ALOPECIA OR HAIRFALL OR BALDNESS AND HOMEOPATHIC MANAGEMENT

                                                                 ALOPECIA

                The term alopecia or hair fall, baldness means loss of hair. Partial loss of hair is common during old age (senile baldness). However, loss of hair in younger persons is pathological. The aetiology remains unknown.

                Probable factors likely to cause alopecia can generally be divided into three broad groups.

a.       DESTRUCTION OF THE HAIR FOLLICLES:-

      Alopecia is due to atrophy, scarring or disuse of the hair follicles. Causes under this group are generally known and include physical or chemical injury, inflammatory conditions of the scalp and local or systemic dermatoses.

b.      DYSFUNCTION OF THE HAIR FOLLICLES-

      There is no destruction of the hair follicles and in fact, no local or systemic disease to account for the loss of hair. The cause remains unknown and may possibly include such factors as heredity, auto immune damage and psychic trauma.

c.       FRACTURE OF THE HAIR FIBRES:-

      In this group of cases, the hair is coarse, brittle and lustureless and easily break away from the roots leaving behind tiny, little stumps (so called fracture of hair fibres). Some of known causes include frequent trauma, use of irritant chemicals and infective conditions of the scalp. Unexplained causes may possibly include hereditary factors, metabolic influences and autoimmune damage.

 CAUSES OR AETIOLOGY:-

                The following factors have been directly or indirectly held responsible for the causation of alopecia or hair fall.

-          HEREDITY – a family history of baldness is present in majority of the cases.

-          AUTO IMMUNE DAMAGE- loss of hair due to follicular dysfunction (e.g. alopecia areata) may be caused by autoimmune damage. Baldness is frequently associated with thyroditis, diabetes mellitus or others.

-          DAMAGE CAUSED BY PHYSICAL TRAUMA- trauma caused by the use of tight curlers, frequent combing or massage may initiate or precipitate baldness.

-          DAMAGE CAUSED BY PHYSICAL AGENTS- alopecia may follow x-ray irradiation or burns.

-          DAMAGE CAUSED BY CHEMICAL AGENTS- irritation caused by the use of irritant soap, shampoo, hair spray or hair dye.

-          EMOTIONAL STRESS- stress is decidedly an important cause of baldness.

-          NUTRITIONAL FACTORS- deficiency of protein or that of vitamins or minerals, particularly the trace elements (copper, zinc, manganese).

-          ENDOCRINAL CAUSES- deficiency of oestrogen or that of the thyroid hormones. Alopecia following pregnancy or childbirth.

-          ASSOCIATED WITH CERTAIN SYSTEMIC DISORDERS- anaemia, leukemia, diabetes mellitus, tuberculosis, carcinoma or lymphoma. Loss of hair may follow an acute illness such as typhoid fever, pneumonia, measles, small pox, viral hepatitis and several other such conditions.

-          SECONDARY TO CERTAIN SKIN DISEASES- a number of skin diseases are known to cause baldness. Dandruff, seborrhoeic dermatitis, tinea capitis, folliculitis, syphilis, leprosy, herpes zoster, lupus vulgaris, vitiligo and scleroderma.

-          FOLLOWING USE OF CERTAIN DRUGS – drugs such as thalium, nitrogen mustard, cyclophosphamide, tranquillisers and weight reducing agents are known to cause or precipitate baldness.

-          IDIOPATHIC – the fact remains that all the above mentioned causes put together may not be able to account for all cases of baldness. Unfortunately, in a majority of the cases, the cause remains unknown.

TYPES:-

                 Clinically, there are four types of baldness

1.       MALE TYPE BALDNESS.

-          This is the commonest type of alopecia and occurs in adult males.

-          Baldness occurs over the temples and the vertex in a typical v- shaped fasion.

-          Surprisingly, hair follicles are present over the affected area but are unable to grow hair.

-          Regrowth of hair over the affected area is not possible.

