SMALLPOX AND HOMEOPATHIC MANAGEMENT

                                                                     SMALLPOX

DEFINITION:-

   Small pox is an acute infectious disease caused by a ‘variola major virus’ and characterized by an initial febrile movement (fever), severe pains in the back, vomiting and peculiar eruption which passes through the stage of papule, vesicle and pustule and secondary fever.

CAUSES AND SPREADS:-

-          The disease is mainly caused by variola major virus.

-          Small pox mostly affects children.

-          Spring season is the most favourable season.

-          Infection spreads by droplet infection, through direct contact with patients or through the agency of articles used by such patients.

-          The incubation period varies from 10-14 days.

PATHOLOGY:-

  After the incubation period, there is period when the virus multiplies in the blood (the prodromal stage). Thereafter, the eruptions appear and grow in a definite set pattern – macules, papules, vesicles, pustules and crust formation. The virus can actually be isolated from the vesicular fluid. The intracytoplasmic inclusion bodies are known as ‘guarnieri bodies’.

SYMPTOMS:-

The disease passes through several stages.

1.       PRODROMAL STAGE:-

-          During the stage, headache, body ache and fever (102-104 F) with sweating are present.

-          In children, convulsions or delirium may present.

-          A true rash appears on the 3^rd day.

-          With the appearance of true rash, the fever which had subsided earlier rises again.

2.       STAGE OF ERUPTIONS:-

-          The rash of small pox begins as a red patch (macule) which quickly (within 24 hours) changes into papule.

-          The papule is dark red in colour, flat and just raised above the surface.

-          After 3 days, the papule changes into vesicles which contains clear fluid and looks like a tiny blister.

-          After 2-3 days, the clear fluid inside a vesicle changes into pus and the vesicle converts into pustules. Each pustule surrounded by a zone of erythema.

-          In these conditions fever which had subside after appearance of rashes and fever reappears (secondary fever).

-          After the lapse of one week, the pustules dry up to form thick, dark crusts. The crusts fall off leaving behind pitted scars.

-          The rashes appear only on face, forearms and the legs. The axillae are free. They are deep seated, depressed at the centre looking like a felt-hat. On drying they leave behind permanent pitted scars.

3.       STAGE OF CONVALESCENCE:-

-          This period is prolonged. Since the crusts still contain the virus, the patient has to be kept in isolation till the crusts fall off.

-          Crusts in the soles and palms take more time to separate, usually several weeks.

COMPLICATIONS:-

-          Secondary infection of the pustules may cause boils, abscesses and bed sores.

-          Bronchopneumonia and pneumonia.

-          Corneal ulceration.

-          Otitis media.

-          Toxic myocarditis and peripheral circulatory failure.

-          Encephalomyelitis and encephalitis.

-          Laryngitis.

-          Dysentery

TREATMENT:-

-          The patient must be isolated and kept in bed till all the crusts have separated and all the scars have healed.

-          Particular care should be taken to prevent sepsis of the skin, mouth and eyes.

-          No specific treatment. Tetracycline orally or a combination of ampicillin and cloxacillin may help to prevent or cure any secondary infection.

-          Some successful vaccination available for preventive purpose.

-          The first vaccination should be given in infants between 3-6 months of age.

-          Diet must be liquid and nutritious like thunder coconut water, curd rice.

HOMEOPATHIC REMEDIES:-

1.       ANTIMONIUM CRUDUM:-

  Pimples, pustules, and boils on face. Yellow crusted eruption on cheeks and chin. Scaly, pustular eruption with burning and itching, worse at night. Pimples, vesicles, and pustules on face, thigh, legs. Thick, hard, honey-colored scabs. Intermittent fever with disgust, nausea, vomiting, eructations, coated tongue, diarrhoea.

2.       ANTIMONIUM TART:-

Given early it will reduce the fever, the pustules will run their normal course and leave very little or no pitting. Especially useful for pulmonary and gastric disturbances. Abortive power is claimed for it. Its the chief remedy in all stages of small pox.

3.       ARSENICUM ALBUM:-

For desperate case, the skin becomes blue, the eruption is hemorrhagic and dark. Great prostration, the pulse is small, thread like so called black smallpox. Itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Icy coldness of body. Delirium; worse after midnight.

4.       BELLADONNA:-

Preferred to aconite, by some for the initial fever. Congestion of head, throbbing carotids. Starts and jumps in his sleep and other well known symptoms of this drug. Erythema; pustules on face. Eruption like scarlatina, suddenly spreading.

5.       MERC SOUL:-

 Yellow colour of the skin, with perspiration which imparts a yellow colour to linen. Miliary, urticarial, pimpled, or pustular and purulent eruptions. For the suppurative fever. To be given as soon as pus appears in the eruption.

6.       RHUSTOXI:-

It is one of the best remedy for small pox. It works well in eruptive stage; the skin is inflamed with stinging, burning and itching. Invaluable, often modifies in considerable degree the cutaneous inflammation and thus favorably influencing the future of the case.

Some of other drugs are aconite, camphor, coffea, opium, stramonium,sarracenia, sulphur, thuja,vaccinium.