LOBAR PNEUMONIA AND HOMEOPATHIC MANAGEMENT

                                                               LOBAR PNEUMONIA

DEFINITION:-

Consolidation or solidification of the lung due to inflammation of the lung alveoli is known as pneumonia. Consolidation of one or more lobes of the lung caused by pneumococcus is known as lobar pneumonia or pneumococcal pneumonia. It is the commonest type of pneumonia.

AETIOLOGY:-

-          The causative agent is pneumococcus in that commonest being ‘streptococcus pneumoniae’.

-          Infection spreads from person to person by droplet infection, overcrowding.

-          Sudden exposure to cold is a strong predisposing factor.

-          The disease more common during winter months and in condition like nephritis or chronic alcoholism.

-          The disease more common in ‘adults’ in the age group of ’15-40 years’.

PATHOLOGY:-

The pneumonic process passes through 3 stages. Stage of hyperaemia, stage of consolidation and the stage of resolution. During the stage of hyperaemia there is exudation of inflammatory exudates (consisting of fibrin, leucocytes and red blood cells)into the lung alveoli. During the subsequent stage of consolidation the exudation get solidified and solidified lung looks like liver. Hence the stage is often called the stage of hepatisation. Initially there is red hepatisation followed by grey heaptisation. During the stage of resolution, jelly like solidified exudates are once again liquefied by the action of macrophages. The liquefied exudates are thereafter either absorbed or coughed out and the normal stage of lung alveoli is restored back. Occasionally, the incomplete resolution may lead to fibrosis or bronchiectatic changes in the affected part of the lung.

SYMPTOMS:-

-          The onset is sudden.

-          The temperature rises to 103 F  or higher, often associated with rigors and vomiting.

-          Initially the cough is unproductive and dry, harassing but later, during the stage of resolution, it is associated with expectoration.

-          The sputum is thick and tenacious initially but later turns rusty in colour .the sputum maybe tinged with frank blood.

-          Pain may felt in the shoulder on the affected side or the upper abdomen if the diaphragmatic pleura is involved.

-          Dyspnoea, breathing is rapid and shallow due to the associated chest pain.

-          Headache, malaise, body ache, anorexia and weakness are other notable symptoms.

-          On examination, the patient looks toxic, dyspnoic and often cyanosed.

INVESTIGATIONS:-

-          There is marked leucocytosis with increased polymorphonuclear cell count.

-          Culture of sputum shows presence of pneumococci.

-          X-ray – shows a homogenous opacity confined to the affected lobe or lobes.

COMPLICATIONS:-

1.       PULMONARY COMPLICATIONS:-

-          Suppurative pneumonia or lung abscess.

-          Creeping pneumonia or double pneumonia.

-          Pleural effusion or empyema.

-          Respiratory failure.

2.       CARDIVASCULAR COMPLICATIONS:-

-          Peripheral circulatory failure.

-          Pericarditis.

-          Endocarditis.

-          Deep vein thrombosis.

3.       GASTROINTESTINAL COMPLICATIONS:-

-          Jaundice.

-          Meteorism.

-          Paralytic ileus.

4.       NEUROLOGICAL COMPLICATIONS:-

-          Meningism.

-          Pneumococcal meningitis.

5.       BONES AND JOINTS:-

-          Osteomyelitis.

-          Suppurative arthritis.

6.       MISCELLANEOUS;-

-          Septicaemia.

-          Oliguria and uraemia.

-          Acute suppurative Otitis media and mastoiditis.

TREATMENT:-

-          The patient should be confined to bed.

-          If dyspnoic, he should kept in a propped up position. Oxygen inhalation is needed if the patient is cyanosed.

-          Benzyl penicillin should be injected intra muscularly in every 6 hours. Ampicillin 500 mg IM 6 hours once, erythromycin should be given.

HOMEOPATHIC TREATMENT:-

1.       ACONITE:-

Acute, sudden, and violent invasion, with fever, call for it. First remedy for inflammations, inflammatory fevers. Hoarse, dry, croupy cough; loud, labored breathing. Child grasps at throat every time he coughs. Cough, dry, short, hacking; worse at night and after midnight. Cold sweat and icy coldness of face during fever. Thirst and restlessness always present.