2.       ALOPECIA AREATA (ALOPECIA CIRCUMSCRIPTA).

-          This is a type of baldness that occurs in younger people.

-          Cause is unknown.

-          Heredity, emotional, hormonal disturbance and presence of a septic focus are factors suspected.

-          Circular patches of baldness appear over the scalp, beard area, eyebrows or other parts of the body.

-          The patch is smooth and shiny with no evidence of any inflammatory reaction.

-          The extent of a patch may increase subsequently or a few smaller patches, any coalesce to form bigger patches.

-          Patches may appear suddenly (even overnight) or appear slowly over a period of weeks, months or years.

3.       ALOPECIA TOTALIS.

-          The scalp is totally bald.

4.       ALOPECIA UNIVERSALIS.

-          The whole body is devoid of hair.

-          No hairs on scalp and body.

TREATMENT:-

-          Prednisolone `given orally (15-20 mg daily) may be useful.

-          Hair transplantation.

-          Keeping wig on scalp.

-          Apply coconut oil daily.

-          Have highly rich in vitamins, proteins, iron etc.

-          Fish.

-          Avoid night watching, stress.

HOMEOPATHIC TREATMENT:-

1.       AURUM METALICUM.

2.       CARBO VEG.

3.       FLOURIC ACID.

4.       GRAPHITIS.

5.       KALI CARB.

6.       KALI SULPH.

7.       LACHESIS.

8.       LYCOPODIUM.

9.       NATRUM MUR.

10.   NITRIC ACID.

11.   PHOSPHOROUS.

12.   SEPIA.

13.   SILICEA.

14.   SULPHUR.

15.   THUJA.

16.   ACID PHOS.

17.   ALUMINA.

18.   VINCA MINOR.

DRUGS FOR ALOPECIA AERATA:-

1.       APIS MELLIFICA.

2.       ARSENICUM ALBUM.

3.       CALCAREA CARB.

4.       CANTHARIS.

5.       FLOURIC ACID.

6.       HEPAR SULPH.

7.       IODUM.

8.       PHOSPHOROUS.

9.       PSORINUM.

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ACNE VULGARIS AND HOMEOPATHIC MANAGEMENT

                                                                ACNE VULGARIS

DEFINITION:-

                Acne vulgaris or pimple is a chronic inflammatory disease of the pilosebaceous apparatus. It occurs in the areas where sebaceous glands are large and numerous such as the face, chest, back and the shoulders. Face is by far, the commonest site.

AETIOLOGY OR CAUSES:-

-          It occurs mostly in young adolescents of either sex during puberty.

-          It is said to be due to an imbalance between the male and female sex hormones that is likely to occur at this age.

-          Over sensitivity of the sebaceous apparatus to androgens leading to excessive secretion of sebum may be possible factor.

-          The disease is possibly familial or genetic.

-          Presence of septic focus.

-          Greasy skin.

-          Constipation.

-          Menstrual irregularities.

-          Continuous changing of soaps and creams.

PATHOLOGY BEHIND ACNE:-

                The basic pathology is that there is hyper secretion of sebum and blockage of the orifices of the sebaceous glands by unusual deposition of lipid and keratin. Keratin plugs that block the orifices of the ducts are called “comedones”. A comedone is blackish in colour (hence the popular name black head) due to subsequent oxidation of the keratin plug. Excessive secretion of sebum along with blocking of the ducts favour secondary growth of propionibacterium acnes which in turn, accentuates the inflammatory process. The caputure sebum subsequently escapes in the surrounding tissues and sets up a foreign body reaction leading to the formation of the papules. At this stage, the lesion may heal completely but more commonly, there is added secondary infection either streptococcus or staphylococcus. This further accentuates the process and leads to formation of pustules, nodules or cysts. Healing subsequently occurs but the area is left with pits, scars or even keloids. The disease is essentially a chronic and lingering condition. Activity continues with involvement of fresh areas whereas healing occurs in the old areas.

SYMPTOMS:-

-          The presence of papules with typical blackish spread heads (comedones).

