Visual Corner
 
A Case of Tropic Ulcer
 
 

Dr. Winston Vargheese MD(Hom)
Lecturer ,Dept. of Materia Medica
Sarada Krishna Homoeopathic Medical College
Kulasekharam.
Kanyakumari Dist -629192
Phone 04651-279448 / 280348
Mobile : 94436 92478


Introduction

        Dr.Winston Vargheese, lecture, physician, and Research scholar is known to every body. His in depth study, innovative application makes every body inspire. He had written many articles in Souvenir, Magazines and Journal and also presented many scientific papers in seminars. His rational approach to his patients and clinical evidence based documents are added advantage for our fraternity. Here he presents a case of Tropic Ulcer treated at Saradha Krishna Homoeopathic Hospital Kulasekharam, Tamil Nadu.

        A male patient aged 35 years presented with the complaint of non healing ulcer since two years over the left heel. The ulcer is punched out and very offensive. The offensiveness is so much that the ulcer was opened in the dressing room which is in the first floor of the hospital and the stench was smelt by the persons who were standing in the ground floor OPD , Saradha Krishna Homoeopathic Medical College Hospital, Kulasekharam. There is no pain. The ulcer started after the patient had got out of bed and started using his leg after a paraphlegia, which followed after he had fallen in a well and injured the spinal cord.

        He also has got incontinence of urine and prolapses of rectum following the injury to spinal cord. Along with these complaints he had fullness of the abdomen and flatulence, which get < after farinaceous food.

Past History

        Past history of asthma in the childhood which gets < during moon phases, cold exposure and as he changed his residence this problem spontaneously got settled.

Family History :

        The family history suggested asthma for his brother and one of the sisters and Rheumatism in mother

Generalities

        The Physical general included increased sweat over the palms and soles and thermally he has aversion to both extremes of temperature and prefers fan in summer. Prefers covering in all season with moderately thick cloth and desires cold-water bathing. There is craving for fish and pungent things.

        Mentally he is very optimistic and easily gets irritated while being contradicted. He was also having artistic talents including stage performance of drama and music concerts. Has got a very sharp memory.

Local Examination

        The examination of the Ulcer revealed the following findings.

        The size of the ulcer measured about 4cmx4cm with a depth of 5cm. The margins are punched out and the floor is by the necrotizing bone Appreciate the ulcer printed at the visual corner, back wrapper There is no sensation A sterile scoop was introduced during dressing and the necrotized bone was scooped out without anaesthesia There was also another small ulcer present near the medial aspect of the foot.

Diagnosis

Post Paraplegic tropic ulcer

First Prescription         17/4/04

Rx/

Fluoric acid 30 was given for two days

Followed by Aurum Met 30.

Follow Up 1 21/9/2004

        There was no progress, the offensiveness was still continuing. So thought of reconsidering the drug. Now the Miasmatic interpretation was given as syphilitic miasm because of the punched out ulcers and the necrosis of bones.

Rx/-

Merc. Sol 0/6 TDS

        Offensiveness had drastically reduced within two days. Merc. Sol was continued for another five months in 0\12, 0\30 potencies. Appreciate the changes on after treatment photograph published in visual corner. Later on Sulphur was given as Constitutional remedy with that patient even had improvement in the incontinence in urine and prolapses of rectum.

Discussion:

        The remedy Fluoric acid and Aurum met were immediately withdrawn as there was no relief. The first and foremost sign in improvement in such type of ulcer is the offensiveness has to get diminished. Merc sol was selected in this case after defining the miasm and also the diagnosis as to tropic ulcer. Boger in his Synoptic Key writes that Merc sol is indicated in painless ulcers after damages to nerves. When we understand the pathology of tropic ulcer it resembles what Boger has narrated along with that the other symptoms of offensiveness and the lardaceous base due to the necrotizing bone was considered and immediately the offensiveness was reduced which is and indication that the infection is under control.
        The wound was also dressed with calendula glycerin and in later stages after complete epithelialization laser was used to have a faster granulation and keratinisation.

Conclusion:

        Usually tropic ulcer is very difficult one to heal, but with homoeopathic remedies a speedy recovery was brought in this case In spite of two years of allopathic remedy the healing was not taking place but within five months without any other surgical procedures, it was cured by Homoeopathy.

        The reduction in the offensiveness is one of the main parameters in these types of ulcers for understanding the action of the remedy.

        Along with proper homoeopathic remedies, if accessory methods as advocated by our Master Hahnemann, the recovery and cure could be rapid, gentle and permanent.