2.       ANTIMONIUM TARTARICUM:-

Great rattling of mucus, but very little is expectorated. Rapid, short, difficult breathing; seems as if he would suffocate; must sit up. Coughing and gaping consecutively. Bronchial tubes overloaded with mucus. Cough excited by eating, with pain in chest and larynx. Pulse rapid, weak, trembling. Dyspnoea relieved by eructation. Cough and dyspnoea better lying on right side - (opposite Badiaga). Coldness, trembling, and chilliness in fever. Intermittent fever with lethargic condition.

3.       ARSENICUM ALBUM:-

     For any dryness, when due to some organic trouble, particularly of the heart, or with emphysema, the cough is violent and dry, with shortness of the breath and suffocative spells, worse at night.raipid emaciation and debility, restlessness, anguish and fear of death.

4.       BRYONIA ALBA;-

Dry, hacking cough from irritation in upper trachea. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored

sputa. Difficult, quick respiration; worse every movement; caused by stitches in chest. Expectoration brick shade, tough, and falls like lumps of jelly. Coming into warm room excites cough. [Nat. carb.]. Chill with external coldness, dry cough, stitches in fever.

5.       CHELIDONIUM:-

Very quick and short inspirations; pain on deep inspiration. Dyspnoea. Short, exhausting cough; sensation of dust not relieved by cough. Whooping-cough; spasmodic cough; loose, rattling; expectoration difficult. Small lumps of mucus fly from mouth when coughing. Constriction of chest.

6.       FERRUM PHOS:-

Bronchitis of young children. First stage of all inflammatory affections. Congestions of lungs. Short, painful tickling cough. Hard, dry cough, with sore chest. Expectoration of pure blood in pneumonia. [Millefol.]. Cough better at night. During fever Chill daily at 1 pm. All catarrhal and inflammatory fevers; first stage.

7.       IPECAC:-

Dyspnoea; constant constriction in chest. Yearly attacks of difficult shortness of breathing. Cough incessant and violent, with every breath. Chest seems full of phlegm, but does not yield to coughing. Suffocative cough; child becomes stiff, and blue in the face. Bleeding from lungs, with nausea; feeling of constriction; rattling cough. Intermittent fever, irregular cases, after Quinine. Slightest chill with much heat, nausea, vomiting, and dyspnoea in fever.

8.       PHOSPHOROUS:-

Cough from tickling in throat; worse, cold air, reading, laughing, talking, from going from warm room into cold air. Sweetish taste while coughing. Hard, dry, tight, racking cough. Congestion of lungs. Pneumonia, with oppression; worse, lying on left side. Sputum rusty, blood-colored, or purulent. Nervous coughs provoked by strong odors, entrance of a stranger; worse in the presence of strangers; worse lying upon left side; in cold room.

9.       PULSATILLA:-

 Dry cough in evening and at night; must sit up in bed to get relief; and loose cough in the morning, with copious mucus expectoration. Expectoration bland, thick, bitter, greenish. Short breath, anxiety, and palpitation when lying on left side. [Phos.]. Smothering sensation on lying down. Chilliness, even in warm room, without thirst in fever. Chill about 4 pm.

10.   TUBERCULINUM:-

Hard, dry cough during sleep. Expectoration thick, easy; profuse bronchorrhoea. Sensation of suffocation, even with plenty of fresh air. Hard, hacking cough, profuse sweating and loss of weight, rales all over chest. Deposits begin in apex of lung. (Repeated doses). Shortness of breath. Post-critical temperature of a remittent type. Here repeat dose every two hours. (Macfarlan).

Some of other drugs are ammonium iod, ammonium mur, antimonium ars, belladonna, iodum and kali carb.

ACUTE BRONCHOPNEUMONIA AND HOMEOPATHIC MANAGEMENT

                                                         ACUTE BRONCHOPNEUMONIA

SYNONYMS OR OTHER NAMES:-

      Lobular pneumonia, broncho pneumonia, ensular pneumonia, catarrhal pneumonia.

DEFINITION:-

 An acute catarrhal inflammation of the terminal bronchioles and air vesicles of the lung, the inflammation forming scattered points of consolidation throughout the lung. Catarrhal pneumonia may be acute or chronic but is generally a secondary disease.

AETIOLOGY:-

-          Common organisms producing bronchopneumonia are bacteria’s like pneumococcus, streptococcus, staphylococcus and H. influenza.

-          Most commonly occurs in children, may also occur in elderly persons.

-          In children it may occur as a primary condition but more often it follows an attack of measles, whooping cough or acute bronchitis.