-          The papules subsequently change into pustules with discharge of sebum.

-          Over lying skin is greasy ad dusky red in colour.

-          Pimples sometimes very painfull and leaves scar marks on body.

-          Acne mainly occurs in face, back, scalp and shoulders.

TREATMENT:-

-          The face should be regularly washed with soap and the area of skin should be kept nongreasy and dry.

-          Calamine lotion with 2% sulphur ointment.

-          Zinc sulphade lotion is also useful.

-          Food items such as chocolates, pastries, creams, butter and eggs should be avoided.

HOMEOPATHIC TREATMENT:-

1.       AURUM METALICUM.

2.       CALCAREA SILICATA.

3.       CARBO ANIMALIS.

4.       CAUSTICUM.

5.       HEPAR SULPH.

6.       KALI BROM.

7.       NUX VOMICA.

8.       SEPIA.

9.       SILICEA.

10.   ARSENICUM ALBUM.

11.   CONIUM.

12.   KREOSOTUM.

13.   LACHESIS.

14.   NATRUM MUR.

15.   NITRIC ACID.

16.   PHOSPHORIC ACID.

17.   PULSATILLA.

18.   SULPHUR.

19.   THUJA.

SCHIZOPHRENIA AND ITS HOMEOPATHIC MANAGEMENT

`                                                                  SCHIZOPHRENIA

DEFINITION:-

                Schizophrenia literally means “SPLIT” personality. It would be more appropriate to call it a split from reality. Actually the patient withdraws himself from reality and lives in a world of his own, full of false beliefs (delusions which cannot be corrected by reasoning or logic) and has false perceptions (hallucinations, sensory experiences mostly auditory which are non-existent) without any obvious stimulus.

AETIOLOGY OR CAUSES:-

                In western countries, schizophrenia is a common mental condition, atleast half of the beds in any mental hospital are occupied by schizophrenia. The aetiology remains unknown. There are a number of speculations as regards its causation.

-          GENETIC FACTORS:-

It is generally accepted that heredity does play a decisive role in its causation. The cold, introvert dreamy eccentric who is oversensitive or suspicious and is unable to deal with the odds of life is the man who is likely to be affected.

-          PSCHOLOGICAL STRESS AND ENVIRONMENT:-

As stated above, any psychological stress is likely to precipitate schizophrenia in a person, strained family or social relationship may similarly act as a precipitating factor.

-          BIOCHEMICAL FACTORS:-

There is possibly an over activity of the dopaminergic neurotransmitter substance in the mesolimbic and mesocortical areas. Drugs that stimulate dopamine receptors in the CNS (e.g. L-dopa and amphetamine) are likely to precipitate schizophrenia. Existence of an abnormal transmitter substance, possibly hallucinogenic in nature, has also been suspected.

-          CEREBRAL DAMAGE:-

Schizophrenia evidences of nonspecific type of atrophic changes in the brain (as deduced from enlargement of the ventricles) have been detected by CT scan. Schizophrenia like syndrome may be associated with such CNS disorders as cerebral tumor, demyelinating diseases, temporal lobe epilepsy and Huntington’s chorea. Role of an unknown virus has been suspected.

SYMPTOMS:-

                The following features are commonly present.

1.       A decreasing interest in the outside world.

2.       An increasing interest in himself – own thoughts, bodily symptoms and the past.

3.       Thinking in “own terms” (autistic thinking) – the thoughts are however, aimless, illogical and inconsistent. His thoughts are bizarre, irrational and jumbled up.

4.       Talking in “own terms”- he may talk and talk and talk on any topic whatsoever although his talk has no meaning or correlation with facts. He may write (and write enthusiastically with a sense of command on the subject) long letters or long essays on a wide variety of topics ranging from philosophy to sexology, often with no meaning.

5.       Showing flatness of emotions – he may quickly listen about the death of a near relative or a close friend and respond with a smile or shrugging of shoulders and does not seem to bother about it. On the contrary, he may start sobbing or crying or even turn violent on a trifle thing like loss of a pen or a match box.

