.

The fever displayed as feeling warm with perspiration present, and sometimes a sense of coldness with perspiration present. When either hot or cold in fever state, the patient would cover himself with a blanket but soon discarded it as he felt worse from it.

The patients voice had lost timbre and sounded quite husky, his tongue was discoloured and coated. The patient complained of a taste in mouth alternating between copper and iron. The patient wanted a little hot food from time to time and only hot drinks and felt better for them.

Nothing further could be discerned through a full physical examination.

Using the P & W Therapeutic Pocket book, the symptoms were examined for Materia Medica study.

Firstly, the expression of the gastric disturbance was manifest in a discernible taste.  Very metallic. Along with this was a coated tongue.

The next obvious changed symptom was that his voice had gone very husky.

These three symptoms, taste, appearance and change in vocal quality, covered the expression of one part of the picture.

Turning attention to the fever, the patient had heat with perspiration and also chilliness with perspiration. He was irritated and made worse by covering himself and felt better for taking hot drinks and hot food.

A quick look in the Repertory elicited the following single remedy for consideration (The Materia Medica confirmed the choice) which cured the patient in 3 doses of 0/1 over the course of a single day.

Nux Vomica.

 

 

Are Your Painkillers Actually Killing You?

I wonder how many practitioners take this into consideration when treating patients?

ABC News Medical Unit
Dec. 20, 2006

 

 Calls for stronger warning labels for certain over-the-counter (OTC) medications question the safety of products that are a fixture in the medicine cabinets of nearly every American household.

On Tuesday, the Food and Drug Administration proposed stronger warning labels for acetaminophen, widely known by the brand name Tylenol, and the common class of pain relievers known as nonsteroidal anti-inflammatory drugs, or NSAIDs. This group includes ibuprofen and aspirin.

Considering the familiarity of these medicines, many consumers assume they are safe.

However, the FDA estimates that 200,000 Americans are hospitalized every year because of overdoses and side effects of normal doses of these drugs, and they are the cause of thousands of deaths per year.

“Too many people assume these drugs are 100 percent safe because they are available over the counter,” said Dr. Roshini Rajapaksa, assistant professor of medicine in New York University School of Medicine’s division of gastroenterology.

The drugs can also cause gastrointestinal problems and liver damage.

“In people over 60, the most common cause of gastritis, peptic ulcers and upper [gastrointestinal] bleeding is the use of NSAIDs,” said Dr. Joel Weinstock, professor and chief of the division of gastroenterology and hepatology at Tufts New England Medical Center in Boston.

Weinstock adds that acetaminophen also has dangers.

“Use of Tylenol, particularly with alcohol, can readily cause hepatitis and liver failure,” he said. “This happens frequently. Some of these patients will require liver transplant because the damage to the liver is so severe.”

“If these drugs had just come to the market today, I would not be surprised if they would require prescriptions and would not be available for over-the-counter sale,” Weinstock said.

Manufacturers Step Forward

Prominent manufacturers and distributors of pain relievers have expressed their willingness to adhere to enhanced labeling requirements.

In a statement issued Tuesday, McNeil Consumer Healthcare, the makers of the acetaminophen pill Tylenol and the ibuprofen drug Motrin, said they had “previously implemented a number of the proposals in the FDA OTC monograph labeling recommendations released today, and will continue to work with the FDA to ensure appropriate information is provided to consumers.”

Linda Suydam, president of the Consumer Healthcare Products Association, said in a statement Tuesday that many of the trade association’s member companies had also already implemented label improvements.

“As FDA states in this proposed rule, consumers should remain confident that over-the-counter analgesics continue to be safe and effective,” Suydam said. “The reality is, however, that over-the-counter medicines are real medicines with real risks if misused.”

 Certain Painkillers More Dangerous Than Most Realize

Not everyone agrees that the over-the-counter painkillers targeted by the regulations are safe.

“Acetaminophen is a very dangerous drug,” said Dr. John Brems, professor of surgery and chief of intra-abdominal transplantation at Loyola University in Chicago.

Brems says he admits at least a dozen patients every year suffering liver failure caused by the drug.

“Many of these patients took acetaminophen in addition to alcohol,” he said. “I end up transplanting three to four patients per year, and two to three die before we can transplant them. It is probably the most dangerous OTC drug in this country.”

Some suggest that acetaminophen’s over-the-counter availability indicates a lack of awareness of its danger.

“[Acetaminophen] is a leading cause of death from pharmaceuticals,” said Dr. Edward Boyer, chief of the division of medical toxicology at the University of Massachusetts. “The fact that it is an OTC medication suggests to the uninformed a lack of danger associated with its use.”

Many patients assume that painkillers like acetaminophen are completely safe because they are available not only through doctors, but also through pharmacies, grocery stores, and even gas stations.

“Consumers usually have no idea of the toxicity of OTC drugs,” said Dr. Walter Peterson, professor emeritus of medicine at the University of Texas Southwestern Medical Center at Dallas. “They believe that because they are OTC, they are safe.”