-          In elderly peoples always secondary to acute or chronic bronchitis, emphysema or an attack of influenza.

PATHOLOGY:-

The process begins with acute inflammation of the terminal bronchioles. There is collection of exudates into the affected groups of alveoli followed by solidification or consolidation. Interstitial oedema and proliferation of cells may occur in the alveolar walls. Compensatory emphysema develops around non functioning or collapsed alveoli. Resolution may not be always complete as in case of lobar pneumonia. Pulmonary fibrosis and bronchiectatic changes are, therefore, likely to develop in the affected areas, more so in elderly patients.

SYMPTOMS:-

-          The three cardinal symptoms are COUGH, DYSPNOEA AND FEVER.

-          Initially the cough is dry and harassing but later becomes productive with purulent expectoration.

-          Dyspnoea is prominent and particularly severe in children in whom it is often associated with central cyanosis.

-          Fever runs high and is often associated with convulsions in children and rigors in adults.

  EXAMINATION:-

 The breath sounds are vesicular in character with prolonged expiration.Rhonchi (both sonorous and sibilant) are heard all over the chest bilaterally and symmetrically.Crepitations are present all over the chest. Presence of unusually coarse crepitations at one of the lung bases, signifies develops of bronchiectatic changes.

INVESTIGATIONS:-

-          There is marked polymorpho nuclear leucocytosis.

-          X-RAY – chest shows multiple patchy opacities with irregular outlines throughout both the lungs, more so in the lower zones.

-          SPUTUM TEST – culture of sputum reveals a mixed bacteria flora.

COMPLICATIONS:-

-          Capillary bronchitis.

-          Phthisis.

-          Pleuritis.

-          Emphysema.

-          Peripheral circulatory failure may occur in course of severe illness.

-          Pulmonary fibrosis, bronchiectasis or lung abscess.

TREATMENT:-

-          Confine the patient in bed, and frequently change is position.

-          Keep the room at an even temperature and the atmosphere moistened with steam.

-          The diet should be nutritious and liquid is more.

-          Treatment may be started with co-trimoxazole or ampicillin orally or gentamicin intra-muscularly.

-          In a severe case, corticosteroid given parenterally is life saving.

-          Oxygen therapy is indicated if the patient is cyanosed.

HOMEOPATHIC TREATMENT:-

1.       ACONITE:-

Acute, sudden, and violent invasion, with fever, call for it. First remedy for inflammations, inflammatory fevers. Hoarse, dry, croupy cough; loud, labored breathing. Child grasps at throat every time he coughs. Cough, dry, short, hacking; worse at night and after midnight. Cold sweat and icy coldness of face during fever. Thirst and restlessness always present.

2.       ANTIMONIUM TARTARICUM:-

Great rattling of mucus, but very little is expectorated. Rapid, short, difficult breathing; seems as if he would suffocate; must sit up. Coughing and gaping consecutively. Bronchial tubes overloaded with mucus. Cough excited by eating, with pain in chest and larynx. Pulse rapid, weak, trembling. Dyspnoea relieved by eructation. Cough and dyspnoea better lying on right side - (opposite Badiaga). Coldness, trembling, and chilliness in fever. Intermittent fever with lethargic condition.

3.       ARSENICUM ALBUM:-

      For any dryness, when due to some organic trouble, particularly of the heart, or with emphysema, the cough is violent and dry, with shortness of the breath and suffocative spells, worse at night.raipid emaciation and debility, restlessness, anguish and fear of death.

4.       BRYONIA ALBA;-

Dry, hacking cough from irritation in upper trachea. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored

sputa. Difficult, quick respiration; worse every movement; caused by stitches in chest. Expectoration brick shade, tough, and falls like lumps of jelly. Coming into warm room excites cough. [Nat. carb.]. Chill with external coldness, dry cough, stitches in fever.

5.       CHELIDONIUM:-

Very quick and short inspirations; pain on deep inspiration. Dyspnoea. Short, exhausting cough; sensation of dust not relieved by cough. Whooping-cough; spasmodic cough; loose, rattling; expectoration difficult. Small lumps of mucus fly from mouth when coughing. Constriction of chest.

6.       FERRUM PHOS:-

Bronchitis of young children. First stage of all inflammatory affections. Congestions of lungs. Short, painful tickling cough. Hard, dry cough, with sore chest. Expectoration of pure blood in pneumonia. [Millefol.]. Cough better at night. During fever Chill daily at 1 pm. All catarrhal and inflammatory fevers; first stage.