6.       Exhibiting impulsive and inconsistent behavior and mannerisms.

7.       Living a life of fantasy full of hallucinations, delusions (usually of bizarre types) and false perceptions.

8.       Prominent feature of schizophrenia is recurrent remissions and relapses. During a period of remission, the patient behaves and lives like a normal man. A relapse is, however, bound to occur sooner or later.

TYPES:-

a.       SIMPLE TYPE:-

The patient lacks feeling for any emotion such as sadness or grief, joy or compassion, love or hate. he is dull, withdrawn, inactive and wishes to live alone.

b.      PARANOID TYPE:-

The patient has delusions (or false beliefs). He is egoistic, argumentative and aggressive due to delusion of grandeur – the feeling of being important.

c.       HEBEPHRENIC TYPE:-

Disorder of thought is the predominant symptoms. Thoughts are confused and the behavior is purposeless or silly. The speech is irrational and mannerisms are present. This type of schizophrenia is more common in males in the early thirties age. The patient gradually becomes depressed, dull and apathetic, losing all interest in the surroundings.

d.      CATATONIC TYPE:-

It is characterized by gross disorders of motor behavior (such as bizarre postures and activities of a madman) or terrific excitement alternating with periods of complete inactivity withdrawal or ever stupor. A peculiar type of muscular rigidity is often present. This is the commonest type of schizophrenia seen in India.

TREATMENT:-

1.       Antipsychotic drugs:-

-          Phenothiazine group of drugs are of great value and provide the first line of treatment.

-          Chlorpromazine (100-1500 mg daily) or thioridazine (50-500 mg daily) is used initially (either IM or orally).

-          Trifluperazine (5-30mg daily) may be tried in cases associated with hallucinations.

-          ECT may be helpful only in cases associated with depression.

2.       Psychotherapy and occupational therapy.

3.       Surgical treatment.

HOMEOPATHIC TREATMENT:-

1.       ANACARDIUM:-

Hallucinations; thinks he is possessed of two persons or wills. Syphilitic patients often suffer with these conditions. Anxiety when walking, as if pursued. Profound melancholy and hypochondriasis, with tendency to use violent language. Impaired memory. Absent mindedness. Malicious; seems bent on wickedness. Lack of confidence in himself or others. Suspicious [Hyos.]. Clairaudient, hears voices far away or of the dead.

2.       AURUM METALICUM:-

Feeling of self-condemnation and utter worthlessness. Profound despondency, with increased blood pressure, with thorough disgust of life, and thoughts of suicide. Great fear of death. Peevish and vehement at least contradiction. Anthropophobia. Mental derangements. Constant rapid questioning without waiting for reply. Cannot do things fast enough. Over sensitiveness; [Staph.] to noise, excitement, confusion.

3.       KALI BROMATUM:-

Profound, melancholic delusion; feeling of moral deficiency; religious depression; delusions of conspiracies against him. Imagines he is singled out as an object of divine wrath. Loss of memory. Must do something-move about; gets fidgety. [Tarant.]. Amnesic aphasia; can pronounce any word told, but cannot speak otherwise. Active delirium. Horrid illusions. Night terrors. General failure of mental power, loss of memory, melancholia, anaesthesia of the mucus membranes, especially of eyes, throat, and skin; acne; loss of sexual desire, paralysis.

4.       LACHESIS:-

Sad in the morning; no desire to mix with the world. Mental labor best performed at night. Great loquacity. Suspicious; nightly delusion of fire. Religious insanity. [Verat.; Stram.]. Derangement of the time sense. Restless and uneasy; does not wish to attend to business; wants to be off somewhere all the time. Jealous. [Hyos.].

