Announcement

Collapse
No announcement yet.

Leg ulcer

Collapse
X
  • Filter
  • Time
  • Show
Clear All
new posts

  • Leg ulcer

    Hello,
    I am a beginner homeopath and i really need some help with a case. I (and my patient) would appreciate it a lot!


    A woman 70 years of age has a leg ulcer that won't heal. It started with a scrach 3 years ago, and in the last year it has spread all around the leg, 12 cm wide! It is on the right lower leg. The way it spreads is that multiple blisters form, around the edge of the initial ulcer, filled with clear fluid, and when they break, raw skin is left. The ulcer is quite superficial, except on the starting place where it is a little bit deeped. Colour of the raw skin in the ulcer is red mixed with yellowish -white (i suppose that is what they called lardaceous base, but i'm not sure). In couple of places there is some growing flesh - proud flesh of red colour. She is in a lot of pain, she cries with the pain, and it is burning and sometimes pricking or pulsating. Tha pain is worse in the evening and when she goes to bed, till midnight. She is compelled to get up then and walk around or sit. She says neither hot nor cold feels good on it but if had to choose would prefer cold applications. There is a clear fluid oozing from the ulcer. There is not much of a smell. The edges are not swollen, the skin on the edge is hard and bluish-purple one cm in width, all around the ulcer.
    Her both legs are swollen with edema. She has problems with the circulation in her legs and her knees are cold. She doesnt have any other health problems, she is obese, hot person but not sweaty and good natured.


    Please let me know if you have any tips. I don't have much experience in treating leg ulcers. The books are not very detailed about them either (anybody knows any good books on them?). I also can't decide if I should treat it therapeutically or constitutionally? She is not the best patient to talk about her personality as she is an old, countryside woman that worked a lot all of her life and didn't have much time to think about it or just doesn't know how to explain things.

    Thanks a million

  • #2
    Probably a venous ulcer,as from the location and fast spreading.
    This may of deep venous insufficiency or superficial as in varicose ulcers, where you can observe varicosity. Also see whether the patient is diabetic.

    This is a chronic condition and needs prolonged treatment as they tend to reappear. So after the healing of ulcer you have to study case in whole extend and prescribe for the patient.

    Please study for Lachesis,Ars,Phos,Anthr,Syph,Sysig etc to cure the present condition.We can cure the acute state by correct prescription.

    What about the state of Homoeopathy in Croatia? about Homoeopathic education?

    regds,
    <a href="http://www.pannakkal.com" target="_blank">www.pannakkal.com</a>

    Comment


    • #3
      Thank you.
      I couldn't open this website for a few days for some reason.

      How do you know that it is varicose ulcer? How would i know it? Nobody ever tought me that. She doesn't have enlarged veins, or pain in legs because of veins, she doesn't have hemorrhoids and she is not diabetic. These are the first things i asked her.
      I talked to her daughter on the phone for a few minutes and asked her some questions, and it all confirmed my thinking - that she is a Calc type of person. I was thinking of giving her Sulph as it covers more the ulcer picture then Calc, and they are complementary.
      Also, Merc and Lach seem close.
      Anthr, Ars are better by warmth, she is worse.

      Maybe I sound a bit confused, but i don't have much experience with leg ulcers. I know they can be dangerous. I already gave some Echinacea to the lady while i am thinking about the case, to prevent sepsis, and help with bacteria. She has three bacteria, Staphyloccocus and two others.

      In Croatia there are not too many homeopaths, especially not in my town. There is a school that has english teachers, and it is a two year school.
      I graduated in an irish school, which lasted 4 years, and we didn't do much therapeutics, and hands on work with deep pathology cases. I eould like to come to India some day and learn a bit more about that. It seems that it is the best place to go to.

      Thanks a million

      Comment


      • #4
        I only wrote the probability. The ulcers are of many types and many tend to chronic and recurrent nature. By mere observation itself we can understand many things about ulcers. Look for the edge, base, type of granulations and colour of base,discharge,surroundings for pigmentations,any varicosities and age of the patient etc

        In case of leg ulcers there are many types. Venous ulcers, Arterial ulcer, Erythrocynoid ulcers,Gummatous ulcers, Martorell's ulcers, infective ulcers, Meleney's ulcers, Ulcers complicating various diseases,Tropical ulcers and yaws etc.