7.       IPECAC:-

Dyspnoea; constant constriction in chest. Yearly attacks of difficult shortness of breathing. Cough incessant and violent, with every breath. Chest seems full of phlegm, but does not yield to coughing. Suffocative cough; child becomes stiff, and blue in the face. Bleeding from lungs, with nausea; feeling of constriction; rattling cough. Intermittent fever, irregular cases, after Quinine. Slightest chill with much heat, nausea, vomiting, and dyspnoea in fever.

8.       PHOSPHOROUS:-

Cough from tickling in throat; worse, cold air, reading, laughing, talking, from going from warm room into cold air. Sweetish taste while coughing. Hard, dry, tight, racking cough. Congestion of lungs. Pneumonia, with oppression; worse, lying on left side. Sputum rusty, blood-colored, or purulent. Nervous coughs provoked by strong odors, entrance of a stranger; worse in the presence of strangers; worse lying upon left side; in cold room.

9.       PULSATILLA:-

 Dry cough in evening and at night; must sit up in bed to get relief; and loose cough in the morning, with copious mucus expectoration. Expectoration bland, thick, bitter, greenish. Short breath, anxiety, and palpitation when lying on left side. [Phos.]. Smothering sensation on lying down. Chilliness, even in warm room, without thirst in fever. Chill about 4 pm.

10.   TUBERCULINUM:-

Hard, dry cough during sleep. Expectoration thick, easy; profuse bronchorrhoea. Sensation of suffocation, even with plenty of fresh air. Hard, hacking cough, profuse sweating and loss of weight, rales all over chest. Deposits begin in apex of lung. (Repeated doses). Shortness of breath. Post-critical temperature of a remittent type. Here repeat dose every two hours. (Macfarlan).

Some of other drugs are ammonium iod, ammonium mur, antimonium ars, belladonna, iodum and kali carb.

MARASMUS AND HOMEOPATHIC MANAGEMENT

                                                           NUTRITIONAL MARASMUS

DEFINITION:-

Nutritional marasmus is a deficiency syndrome occurring in infants and young children caused by continued deficiency of all the elements of food (i.e., a state of continued semi starvation). It is another extreme form of protein energy malnutrition (PEM) in which there is a gross deficiency of proteins as well as calories.

AETIOLOGY:-

-          It is mainly caused by deficiency of protein and all calories in body.

-          This disease mostly affects infants below one year of age. In India, it is at least 3 times more common than kwashiorkor.

-          Infants born of poor parents living in slum areas of towns and cities are more commonly affected.

-          Extreme poverty and repeated pregnancies are the prime factors responsible for marasmus in this country.-

-          EARLY WEANING:- early weaning is forced on the infant mostly due to successive pregnancy. The infant is deprived of breast milk rather too early. The mother refuses to continue breast feeding since it would spoil her ‘feminine figure’.

-          WEANING WITH INSUFFICIENT FOOD:-  due to sheer poverty, economical poor, weaning in most cases is done with little barley water or rice gruel with small quantity of diluted cow milk or no milk at all, with a meager family income and large number of members to feed.

-          RECURRENT DIARRHOEA AND INFECTIONS: - recurrent gastroenteritis and other forms of diarrhoea as well as recurrent childhood infections are important precipitating factors.

SYMPTOMS:-  

-          Loss of weight up to less than 60% of the standard weight.

-          Gross wasting of muscles – the arm circumference (measured by a tape just above the elbow joint) is under 12.5 cm (normal – 13.5 cm or more).

-          Thin skin which can easily be pinched up due to loss of subcutaneous fat. The infant looks like a ‘little old man’ made up of just ‘skin and bones’. The face is shrunken (‘monkey face’).

-          Growth retardation.

TREATMENT:-

-          Initially, the diet must contain 30-60 calories and 1-1.5 gm of protein per kilogram of body weight.

-          Gradually, it should be increased to contain 100-120 calories and 3-4 gm of protein per kilogram of body weight.

-          Anaemia should be treated with blood transfusion.

-          Associated fluid and electrolyte deficiencies must be corrected, vitamin supplement should be provided.

HOMEOPATHIC TREATMENT:-

1.       ABROTANUM:-

A very useful remedy in marasmus, especially of lower extremities only, yet with good appetite. Rheumatism following checked diarrhoea. Wrinkled, cold, dry, pale face. Blue rings around dull-looking eyes. Indigestion, with vomiting of large quantities of offensive fluid.