5.       STRAMONIUM:-

Devout, earnest, beseeching and ceaseless talking. Loquacious, garrulous, laughing, singing, swearing, praying, rhyming. Sees ghosts, hears voices, talks with spirits. Rapid changes from joy to sadness. Delusions about his identity; thinks himself tall, double, a part missing. Cannot bear solitude or darkness; must have light and company. Sight of water or anything glittering brings on spasms. Delirium, with desire to escape. [Bell. Bry; Rhus.]. Religious mania.

6.       HYOSCYAMUS:-

It is as if some diabolical force took possession of the brain and prevented its functions. Very suspicious. Talkative, obscene, lascivious mania, uncovers body; jealous, foolish. Great hilarity; inclined to laugh at everything. Delirium, with attempt to run away. Low, muttering speech; constant carphologia, deep stupor.

7.       BELLADONNA:-

Patient lives in a world of his own, engrossed by specters and visions and oblivious to surrounding realities. While the retina is insensible to actual objects, a host of visual

Hallucinations throng about him and come to him from within. He is acutely alive and crazed by a flood of subjective visual impressions and fantastic illusions. Hallucinations; sees monsters, hideous faces. Delirium; frightful images; furious; rages, bites, strikes; desire to escape. Loss of consciousness. Perversity, with tears. Changeableness. Disinclined to talk.

8.       CHINA OFFICINALIS:-

Discontent; the patient deems himself unfortunate, and ill-used by the whole world. Great abundance of ideas, and of projects, with slow progress of thought (especially in the evening and at night). Fear of dogs and of other animals, especially at night. Excessive irascibility, with pusillanimity, and inability to bear the least noise. Disobedience. Hypochondriacal dejection. Apathy and moral insensibility.

9.       COCAINA:-

Talkative. Constant desire to do something great, to undertake vast feats of strength. Frightful persecutory hallucinations; sees and feels bugs and worms. Personal appearance neglected. Thinks he hears unpleasant remarks about himself. Hallucinations of hearing. Insomnia. Cerebral activity. Moral sense blunted.

Some of other drugs for schizophrenia are ignitia, nux vomica, rhus toxi, sulphur, zincum met, veratrum album, silicea, opium, lycopodium and helliborus.

OBSESSIVE COMPULSIVE DISORDER (OCD) AND HOMEOPATHIC MANAGEMENT

                                                     OBSESSIVE COMPULSIVE DISORDER

DEFINITION:-

  An obsession is a persistently recurring thought which the patient himself realizes to be foolish or absurd, yet he cannot get rid of it. Compulsive means something which one is forced to do even against his will. Obsessive compulsive neurosis is a psychoneurotic state comprising either of an obsessive compulsive thought or an obsessive compulsive act. The thought is either absurd or painful (e.g. baseless fears). The physical act is either simple or harmless (e.g. washing hands again and again for the fear of dirt or disease) or immoral and antisocial (e.g. urge to abuse anybody).

AETIOLOGY OR CAUSES:-

 An obsessive character may be inherited. It may also be acquired during childhood as a result of rigid codes of conduct enforced by unscrupulous parents on a young growing child.

Such a child learns to be rigid and perfectionist in his doings. So as to come up to the expectations of his parents. Simultaneously he develops an equally strong desire to resist this tendency.

Anxiety about health and un known fear about disease.

SYMPTOMS:-

-          Symptoms may appear even during childhood or during the period of adolescence.

-          The affected person is usually a hard working, dead honest, neat and tidy individual who always to surpass others in all spheres of activities.

-          In his attempts to overdo things, he becomes suspicious and undecisive.

-          In order to attain perfection he does a particular work again and again and becomes a victim of OCD.

-          Phobias (unusual fears).

-          Ruminations (i.e. the practice of meddling over a problem again and again).

-          Impulses (e.g. arranging some objects again and again, abusing or beating people or even murmuring at off springs).

-          Such a patient is beset with great anxiety and tension and may even be agitated.

DIAGNOSIS:-

-          Recognition of an obsessional characteristic associated with a feeling of compulsion is not difficult. The hallmark of the condition is that the patient himself realizes and resists these feelings but is helpless.