        Venous ulcers usually at the lower third of leg and medial side and shallow.Usually painless later, but at the begining there will be pain. Surrouding reddish discoloration, pigmentation are diagnostic. The varicosities may or may not be seen. In case of deep vein complaints there will be no varicosities.

        Arterail ulcer-due to poor circulation and seen in old people.It is deep ulcer and there may be discoloration of one or more toes.

        Martorell's ulcer or hypertensive ulcers- Old age group, severe pain, the region usually calf or back, deep and extending, severe pain is characteristic. Some times seen in both sides. Atherosclerosis is the reason. It will takes month to heel.

        Erythrocynoid ulcer-exclusively of young women.

        By diagnosis of case may not help in selection of our remedy but we can know the prognosis and the nature of diseaes.So disease knowledge is always helpful.
        No doubt for complete cure constituitional internal medication is a must.
        <a href="http://www.pannakkal.com" target="_blank">www.pannakkal.com</a>

        Comment


        • #5
          Leg ulcer

          Zina,
          This is a suggestion as One of my patient cured with Silicea and Tarentula.
          As per your posting
          She is in a lot of pain, she cries with the pain, and it is burning and sometimes pricking or pulsating. Tha pain is worse in the evening and when she goes to bed, till midnight.
          ........
          the skin on the edge is hard and bluish-purple
          which indicates Tarentula Cubensis.
          Clinical Case cured:
          A lady 5'1" height with obesity having ulceration in her thigh since last 4 years tried several medicines in Allopathy and was using external application of Neurobin powder with out any permanent improvement.
          When she approched me I found- clear fluid oozing from the ulcer,colour=pink + yellow,suppuration was there,no smell. I gave her one dose Silicea-200 followed with Sac.lac for a week.oozing of fluid reduced and the lady got relief of some pain.The colour of the edge changed to purple.I gave her one dose Tarentula Cubensis 12x followed with SL for one week.She reported that now she can sleep in the night without any trouble.SL continued for next three days when she complained about burning and stinging pain next dose of Tarentual Cubensis 12 x given followed with SL for one week.The wound healed magically turning the skin normal.
          So plz go through the case again and note down the peculiarity of symptoms to find out the remedy that will help you to cure the case.
          Hope to hear progress from you.
          Dr.S.K.Pattnaik,HMD,M.D(Alt.Med),Ph.D
          Chairman,Indian Council for Holistic Health Care
          http://ichhc.tripod.com/
          http://holistichealing.forumup.in
          http://drskp.weebly.com/

          Comment


          • #6
            Thank you both,

            Actually on her diagnosis sheet from her doctor it says Ulcer cruris. Cruris is leg, right? So it doesn't say much, but i am thinking if it was varicose it would probably say so, but i am not sure? What do you think? I think it is important to know if it is varicose or not as the remedy should have the affinity to it.

            Of course constitutional treatment is necessary. I know.

            Some people have suggested Arnica for circulatory problem ulcers like this one. What is your thought on that?

            I will also have a look at Tarentula, thank you. That case does sound a lot like mine. Was the ulcer deep or shallow, and was it spreading by itchy blisters?

            Comment


            • #7
              reply

              Dear Zina
              Yes const. presc. is best then follow up with a nosode then back to const. to finish it off.......................(you did mention staph infection)

              THis is only my suggestion

              Gina Tyler

              Comment


              • #8
                The ulcer may be of infective type.
                Usually the ulcer may be in three stages.
                1.Spreading 2.Healing 3.Callous
                Here the ulcer has thick edge with bluish surrouding. It means it is in Callous stage and no tendancy to heal. For correct prognosis and to know whether the ulcer is towards healing or worse, you have to observe the base,edge,surroudings,granulations etc.
                After relief of present crisis you have to go for anti miasmatic treatment.
                Night<,rest<,watery discharge etc clearly shows miasmatic tendancy.
                <a href="http://www.pannakkal.com" target="_blank">www.pannakkal.com</a>

                Comment


                • #9
                  Sorry, what do you mean by "the edge is thick"? Do you mean elevated? It is not elevated, it is the same height as the rest of the skin...

                  Comment


                  • #10
                    Originally posted by Zina
                    Sorry, what do you mean by "the edge is thick"? Do you mean elevated? It is not elevated, it is the same height as the rest of the skin...
                    You wrote:

                    < what do you mean by "the edge is thick"? Do you mean elevated? >
                    Why do you ask that question, Zina ? Or rather,what was in your mind when you asked the second question ? This trend of thoughts is relevant in view of the chronicity of the ulcer.