2.       ACETIC ACID:-

This drug produces a condition of profound anaemia, with some dropsical symptoms, great debility, frequent fainting, dyspnoea, weak heart, vomiting, profuse urination and sweat. Pale, waxen, emaciated face. Eyes sunken, surrounded by dark rings. Vomits after every kind of food. Frequent watery stools, worse in morning. Burning, dry, hot skin, or bathed in profuse sweat.

3.       AETHUSA:-

Expression anxious, full of pain; linea nasalis marked. Intolerance of milk; vomiting as soon as swallowed or in large curds. Vomiting, with sweat and great weakness, accompanied by anguish and distress followed by sleepiness. Undigested, thin, greenish preceded by colic, with tenesmus, and followed by exhaustion and drowsiness. Weakness of lower extremities.

4.       NATRUM MUR:-

Emaciation most notable in neck. Great debility; most weakness felt in the morning in bed. Feels bruised, with headache in school children. Numbness and tingling in fingers and lower extremities.

5.       SILICEA:-

Some of other drugs are apis, ars alb, belladonna, cal phos, iodum, lycopodium, mag carb, nux moschatae, nux vom, sarasaparilla and sulphur.

MALARIA AND HOMEOPATHIC MANAGEMENT

                                                                      MALARIA

DEFINITION:-

 Malaria is a communicable disease which is caused by genus plasmodium protozoa. The features of this disease are periodic type of intermittent fever which comes with rigors and subsides with sweating, splenomegaly and anaemia.

CAUSES AND SPREADS:-

-          Mainly caused by plasmodium vivax and plasmodium falciparum virus.

-          The disease is transmitted from man to man mainly by the bite of ‘female anopheline mosquitoes’.

-          The disease may be acquired by infected blood transfusion.

-          Malaria mainly occurs in tropical and sub- tropical countries where the hot and humid climate is favourable for breeding of mosquitoes. In the year 1935, it was estimated that in India alone 100 million people used to be affected every year, out of which 1 million used to die. Due to intensive efforts made by the WHO(world health organization), the incidence of malaria had declined or reduced remarkably during the years 1950-60, but flared up again since the year 1970.although the problem is not reduced, malaria is still actively prevalent in several countries including india.

PATHOLOGY:-

In human beings, malaria is caused by 4 species of plasmodium. Plasmodium falciparum, plasmodium vivax, plasmodium malariae and plasmodium ovale. Out of these four, the first two types are mainly present in India and other tropical and subtropical countries.

Whenever a female anopheline mosquito bites an infected person, it takes up gametocytes or the sexual form of the parasite from the blood of the infected person. Inside the stomach of the mosquito, the male and female gamatocytes unite to form a zygote which is converted into a ookinete. The ookinete is very motile and is capable of piercing the wall of the mosquito’s stomach. It is soon converted into  an oocyst bursts to in liberate the sporozites that find their way into the salivary glands of the mosquito. This sexual cycle of the parasite inside the body of the mosquito is completed within 3 weeks.

Sporozoites are introduced into the blood of a healthy person from the bite of an infected mosquito. From blood these sporozoites quickly reach the liver cells when the first liver cycle  or the preerythrocytic cycle is completed within 6-8 days

SYMPTOMS:-

Malaria is recognized by the clinical triad of intermittent type of fever, splenomegaly and anaemia.

-          The fever of the intermittent type appears with a definite time schedule and shoots to 102-104F or higher. The febrile episode passes through three stages – the cold stage, the hot stage and the stage of sweating.

-          During the cold stage or the stage of shivering, the patient gets severe rigors, so much so that he may be grinding his teeth. Headache and vomiting may be associated.

-          In the hot stage, the patient may be delirious, after this stage patient starts sweating and the temperature settles down to normal.

-          The spleen becomes just palpable after a few febrile episode but later enlarges further and feels firm and hard in consistency.

-          Anaemia occurs mainly due to hemolysis of the red cells. Hemolysis is greater in plasmodium falciparum infections.

-          Subsequent destruction and removal of the red cells is caused by enlarged and hyperactive spleen. The bone marrow function is suppressed.