-          Thus, he always remains in touch with reality. Obsessional symptoms may be present in other mental conditions but in obsessive neurosis, it is the dominant feature and the patient is well aware of it and even tries to resist it.

TREATMENT:-

-          Psychotherapy is the only effective form of treatment, particularly when begun early.

-          Behavior therapy may be tried but results are generally poor.

-          Antidepressants may be tried when depression is coexistent.

HOMEOPATHIC TREATMENT:-

1.       ARSENIC ALBUM:-

Among these the all-prevailing debility, exhaustion, and restlessness, with nightly aggravation, are most important. Great anguish and restlessness. Fears, of death, of being left alone. Thinks it useless to take medicine. Changes place continually. Chilly patient, anxiety about health, fastidious, avarice, neat and clean peoples.

2.       ANACARDIUM:-

Fixed ideas. Suspicious [Hyos.]. Very easily offended. Absent mindedness. Profound melancholy and hypochondriasis, with tendency to use violent language. Hallucinations; thinks he is possessed of two persons or wills. Anxiety when walking, as if pursued. Lack of confidence in himself or others. Clairaudient, hears voices far away or of the dead.

3.       ARGENTUM NITRICUM:-

In this drug the neurotic effects are very marked, many brain and spinal symptoms presenting; themselves which give certain indications for its homoeopathic employment. Fearful and nervous; impulse to jump out of window. Time passes slowly. [Cann. ind.]. Fears and anxieties and hidden irrational motives for actions. Impulsive; wants to do things in a hurry. [Lilium.]. Thinks his understanding will and must fail.

4.       HYOSCYAMUS:-

Disturbs the nervous system profoundly. Very talkative, and persists in stripping herself, or uncovering genitals. Very suspicious. Talkative, obscene, lascivious mania, uncovers body; jealous, foolish. Great hilarity; inclined to laugh at everything. Delirium, with attempt to run away. Low, muttering speech; constant carphologia, deep stupor.

5.       MEDORRHINUM:-

Great disturbance and irritability of nervous system. Loses the thread of conversation. Time passes too slowly. [Cannab. ind.; Arg. n.]. Hopeless of recovery. Fears going insane. [Mancinella.]. Fear in the dark and of some one behind her. Melancholy, with suicidal thoughts.

6.       NATRUM MURATICUM:-

Psychic causes of disease; ill effects of grief, fright, anger, etc. Depressed, particularly in chronic diseases. Consolation aggravates. Irritable; gets into a passion about trifles. Wants to be alone to cry. Ocd, headache < sun, animal lovers, hot patient, desires salt items, salt.

7.       PLATINA:-

Is pre-eminently a woman's remedy. Irresistible impulse to kill. Self-exaltation; contempt for others. Arrogant, proud. Everything seems changed. Mental trouble pressed menses. Dominates his own husband or male groups, hot patient, haughty peoples. Physical symptoms disappear as mental symptoms develop.

8.       VERATRUM ALBUM:-

Melancholy, with stupor and mania. Sits in a stupid manner; notices nothing; Sullen indifference. Puerperal mania. Aimless wandering from home. Mania, with desire to cut and tear things. [Tarant.]. Attacks of pain, with delirium driving to madness. Cursing, howling all night.

Some of other drugs for obsessive compulsive disorders are calc carb, carcinosin, natrum sulph, ignitia, silicea, staphysagria and thuja.

BELL'S PALSY AND HOMEOPATHIC MANAGEMENT

                                                                     BELL’S PALSY

DEFINITION:-

 Bell’s palsy or facial paralysis (named after Sir Charles bell who first described it) is a condition characterized by isolated lower motor neuron paralysis of the facial nerve affecting one complete half of the face. Bell’s palsy is perhaps the commonest neurological condition in this country.

AETIOLOGY:-

-          The cause is remain unknown, but some of predisposing factors can cause.

-          Due to a viral infection resulting in swelling and compression of the inside the facial canal with consequent loss of function.