                    With regards
                    Lew

                    Comment


                    • #11
                      The patho-physiological basis of stasis ulcer due to lymphatic obstruction.

                      Originally posted by Zina
                      Thank you.
                      I couldn't open this website for a few days for some reason.

                      How do you know that it is varicose ulcer? How would i know it? Nobody ever tought me that. She doesn't have enlarged veins, or pain in legs because of veins, she doesn't have hemorrhoids and she is not diabetic. These are the first things i asked her.
                      I talked to her daughter on the phone for a few minutes and asked her some questions, and it all confirmed my thinking - that she is a Calc type of person. I was thinking of giving her Sulph as it covers more the ulcer picture then Calc, and they are complementary.
                      Also, Merc and Lach seem close.
                      Anthr, Ars are better by warmth, she is worse.

                      Maybe I sound a bit confused, but i don't have much experience with leg ulcers. I know they can be dangerous. I already gave some Echinacea to the lady while i am thinking about the case, to prevent sepsis, and help with bacteria. She has three bacteria, Staphyloccocus and two others.

                      In Croatia there are not too many homeopaths, especially not in my town. There is a school that has english teachers, and it is a two year school.
                      I graduated in an irish school, which lasted 4 years, and we didn't do much therapeutics, and hands on work with deep pathology cases. I eould like to come to India some day and learn a bit more about that. It seems that it is the best place to go to.

                      Thanks a million
                      You wrote:

                      < I already gave some Echinacea to the lady while i am thinking about the case, to prevent sepsis, and help with bacteria. She has three bacteria, Staphyloccocus and two others. >
                      Where was the pathological sampling taken:

                      From 1. The ulcer's discharge ?
                      2. Blood ?
                      3. Urine ?

                      Are there any palpable lymph nodes in the groins ? These may be enlarged and tender when there is an ongoing process of infection in the areas of their drainage ( legs and the pelvis notably ) . Is there any obstetric or gynecological history of note given by this patient ? Any intra-pelvic infection or her reproductive system may lead to lymphatic obstruction by the enlarged intra-abdominal and pelvic lymph nodes which hinder the lymphatic drainage and irrigation of her lower limbs thus causing the swelling of her legs with stasis ulceration. The compression by the oedema on the micro-circulation of the lower limbs causes pain ,tingling and sometimes numbness due to cellular malnutrition and under oxygenation with accumulation of toxic metabolites.
                      In Hahnemann 's Organon In The Art Of Healing, # 119 implies the knowledge of properties of Plants and its mineral constituents with their patho-physiological provings in human subjects and their homeopathic application.

                      With regards
                      Lew

                      Comment


                      • #12
                        In your first message it was written that the edge is hard and surrounded by pigmentation. If so it means it is 'callous' and not towards healing.
                        <a href="http://www.pannakkal.com" target="_blank">www.pannakkal.com</a>

                        Comment


                        • #13
                          Reply

                          zina,
                          Yes the ulcer was deep and spreaded with itchy blisters.As per the patient it was more itchy in night.
                          Dr.S.K.Pattnaik,HMD,M.D(Alt.Med),Ph.D
                          Chairman,Indian Council for Holistic Health Care
                          http://ichhc.tripod.com/
                          http://holistichealing.forumup.in
                          http://drskp.weebly.com/

                          Comment


                          • #14
                            &quot;Disease gets well from within out.&quot;

                            Originally posted by drskp
                            zina,
                            Yes the ulcer was deep and spreaded with itchy blisters.As per the patient it was more itchy in night.
                            Greetings

                            The theory of psora grew out of Hahnemann's efforts to understand and cure the tedious diseases common to humanity by examining humanity's common experiences in the 'light of unprejudiced observation. Nothing was assumed. A multitude of common facts, regarding life, health and disease, were observed and tabulated relating to the experience of many chronically sick persons. Guided by these facts an understanding of chronic sickness was gained and a method of cure for chronic sickness was discovered.
                            The skin, in addition to being a protective covering for the body, is an external vital excretory organ. It participates, in the vital activities of the internal organs. Its health is conditioned on the health of the internal organism. In turn the health of the organism is influenced by the state of function of the skin. A healthy skin on an unhealthy organism is inconceivable. And an unkept infected skin menaces the health of the organism. The skin is the only vital organ over which immediate care and attention can be exercised.