 Abuse Remains Most Dangerous Mistake

Most of those who endanger their health with pain relievers do so by simply taking too much of the drug too quickly.

“We know that people occasionally use the products outside the product label — sometimes on a physician’s recommendation, sometimes on their own, and sometimes inadvertently,” said Randy Juhl, former chair of the FDA Nonprescription Drug Advisory Committee and vice chancellor for research conduct and compliance at the University of Pittsburgh.

Occasionally, the overdose is intentional.

“I think that most people don’t understand just how dangerous these drugs are,” Boyer said. “For example, I know of a ‘weight loss club’ whose members ingested [acetaminophen] because they knew it would make them vomit. The girls in the club kept winding up in hospitals. … And nobody could figure it out until one died.”

Acetaminophen is also a common drug for those who attempt suicide by overdose.

In most cases, however, the overdoses are unintentional, and the mistake is often an easy one to make.

“Consumers are generally not aware of the four-gram maximum daily dose of acetaminophen,” said Edward Krenzelok, director of the Pittsburgh Poison Center and professor of pharmacy and pediatrics at the University of Pittsburgh Medical Center.

Worse, for children the maximum dose is significantly smaller, at 2.6 grams per day.

Yet many adults and children may be in danger of overdosing because they don’t perceive the drug as potentially harmful.

“Most people underestimate the potency of medications, and may act on the principle that ‘if one is good, two is better,'” said Dr. Vivian Tellis, chief of the division of transplant surgery at Montefiore Medical Center in New York City.

In addition, because numerous “combination” medications contain significant amounts of pain relievers mixed in with other active ingredients, consumers may end up taking many different brands at once.

“Often people take over-the-counter compounds for cold, cough, sinus problems, allergies, arthritis or other common conditions,” said Dr. Doris Cope, professor and vice chair for pain medicine at the University of Pittsburgh School of Medicine’s Department of Anesthesiology. “These proprietary medications, more often than not, already contain the maximum daily doses of acetaminophen, aspirin or ibuprofen.”

“When a patient then adds acetaminophen, aspirin or ibuprofen they will reach toxic doses without even realizing how much they have taken,” Cope said.

Alcohol is another factor that makes certain OTC drugs even more damaging to the liver. Though the danger of mixing alcohol with acetaminophen has been publicized in the past, many remain unaware of the danger.

“The risk of liver damage with Tylenol is significant, when taken in high doses and when mixed with alcohol,” Rajapaksa said. “Even in only slightly higher doses, Tylenol can cause liver damage in susceptible people. And Tylenol is the No. 1 cause of acute liver failure in the U.S.”

 Effect of FDA Regulations May Be Negligible

Even though the labeling guidelines proposed by the FDA will likely be applied to boxes and bottles, the impact of the warnings may not be enough to protect many consumers.

“It probably will have little impact on the patient since many do not read the label anyway,” Krenzelok said.

As for physician reaction to the labeling changes, Krenzelok said, “I do not think that it will change the prescribing habits of many physicians. Most probably have a degree of comfort with these meds.”

Some in the medical community, however, remain optimistic that the stronger labeling will have a positive effect.

“Physicians will continue to recommend these medications, but both the patient and the physician will become more aware of side effects,” Weinstock said. “They will stop these medications more readily if early signs of side effects develop.”

“Perhaps the most helpful aspect of the labeling change is the provision for all products containing these drugs to prominently display that characteristic on the label,” Juhl said.

“This should reduce the inadvertent overdosing that may occur when consumers take — or give to their kids — two or three products all of which contain acetaminophen or another NSAID.”

Renal Colic. (In Spanish)

http://homeopathyonline.org/Blogespanol/?p=732

Cólico Renal


Publicado por el Dr. José Guillermo Zamora de La PAz, Médico Cirujano UAG, Homeópata del Institute for Homeopathic Medicine, I.H.M Dhom (Lic.)

 

El día 02 de Febrero del 2012, fui llamado a las 3:00 am para atender a un paciente con un dolor intenso. Estando ya en la clínica, es traído por otras dos personas casi en peso, un paciente del sexo masculino de 66 años de edad, el cual refiere dolor intenso de 30 minutos de evolución, localizado en flanco derecho del abdomen y en región dorso-lumbar en el mismo lado y nivel. El paciente refiere que el dolor es como de un golpe, penetrante, el cual lo sofoca. Refiere constipación y deseos repentinos de defecar aunque no logra evacuar. Hace 20 minutos trató de defecar haciendo gran esfuerzo y evacuó solamente sangre (refiere que el agua de la taza del baño se tiñó de rojo). Menciona que el dolor mejora un poco cuando logra flatular y al semi-sentarse (Semifowler) y agrava acostado sobre la espalda (decúbito-dorsal). Refiere que desde el comienzo ha tenido mucha sed para lo que tomó bastante agua, la cual fue vomitada a los 15 o 20 minutos. No reportó síntomas urinarios. El paciente refiere lo siguiente: -“Los últimos 3 días, en mi empleo, he tenido que caminar mucho con lo que me había sentido muy agotado, quizá por tanto sudar”

 

Como antecedente de importancia refiere que hace 10 años presentó cuadro similar, el cual fue manejado alopáticamente con analgésicos, líquidos abundantes y dieta. El dolor fue casi constante durante días, mejorando sólo con los analgésicos. Al cabo de 2 semanas arrojó pequeño lito de aproximadamente 0.5 cm el cual fue enviado para su estudio. Refiere que le comentaron el lito era de Calcio.