-          Axonal degeneration may occur later.

-          Due to stress and tension.

-          Infraction in facial nerve or any blocks in facial nerves.

-          Sometimes due to over usage of alcohol and drugs can leads facial palsy.

SYMPTOMS:-

-          The onset is sudden. Dull aching pain may be felt in the mastoid region.

-          Paralyses of one complete half of the face resulting in facial asymmetry.

-          Affected side of the face looks flat with absence of the nasolabial fold and wrinkles over the forehead.

-          The eye on the affected side cannot be closed and on attempting to close the eye, the eyeball rolls upwards and outwards (bell’s phenomenon).

-          The cheek on the affected side cannot be blown and the patient is unable to whistle. On attempting to show the teeth, the mouth is drawn towards the healthy side.

-          The ocular fissure is wider on the affected side due to weakness of the orbicularis oculi. On the attempting to raise the eye brows, the affected side of the forehead remains smooth and flat while wrinkles are present on the healthy side.

-          Tears roll down the eye and saliva trickles down the angle of mouth of the affected side. Food may collect inside the cheek while eating.

-          Although the affected side of the face may feel numbness, there is no objective sensory loss. Loss of sense of the taste over the anterior two-thirds of the tongue on the affected side and excessive response to sound on the affected side.

TREATMENT:-

-          The drug choice is prednisolone (20 mg daily) for about the week and then tapered off gradually.

-          Ibuprofen (400mg twice in day) is also useful.

-          Physiotherapy should be started early but fatigue of muscles should be avoided.

-          The patient should attempt to blow the cheek, close the eye and corrugate the forehead on the affected side.

-          Surgical decompression of the facial nerve may be tried if the affected muscles fail to recover by the end of the 3^rd week.

-          Dark sunglasses should be used in order to protect the affected eye from light and dirt.

HOMEOPATHIC TREATMENT:-

1.      BELLADONNA:-

Facial neuralgia with twitching muscles and flushed face. Red, bluish-red, hot, swollen, shining; convulsive motion of muscles of face. Swelling of upper lip. Eyes feel swollen and protruding, staring, brilliant; conjunctiva red; dry, burn; photophobia; shooting in eyes. Sensation as if eyes were half closed. Ocular illusions; fiery appearance.

2.      CAUSTICUM:-

Paralysis of right side of the face. Pain in facial bones. Pain in jaws, with difficulty in opening mouth. Cataract with motor disturbances. Paralysis of ocular muscles after exposure to cold. Ringing, roaring, pulsating, with deafness; words and steps re-echo;Chronic middle-ear catarrh; accumulation of ear-wax. Paralysis of tongue, with indistinct speech.

3.      ACONITE:-

Neuralgia, especially of left side, with restlessness, tingling, and numbness. Tingling in cheeks and numbness. On rising the red face becomes deathly pale, or he becomes dizzy. Constantly moves lower jaw as if chewing.

4.      COCCULUS:-

Paralysis of facial nerve. Cramp-like pain in masseter muscle; worse, opening mouth. Prosopalgia in afternoon, with wide radiations of pain. Sick headache from carriage riding cannot lie on back part of head.

Some of other drugs are agaricus, ammonium phos, baryta carb, cuprum met, dul camara. Gelsemium, graphitis, ignitia. Kali iod, nux vomica, rhustoxi.

EMPYEMA AND ITS HOMEOPATHIC MANAGEMENT

                                                                    EMPYEMA

DEFINITION:-

  Collection of purulent fluid or frank pus inside the pleural cavity is known as empyema. Such a fluid may fill up the whole or only a part of the pleural cavity or remain localized inside a pocket (localized or encysted empyema).

AETIOLOGY OR CAUSES:-

-          Most cases occur due to spread of infection from the adjoining lungs. Two such common conditions are pulmonary tuberculosis and pneumonia.

-          It may also occur due to a penetrating wound in the chest or due to rupture of a subpleural septic focus or lung abscess.

