Diabetic Gangrene and Simillimum


Dr. Prabhakar Shetty

 

CASE 1

     Mr. A.H.Q., aged 70 years, came with the great toe amputation at South Africa of his right foot with the H/o Cardiac By-pass Surgery. The Cardiac by-pass Surgery was done as preparation for the amputation of the great toes and finally go for B/K amputation. In fact the blood circulation was poor all over. True, the picture does depict the book picture of a Diabetic Foot but with some sign. The head of the first metatarsal bone is covered up with green pussy slough.

      In spite of various good indicated remedies like Ars Alb, Hepar Sulp, Kali Sulp, Pulsatilla, the slough would not yield to the treatment. On the contrary it started spreading and the situation worsened. The Surgeon and Physician friends started pressurizing me for Anti-biotic therapy. I understand in normal conditions of chronic ailment it would have been not difficult for me to wait and watch as a Homoeopath. Whereas here the patient might have gone into other complication like Renal failure and worst was amputation.

I remembered J.HENRY ALLEN M.D. Writings on Chronic Miasma.

      "There comes a time when we can not do this or, at least, it would not be wise to do so, as is seen in cases of incurable disease or when the miasmatic action has progressed so far that no permanent reaction can be solicited and any attempt to make a positive cure result in injury to the patient and often shortens life. This is frequently seen in such disease as diabetes mellitus, in the last stages of cancer, tuberculosis in its third stage. Here it is well not to base our prescription upon the basic miasmatic symptoms; as the attempt made by nature under the basic remedy causes over action and death follows sooner than if we left the patient alone. Here it is better to palliate the disease by remedies not based fully upon miasmatic symptoms."

…..Page no 68.

     I immediately ordered for blood investigation and to my expectation the Haemoglobin was 7.5 g/dl. I preferred for blood transfusion. I gave 3 bottles of whole blood against the wish of my Physician friend.

      The patient was meticulous, fastidious and afraid of the disease was incurable, Cadaveric smell of the ulcer with burning sensation > by covering. I returned back once again to Ars Alb1m with great confidence. The wound improved. The spreading cellulitis of the center of foot disappeared. The sloughs vanished and small incision was done on the healthy granulated part of the wound anteriorly to unload the wound. The whole wound with the gangrenous margin closed as shown in the after treatment picture. The foot was salvaged without further surgery.

      Refer the before and after treatment photographs published at the back wrapper under case No 1.

Before
After
   

CASE 2

      Mr. J.M. from East Africa came to me with post-surgical large wound of the right foot. The First metatarsal and second metatarsal bones head being exposed and infected. The third toe being gangrenous and the surrounding skin with thick gangrenous margin.

      I started with Ars Alb1000 3 hourly but the surgery was to be designed to my choice. The decreased vascularisation improved within 48 hours as per Non- Visualising Doppler study.The whole wound was sutured and an attempt was to cover up the maximum part of the wound. At this juncture Sul.Acid 200 was introduced. Sulph.Acid is a king remedy to hold sutures intact and also keeps the sutures from getting infected in all cases. Here the patient being diabetic the fear of infection is much higher but Sulph.Acid will never disappoint. Sulph.Acid prevents the complication of surgical trauma.

      Later step wise the sutures were removed. This picture also shows that rest of the toes has completely recovered from Dry gangrene and the shapes were also maintained. After the complete removal of the sutures the patient was once again put on to Ars.Alb1m three hourly for another 15 days. The X-Ray was advised to rule out any postoperative complication of osteomyelitis. Though in the initial stages of diabetic foot the X-Ray is always deceptive, still the precaution was observed.

      Complete recovery and the patient went back walking on his foot. Ars.Alb was chosen as the patient had mental disgust, Fear of recovery without suicidal tendency and without thirst.

      Refer the before and after treatment photographs published at the back wrapper under case No 2.

Before
After
   

      The other Remedies as per indication are: Sec.Cor, LachesIs, Crotalus Horridus, Carbo Veg, Tarent.Cub, Kreosotum, Antraxinum etc…

For spreading cellulitis : Rhus Tox., Apis M., etc..
For Bleb : Hep.Sulph, Apis etc...
For Callosities : Antimony Crud, Thiosinaminum etc…
Local (Topical) application : Echinacea Mother tincture in 1: 5 dilutions with distilled or auto-claved water.



Dr. Prabhakar Shetty L.C.E.H.
1 / Kanti Mahal,Telli Galli
Andheri (East)
Mumbai - 400 069.
Phone : 91-22 - 2684 2436 / 2684 0255
E Mail : sdfoot@vsnl.com