A Case of Non Healing Wound with Diabetes Mellitus

Preliminary Data:

Name: Mr. MNS	Marital status: Married
Age: 62yrs	Religion: Hindu
Sex: Male	Address: DEF
Education: Graduate	Date: 8-01-16
Occupation: Retired

 

Chief Complaints: Patient came with complaints of non-healing wound below the left great toe for one year. The patient was on allopathic medicines but there was no improvement in the wound healing. The wound was oval in shape measuring 1cm width and half a cm deep with surrounding dead tissue as if corroded. There was offensive odor and occasional bleeding on walking. He also has left leg pain agg on motion and amel on rest. The wound (Homeopathy Treatment for Wound) developed after the removal of a corn at the base of the toe.

Location	Sensation	Modality	Concomitant
Lower Extremity Left toe Palmar aspect Since 1yr	Offensive Odor Painless wound Bleeding+ Skin edges hard	A/f Corn removal at base of toes	Left leg pain

Past History:

Diabetes Mellitus since 22 years and on hypoglycemic agents thrice a day

Family History:

Grandfather: Hypertension      Grandmother: Osteoporosis

Father: Diabetes Mellitus                     Mother: Rheumatism

Patient as a person:

Appearance: Tall Thin emaciated         Diet: vegetarian

Appetite: Average                                 Thirst: 5-6 glass/day

Desire: Spicy food++                           Aversion: non specific

Bowel: Regular                                                 Urine: 4-5 times /day

Sleep: Sound                                        Perspiration: Head++

Dreams: Daily routine                          Habits: Tea twice daily

Thermals: chilly

	Summer	Rainy	Winter
Fanning	Slow	Slow	No fan
Covering	1 thin	1 thin	2 thick
Bathing(water)	Warm	Warm	Warm

Life Space Investigation:

He is a retired serviceman staying alone with his wife. He is soft by nature but gets angry when he sees someone suffering because of another’s fault. He fights for the people if they are in need. He said that earlier he used to get angry easily and used to shout at others if they have made any mistake in their work but along with that he used to care about them and help them when they are in need.  He feels very sympathetic for the poor people and also helps them as much as he can. Sensitive to seeing others getting hurt. Very much punctual and conscientious about his work. Even after retirement he works for the society and feels that it is his duty to do so as a member. Even with this condition of his leg, he attends meetings and works for everyone. Anxious about his health and want to get cured. Optimistic attitude towards life

Physical Examination

General Examination:

T – 98⁰ F               P/R – 68/min            RR – 16/min

BP-120/60mmHg    Weight – 62kg

BSL (Fasting) – 160mg/dl        BSL (PP) – 275mg/dl

Urine Sugar – ++, Haemogram- WNL

No signs of pallor, cyanosis, clubbing, lymphadenopathy and icterus

Systemic Examination: 

Respiratory System: Air entry bilaterally equal and clear

CVS: S1S2+, no murmur         P/A: Soft, non-tender   CNS: Normal

 

Diagnosis of Disease: Non-healing wound

 

Miasm: Syco syphilitic

 

Susceptibility of the case: Moderately susceptible

 

Analysis of symptoms:

 

Mental Generals	Physical generals	Particulars
Censorious Injustice cannot support Irritability easily Misfortune of other agg Sympathetic Conscientious	Desires spicy food Emaciation with good appetite Perspiration on head	Wound toes Extremity pain legs agg walking Slow healing wound

Repertory used: Complete Repertory

Probable Remedies: Caust, Sulph, Nux, Nat-m

Constitutional remedy: Causticum                   Potency: 30

Reason: Causticum people are very conscientious and duty bound. They are sympathetic by nature and highly sensitive to others’ suffering and to injustice. Syco-syphilitic miasmatic state.  Here you can also see some of the 4^th Row issues such as Duty/work, Anxiety about health, Routine work/Performance and Responsibility. Thus the causticum gets highest marks in the repertorization and is prescribed.

Prescription: Caust 30 (4 pills) OD x 15 days + Syzygium jambo 10 drops Bd

Auxiliary measures: Daily Dressing of wound with Calendula tincture. Avoid sugar and sweet things; eat balanced healthy diet with vegetables and fruit juices.

Debridement of the wound was done by me twice during the treatment to remove the dead tissues.

Follow Up:

DATE	OBSERVATION	PLAN	TREATMENT
25-01-16	Discharges have reduced, no offensive odor from wound, leg pain still present.	Wait and watch	S.L. BD x 1month + jambo tincture
24-02-16	Generally feeling better, wound showing signs of healing with granulation, leg pain reduced 30%. Appetite improved, sleep sound Fasting- 84mg/dl, PP – 138mg/dl, urine- +	Wait and watch	S.L. BD x 1month + jambo tincture
28-03-16	Wound healthy, no discharge, granulation tissue can be seen, wound almost 50% closed. Leg pain significantly reduced. Fasting- 68mg/dl, PP – 122mg/dl, Urine- Nil	Wait and watch Tapered Anti diabetic drugs twice daily	S.L. BD x 1month + jambo tincture
24-04-16	Wound was healthy but not much improvement from earlier follow up. Debridement was done to remove dead tissue Rest generally doing well	Repeat the dose	Caust 30 OD S.L. BD x 2wks + jambo tincture
10-05-16	Significant Improvement in wound, almost 80% closed, No more leg pain, generally doing well.	Wait and Watch	S.L. BD x 1month + jambo tincture
05-06-16	Wound healed completely. He was overwhelmed by the response of homoeopathic treatment. At all levels he felt better. Sugar levels are also good.	Advised to stop the treatment	Only to continue Tincture for few weeks and then stop.

 

BEFORE TREATMENT

   

                                                 AFTER TREATMENT