                            Infection may gain entrance to the internal organism through skin abrasions. And that is the route by which chronic sickness invades the organism. Chronic sickness comes to the skin to be eliminated in eruptions. Any interference with these eruptions interrupts the progress of the cure. A permanent suppression of the eruptions affects the internal organism with a permanent internal malady. Destroying the local manifestation does not drive the disease in, but does compel the disease to develop internal symptoms and manifestations. A malady so manifesting itself is incurable till the symptoms and manifestations can again become local. This can be accomplished only by homoeopathic art, by the restoration of the eruption to its place on the skin. This fact gives rise to the formula "Disease gets well from within out." Without the restoration of its primary lesion,no chronic sicknes is ever healed.

                            The primary lesion of psora is an itching eruption. Itch is a primary skin pathology and was at the time of the development of the theory of psora a common human experience and the common treatment of it was suppressive. Besides his own observation of instances of internal diseased states following the suppression of the itch eruption ,Hahnemann reports recorded observations of one hundred different doctors. These doctors also noted that the internal disease was healed, only if the eruptions were restored to their place on the skin.

                            Is it possible that one hundred doctors were mistaken ? Hundreds of doctors in the past one hundred years have made similar observations. The discovery of the itch mite, as the exciting cause of itch, occasioned opposition to the theory of psora, but never discredited it in the minds of those who had employed their knowledge of psora to cure chronic sickneas. One of the tragedies of science is the destruction of an old theory by a new fact but the newer fact that the mosquito carries malaria and the tsetse fly carries sleeping sickness may yet lend credence to the idea that the itch mite carries a chronic miasm. Itch is an experience from which the race has escaped only through improved conditions of living. But the race has not yet recovered from the consequences of bad conditions of living through thousands of generations. Moreover the principles of sickness applied to psora can be observed operating in any acute disease having an eruption as a part of its symptom complex. Whatever criticism may be launched against the theory of psora the remedy psorinum should silence it when it is used strictly in accordance with the law of cure. Homoeopathy has always flung out its challenge, "Test its principles and its methods and publish the failures."

                            Psora does not comprehend all non-venereal chronic sickness. It does not include occupational, deficiency, medicinal, unhygenic disturbances produced by their own peculiar causes. Psora is in a class by itself just as is syphilis. Psora sets up a condition of suboxidation inducing what is called the carbo-nitrogenoid state, a metabolism in which elimination is deficient. It perverts organ function made manifest in a multitude of symptoms present in those tedious states of sickness whose name is legion and whose cure can be accomplished by the restoration of eruptions that have been suppressed in millions of individuals through countless generations.
                            Research on memory has revealed a curious phenomenon known as State Dependent Learning. We are
                            slightly more likely to recall information learned in a particular environment or context when we are back in the context in which it was learned in the first place. It has been experimentally demonstrated thst deep-sea divers find it earier to remeber facts learned underwater when they are underwater again and one is slightly more likely to remember information acquired while drunk when drunk again.

                            With regards
                            Lew

                            Comment


                            • #15
                              I gave her Merc 30 in water plussing daily, a week ago.

                              I just talked to her on the phone (I am in another country at the moment). These are the changes: less pain at night, some nights she doesn't have any pain, some she still has but less. She doesn't have to get up and walk around because of it.

                              She thinks the swelling of the leg is more pronounced, and that it is more purple. The edge of the ulcer is now swollen as well and sensitive to pressure. The edge is burning (sometimes more sometimes less), it is better for cold application. She has pricking pains under the ulcer, on her leg just above her ankle. She has more proud flesh (she thinks, not sure), and a little bit more bleeding on an area big as a coin. She sees a bit of blood on her bandage when she takes it off, only some days.
                              She says when she has pain in the ulcer her whole body gets cold (she had that before as well, and less now that the ulcer is less painful).

                              So, I'm thinking - if it was more syphilitic before (night pains), now it is more sycotic. That is a good sign, isn't it? Would you agree? So am i suppose to tell her to keep taking Merc and call her every few days or change the remedy? Lach or something.

                              What do others think?

                              Thanks

                              Comment

                              Working...
                              X