COMPLICATIONS:-

-          CEREBRAL MALARIA – red blood cells loaded with schizonta get stuck inside the cerebral capillaries and cause obstruction to the flow of blood. Coma, hyperpyrexia, patient feels drowsy and becomes unconscious. Convulsions and twitching in muscles.

-          Algid malaria.

-          Black water fever.

INVESTIGATIONS:-

-          Serological test.

-          Marked elevation of serum IgM levels.

TREATMENT:-

-          Use some antibiotics.

-          Control of mosquitoes by spraying insecticides in houses.

HOMEOPATHIC TREATMENT:-

1.       ACONITE.

2.       APIS.

3.       ARNICA.

4.       ARSENICUM ALBUM.

5.       CAPSICUM.

6.       CHINA.

7.       EUPATORIUM PERFORATUM.

8.       GELSEMIUM.

9.       IPECAC.

10.   NATRUM MUR.

11.   NUX VOMICA.

12.   OPIUM.

13.   RHUS TOXI.

14.   VERATRUM ALBUM.

15.   VERATRUM VIRIDAE.

MEASLES AND HOMEOPATHIC REMEDIES

                                                                      MEASLES

DEFINITION:-

Measles is an acute infectious disease caused by specific paramyxovirus and characterized by Coryza, cough, conjunctivitis, koplik’s spots and cutaneous rashes.

CAUSES AND SPREADS:-

-          Mainly caused by specific paramyxovirus.

-          More common on children’s (below 3 years) in developing countries.

-          Attacks are more common during spring and winter months.

-          The incubation period varies from 10-14 days.

-          It’s get spreads by droplet infection. Direct contact with patient or fomites.

SYMPTOMS:-

The disease passes through 2 stages, a. catarrhal stage and b. exanthematous stage.

a.       CATARRHAL STAGE:-

-          This stage lasts for 4 days. In the stage start wanning with the appearance of the rashes.

-          Coryza (sneezing, watery nasal discharges and redness of eyes) are present.

-          Temperature raises on very first day (100-103 F) subsides on 3^rd day and again raises on 4^th day with appearance of rashes.

-          Dry cough and hoarseness of voice may be present due to associated laryngitis.

-          KOPLIK’S SPOTS – tiny white spots seen inside the cheeks opposite the second molar teeth. These spots look like grains of salt spread over the red, velvety surface of the mucous membrane.

b.      EXANTHEMATOUS STAGE:-

-          The typical rash appears on the fourth day – first behind the ears, then over the forehead, face and finally trunk and limbs.

-          The rash is a pink or dusky red macule which changes into a papule in a day or 2^nd day.

-          Papules fuse together to produce irregular, blotchy areas which impart a swollen appearance to the face.

-          Rashes gets reduce in a weeks and leaving behind brownish mottling over the skin.

COMPLICATIONS:-

-          Bronchopneumonia.

-          Otitis media.

-          Corneal ulcerations.

-          Gastroenteritis.

-          Encephalomyelitis.

-          Myocarditis or hepatitis.

-          Loss of weight, retardation of growth.

-          Foetal death in pregnant women.

TREATMENT:-

-          The patient should be kept in isolation and adequate nursing care should be provided.

-          Antibiotics should be should given for preventing secondary infection.

-          Tetracycline 250 mg- 1 capsule, 6 hourly may be sufficient.

-          In case of severe bronchopneumonia gentamicin, ampicillin may be prescribed.

HOMEOPATHIC TREATMENT:-

1.       ACONITE:-

Great fear, anxiety, and worry accompany every ailment, however trivial. Red, inflamed eyes and Feel dry and hot, as if sand in them. Coryza much sneezing; throbbing in nostrils. Mucus membrane dry, nose stopped up; dry or with but scanty watery Coryza. Rash like measles on skin.

2.       APIS MELLIFICA:-

Extreme sensitiveness to touch and general soreness is marked. Conjunctiva bright red, puffy eyes and eye lids. Involuntary on every motion; anus seems open. Hoarseness; dyspnoea, breathing hurried and difficult. Afternoon chill, with thirst; worse on motion and heat in fever stage.

3.       BRYONIA ALBUM:-

Coryza with shooting and aching in the forehead. Dryness, sticking on swallowing, scraped and constricted. [Bell.]. Hoarseness; worse in open air. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored

sputa.

