Carbolic Acid Poisoning and Tautopathy

Abstract– Household poisonings are very common in India due to various Psycho-social factors like dowry, mood disorders, financial loss etc. The commonest type is phenol.

Homoeopathically, poisoning is classified as artificial disease which later evolves in to miasmatic disease with fully developed symptoms. The concept of “tautopathy” is one of the methods of treatment of toxicological or poisoning cases.

Keywords– Carbolic Acid, Stuart Close, Hahnemann, Tautopathy, Homeopathy, Boger, Boericke, House Hold Poisoning.

Introduction – Household chemicals like phenol which is used as floor cleaner are most common cause of death due to poisoning. 25-50 ml of household phenol can lead to fatal poisoning. Homeopathic management of Poisoning cases requires integration of toxicology, medico legal laws, emergencies, strategies, philosophy and materia medica.

This case was treated on the concept of Tautopathy. Tautopathy  (Tauto-same),  is the method of curing or removing the bad effects of drugs by means of identical potentised drugs.

Case History

A 29 year old female was brought to the IPD by her husband at 7.30 am on 22th January, 2018 with A/H/O- consuming 250-300 ml of PHENOL at 3.30 am.

Symptoms –

1. Pulling pain in throat ⁺³
2. Burning Sensation in Throat3+
3. Sensation as if she wants to cut her throat <Drinking2+ <swallowing2+
4. Pain and Heaviness of Head⁺²

Left sided headache from supra orbital to occipital region

>pressure⁺³

5. Excessive Salivation⁺³
6. Numbness is felt in whole body⁺³

Vital Parameters: –   Pulse: 94 bpm    Spo2: 98%

Blood pressure: 130/70 mm hg    Respiratory rate: 24/min

Systemic Examination:  Throat Congestion⁺³      

CNS- conscious, well oriented in time, place and person,

Pupils- reactive to light, not pin point

Weak and Exhausted    Reflexes: Normal

Tone of Muscles- Normal    Power-5/5 both upper and lower limbs

   

Figure 1: Clinical Presentation in cases of poisoning.

 

Figure 2: Carbolic Acid Poisoning and its effects.

Investigations-

         CBC

• Hb- 11.9 mg% RBC- 4.06 millions/cumm     WBC- 9700/cumm    Platelets-296000/cumm
• SGPT- 25 mg/dl, Creatinine- 0.5 mg/dl        Urine routine- Normal

Diagnosis- Acute Phenol (Carbolic acid) Poisoning

Therapeutic Strategy in Poisoning Case:

Step 1– Inform the police (medico legal case)

Step 2- Maintain the vitality of the patient by giving IV fluids and maintaining the haemodynamic state of the patient.

Step 3- Removal of the residual poison by inducing vomiting with warm salt water solution because patient is conscious.

Step 4:  Use homoeopathy as an antidote.

It is important to construct totality (As per Boericke’s Materia Medica with repertory, to let the characteristic symptoms of the individual patient, largely independent of the pathological nature of the case, be paramount in selecting the remedy).

Totality Construction:

• Burning sensation⁺³ in the throat < drinking < swallowing
• Numbness⁺² of the whole body
• Headache > Pressure⁺³

Figure 3: Concept of Selection of the Remedy in Cases of Poisoning

Prescription-

We administered IV fluids. (No neutralization nor removal of poison was done)
Patient was prescribed Carbolic acid 200 1P stat

STRICT MONITORING OF PATIENT

• Patient was kept nil by mouth
• HGT- 6 hourly
• TPR/BP was monitored every ½ hourly
• Pupillary reaction every ½ hourly
• SP02 every 1 hourly
• Strict Input/output Charting
• IV fluids were given

TREATMENT AND FOLLOW UPS

Date and Time	Progress	Rx
22/1/18 – 12pm	Burning throat –SQ- Pain throat –SQ- Loss of taste- SQ- TPR/BP was monitored every 4 hourly Patient was kept NBM	Carbolic acid 200 in 1st dilution every 10 mins
22/1/18- 4pm	Patient stable Burning in throat > Pain  in throat > TPR/B.P – Normal	Carbolic acid 200 in 1st dilution every 10 mins
22/1/18- 10pm	Patient was better overall	Start patient with oral fluids Carbolic acid 200 in 1st dilution every 10 mins
23/1/18- 9pm	Pt vital parameters – normal Burning in throat >> 80% Throat congestion >> Headache >> 90 %	Advised to take soft diet Continue monitoring Carbolic Acid 200 every 1 hourly
23/1/18- 6pm	Patient Stable , all symptoms >-	ctall
24/1/18- 9am	All complaints better Burning – > 90 % Headache > 90% Tolerating oral foods Vitals- normal	Carbolic acid 200 1St dilution 1 hourly Start soft diet Stop IV fluids
24/1/18- 6pm	Patient tolerating soft diet All symptoms better	Carbolic acid 200 1St dilution 1 hourly
Day 4(Follow Up)	Patient was asymptomatic Pulse – 80/min B.P- 120/80 mmHg SPO2- 98% CVS/RS/PA- NAD	Discharged from the hospital Carbolic acid 200 1P sos Sac Lac 30 3 pills qds

Case Lessons –

• Concept of poisoning management.
• High potency of the remedy is best antidote to crude drug
• Concept of tautopathy
• Role of homeopathic physician in poisoning Cases.
• Application of forensic medicine and toxicology knowledge in actual practice.
• Important of psycho social factors and its relevance in history taking in case management.