-          Common causative organisms are pneumococcus, streptococcus, staphylococcus, tubercular bacillus, e.coli and h. influenza in children, staphylococcus is the commonest pathogen.

PATHOLOGY:-

  The purulent fluid collected inside the pleural cavity is thick and light yellow in colour. The protein content of the fluid is high, the principal content being fibrin. The fluid is golden yellow in colour and full of pus cells and microorganisms when the causative organisms are pneumococcus, where if the organism is p.pyocyaneus, it is greenish yellow in colour and foul smelling. In streptococcal empyema, the fluid is thin and light yellow in colour. Since the fluid contains lot of fibrin, it is likely to get organized soon and cause fibrosis. Accordingly, pleurogenous fibrosis, adhesions and contraction of affected part of the chest wall are possible sequelae. The fluid may get loculated in a pocket.

SYMPTOMS:-

-          Swelling and tenderness present in the inter costal spaces. There may be a sinus or a bronchopleural fistula present over the chest wall. This may discharge pus while coughing.

-          The patient is wasted and looks ill.

-          Intermittent fever with rigors.

-          Sharp, stitching or scratching pain present disappears and is replaced by a dull, dragging discomfort or a feeling of heaviness on affected side.

INVESTIGATIONS:-

-          X- ray chest.

-          Routine blood count wbc count.

TREATMENT:-

-          Aspiration of the requisite amount of fluid.

-          Use of appropriate antibiotics.

HOMEOPATHIC TREATMENT:-

1.       ARSENIC ALBUM:-

Unable to lie down; fears suffocation. Air-passages constricted. Burning in chest. Cough worse after midnight; worse lying on back. Expectoration scanty, frothy. Darting pain through upper third of right lung. Haemoptysis with pain between shoulders; burning heat all over. Cough dry, as from sulphur fumes; after drinking.

2.       CALCAREA SULPH:-

Suppurative processes come within the range of this remedy, after pus has found a vent. Mucus discharges are yellow, thick and lumpy. Cough, with purulent and sanious sputa and hectic fever. Empyema, pus forming in the lungs or pleural cavities. Catarrh, with thick, lumpy, white-yellow or pus-like secretion. Purulent, sanious expectoration.

3.       KALI SULPH:-

Yellow, mucus and serous discharges, profuse and intermittent. Rattling of mucus in chest. [Tart. em.]. Post-grippal cough, especially in children. Bronchial asthma, with yellow expectoration. Cough; worse in evening and in hot atmosphere. Croupy hoarseness. [Hep.; Spong.]. Pain in nape, back and limbs, worse in warm room.

4.       MERC SOL:-

Spasmodic cough (whooping cough); two paroxysms follow one another rapidly, from tickling in larynx and upper part of chest, at night, without cough during day, with expectoration of acrid yellowish mucus, which is sometimes mixed with coagulated blood, tasting putrid or salty. Dyspnoea (sensation of spasmodic contraction when coughing or sneezing). Pains in head and chest when coughing, as if these parts were about to burst; or shootings in occiput; or pain as from excoriation in chest, and pain in loins. Cough with expectoration of pure blood.

5.       SILICEA:-

Colds fail to yield; sputum persistently mucopurulent and profuse. Slow recovery after pneumonia. Cough and sore throat, with expectoration of little granules like shot, which, when broken, smell very offensive. Cough with expectoration in day, bloody or purulent. Stitches in chest through to back. Violent cough when lying down, with thick, yellow lumpy expectoration; suppurative stage of expectoration. [Bals. Peru.]

6.       SULPHUR:-

Oppression and burning sensation in chest. Difficult respiration; wants windows open. Loose cough; worse talking, morning, greenish, purulent, sweetish expectoration. Chest feels heavy; stitches, with heart feeling too large and palpitating.

Some of other drugs for empyema are arsenic iod, calcarea carb, carbo veg, china, hepar sulph, kali carb, lachesis, natrum ars, nitric acid, phos and sepia.