 

A la exploración física se encuentra T/A: 170/100 mmHg; FC: 105 por minuto; FR: 25 por minuto; Temperatura: 37.0 grados C. Paciente consiente, inquieto, diaforético, quejándose de dolor intenso, pálido (+), deshidratado (+).

 

A la exploración abdominal se encuentra abdomen sensible, doloroso a la palpación superficial y media en flanco derecho. Peristalsis ausente, timpánico a la percusión. Se encuentra puño-percusión (y Giordano) positiva del lado derecho.

 

En aquel momento y dadas las circunstancias de la Urgencia médica procedí a realizar un análisis repertorial rápido seleccionando las siguientes rúbricas en el “P & W Synopsis en Español”.

Debemos tener en mente que las rúbricas son representaciones de síntomas y que como es el caso, las modalidades son los elementos que guardan la mayor precisión para que el síntoma sea consistente (Característico) y peculiar (Par. 153) para el paciente y para el remedio. De cualquier modo, presento la repertorización abajo, agregando la localización y otro síntoma concomitante para que se pueda observar que no se altera (aunque la mayor parte de los casos solo requieren 2-4 rúbricas. Eso hace al “P & W TPB  Synopsis” más exacto).

En ese momento administré una toma de Arnica montana 30c (L) la cual repetí cada 10 minutos. A la 4ta. toma el dolor había desaparecido casi completamente. Cité al paciente a la mañana siguiente. El paciente refiere que ha estado evacuando normalmente y sin hemorragia. El dolor ha desaparecido, por lo que dejo algunas repeticiones al día de la misma potencia y remedio durante una semana. A los 5 días, el paciente trae consigo pequeño lito, oval, NO espiculado sino más bien liso, de aproximadamente 0.5 cm de diámetro. Hasta el momento el paciente se encuentra bien.

 

Al hacer el diferencial en MMP encontramos lo siguiente:

150: Sequedad de boca con gran sed.

198: Violentas arcadas para vomitar

199: Vómitos.

210: Flatulencia con dolor de estómago.

228: Distención dura en el lado derecho del abdomen, duele cuando lo descansa sobre sí mismo, como un dolor interno, al toser, al sonarse,…Solamente aliviado por la descarga de flatos.

235: Dolor en el lado derecho del abdomen como por una contusión repentina al caminar (Desp. 36 h.) [Fz.]

249: Cólico flatulento.

257: Urgencia ineficaz para evacuar.

258: Gran urgencia para evacuar cada media hora pero nada sale excepto moco.

259: Evacuación difícil con dolor en el abdomen (desp. 36 h). [Hbg.]

261: Evacuaciones sanguinolentas.

268: Constipación.

 

Viene a mi mente el Parágrafo 6 del Organon 6ª. Edición el cual menciona:

“El observador desprovisto de prejuicios y bien consciente de la futilidad de las especulaciones trascendentales que no pueden ser confirmadas por la experiencia, ante cada caso individual de enfermedad toma nota exclusivamente -Mediante su facultad de penetración ejercitada al máximo –de los cambios en la salud de su cuerpo y de la mente (Fenómenos mórbidos, accidentes, síntomas) que pueden ser percibidos externamente por medio de los sentidos; es decir que él advierte solamente las desviaciones que partiendo del estado de salud anterior llevan hasta el individuo ahora enfermo, las que son sentidas por el mismo paciente, confirmadas por quienes viven con él y observadas por el médico. Todos estos signos perceptibles representan a la enfermedad en toda su extensión o sea que, en su conjunto, constituyen el verdadero cuadro y el único concebible, de la enfermedad.”

 

Advirtiendo lo anterior, tomando en cuenta lo que está presente en el caso, me doy cuenta de la utilidad, la rapidez y la eficacia que se puede desarrollar usando el método apropiadamente. Recordemos que la jerarquización de los síntomas de acuerdo a Boenninghausen no es la misma a la de Kent. Uno puede notar que en el caso de Boenninghausen no hay una sección para síntomas mentales dentro de la misma. Y no es que Boenninghausen no contemple los síntomas mentales, sino que ellos más bien son tomados en cuenta si se presentan como síntoma principal, o como síntomas concomitantes y/o caracterizadores desde la modalidad.