4.       EUPHRASIA:-

Catarrhal affections of mucus membranes especially of eyes and nose. Catarrhal headache, with profuse discharge from eyes and nose. Catarrhal conjunctivitis; discharge of acrid matter. Sticky mucus on cornea; must wink to remove it. Profuse, fluent coryza in morning, with much cough and expectoration. First stage of measles; eye symptoms marked.

5.       MORBILLINUM:-

Catarrh.

Coryza.

Cough.

Ear, affections of.

Eye, affections of.

Measles. Skin, affections of.

6.       PULSATILLA:-

Sub acute conjunctivitis, with dyspepsia; worse, in warm room. Profuse lachrymation and secretion of mucus. Coryza; stoppage of right nostril, pressing pain at root of nose. Capricious hoarseness; comes and goes. Measles.

7.       SULPHUR:-

Chronic dry catarrh  dry scabs and readily bleeding. Pressure as from a lump, as from splinter, as of a hair. Difficult respiration; wants windows open. Loose cough; worse talking, morning, greenish, purulent, sweetish expectoration. Dry, scaly, unhealthy; every little injury suppurates. Itching, burning; worse scratching and washing.

Some of other drugs are amm. Carb, ars album, bell, coffea, drosera, gels, rhus toxi, phos and stramonium.

CHICKEN POX AND HOMEOPATHIC REMEDIES

                                                                    CHICKEN POX

DEFINITION:-

 Chicken-pox is an acute infectious disease caused by varicella- zoster virus (VZV) and characterized by successive crops of superficial vesicular eruptions and severe fever, headache and malaise.

CAUSES AND SPREAD:-

-          Mainly caused by varicella-zoster virus same as herpes zoster virus.

-          Most commonly affects children under 10 years of age.

-          The disease spreads by droplet infection, through hands and clothing of attendants, by fomites, or by actual contact with the patients.

-          The average incubation period is 14 days.

SYMPTOMS:-

-          Low grade fever, malaise, headache and backache.

-          The rash usually appears on the 2^nd day.

-          The rash 1^st appears on trunk, especially the back, face and upper part of the limbs. The axillae also involved. Rashes are most thickly populated on trunk and thin over the distal parts of the body.

-          Macules appear first which quickly (within few hours) change over to papules and within few hours turns to vesicles.

-          The vesicles are superficial, thin walled, pyramidal in shape (like a top hat) and pearly white in colour. The rashes often been compared to the morning dew drops.

-          The rashes are very fragile and easily get ruptured with intense itching.

-          Within 24 hours the vesicles change in pustules which dry up and form scabs within few days, scabs peel off easily without leaving any permanent spots or scars.

COMPLICATIONS:-

-          Secondary skin infections like boils, abscesses and bed sores.

-          Meningo encephalomyelitis.

-          Varicella pneumonia.

-          Congenital deformities in fetus if during pregnancy

-          Chicken pox in pregnant mothers may cause foetal death.

TREATMENT:-

-          The patient should be isolated and kept in bed till the formation of scabs and till fresh eruptions stop appearing.

-          Itching may be relieved by antihistaminic drugs orally.

-          Anti biotics is needed for preventing any secondary infection.

-          Acyclovir may be used in an immunocompromised patient (800mg four times for 7 days).

-          Avoid spicy foods. Take liquid items and nutritious food and fruit juices.

HOMEOPATHIC TREATMENT:-

1.       ANTIMONIUM CRUDUM:-

 Pimples, pustules, and boils on face. Yellow crusted eruption on cheeks and chin. Diarrhoea after acids, sour wine, baths, overeating; slimy, flatulent stools. Pimples, vesicles, and pustules on skin. Scaly, pustular eruption with burning and itching, worse at night. Intermittent with disgust, nausea, vomiting, eructations, coated tongue, diarrhoea. Itching when warm in bed.

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 chicken pox.

3.       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.

4.       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.

5.       RHUSTOXI:-

It is one of the best remedy for chicken 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.

6.       SULPHUR:-

Dirty, filthy people, prone to skin affections. Very weak and faint about 11 am; must have something to eat. Very sensitive to pressure; internal feeling of rawness and soreness. Morning diarrhoea, painless, drives out of bed, with prolapsus recti. Talks, jerks, and twitches during sleep. Dry, scaly, unhealthy; every little injury suppurates. Pimply eruption, pustules, rhagades, hang-nails. Itching, burning; worse scratching and washing.

Some of other drugs are aconite, carb veg, ledum pal, silicea, sepia, coffea, hyoscyamus and thuja.

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.