Stuart Close in chapter 8, page 120 mentions the method of treatment which is also known as Tautopathy. Tautopathy (Tauto-same) is the method of curing or removing the bad effects of conventional drugs by means of identical potentised drugs. For example, if you are suffering from the bad effects or side-effects of the antibiotic Penicillin, you can use potentised Penicillin to remove its side effects.

There have been studies in which potentised lead and potentised arsenic have been used to promote excretion of the same substances in cases of poisoning. This removes the symptoms by elimination of the toxin from the tissues (Tautopathy an Introduction by Dr Manish Bhatia).

Tautopathic treatment

One of the earliest studies on the effects of tautopathic treatment was conducted by the British Homoeopathic Society and the Ministry of Home Security during World War II.  John Paterson, the president of the Society, along with                    W. Lees Templeton, headed a “Gas Research Committee” to coordinate research conducted in Glasgow and London.

Trials were conducted under carefully controlled conditions, with the blinded use of placebo control groups, a rare feature of clinical trials at the time. In the Glasgow trials, Mustard gas 30c or placebo was given to volunteers before real mustard gas was applied to their forearm.

Of the treated group two cases showed deep lesions and twelve cases did not show any deep lesions from mustard gas. However, twelve volunteers in the placebo group had deep skin lesions, while only two did not have deep lesions. Similar experiments were conduct-ed in London. A report showed that statistically significant tautopathic treatment One of the earliest studies on the effects of tautopathic treatment was conducted by the British Homoeopathic So-ciety and the Ministry of Home Security during World War II. John Paterson, the president of the Society, along with W.

Lees Templeton, headed a “Gas Research Committee” to coordinate research conducted in Glasgow and London. Trials were conducted under carefully controlled conditions, with the blinded use of placebo control groups, a rare feature of clinical trials at the time. In the Glasgow trials, Mustard gas 30c or placebo was given to volunteers before real mustard gas was applied to their forearm. Of the treated group two cases showed deep lesions and twelve cases did not show any deep lesions from mustard gas. However, twelve volunteers in the placebo group had deep skin lesions, while only two did not have deep lesions. Similar experiments were conducted in London. A report showed  statistically significant effects of mustard gas were reduced by tautopathic treatment.

Boger Synoptic Key–

Boger à painless destruction silence  à Destroying (mind- suicidal tendency)

Burning sensation in throatà Seat of disease

Differential Remedies-

• Carbolic Acid
• Mercuris Solubilis
• Arsenic Alb

Boericke’s Materia Medica-

• Carbolic Acid is a powerful irritant and anaesthetic.
• A languid, foul, painless, destructive remedy.
• Burning in mouth to stomach.  
• Fauces red, and covered with exudation.
• Uvula whitened and shrivelled.
• Almost impossible to swallow.

Homeopathic Conceptualization for the treatment of Poisoning cases

Reflection of poisoning in the repertory is poor except Murphy’s Homeopathic Medical Repertory.

According to Stuart Close:

“If all the diseases are the results of some form or degree of poisoning, then in the last analysis all  curative treatment is antidote treatment, and cure is accomplished by the use of agents which have power to antidote or neutralize the poisons and remove their effects.”

Antidotes-

1. Physiological or dynamic
2. Chemical
3. Mechanical

(Chemical and mechanical antidotes are only for physical expulsion of poison from the body) after which “Dynamic antidotes are required to remove the pathogenetic effects of the poison being absorbed”

Three Methotesds of Antido
• Alcohol, vinegar, chalk, iod., •Glauber’s salt in watery solution. • (Ref, carbolic acid – Boereicke’s Homoeopathic Material Medica	•  High potency of a drug is sometimes the best antidote for the effects of the crude drug • (Ref, pg120 chapter VIII, the genius of homoeopathy- Dr. Stuart Close)	• According to the totality of symptoms of the case

Acknowledgement: –

We thank to Dr Mohanbhai Patel, Chairman, The Homoeopathic Education Society (Smt. Chandaben Mohanbhai Patel Homoeopathic College), Dr Asmita Parikh; General Secretary, The Homoeopathic Education Society (Smt. Chandaben Mohanbhai Patel Homoeopathic College) and Dr Parizad Damania- Principal, Smt. Chandaben Mohanbhai Patel Homoeopathic College for the encouragement, support and hospital infrastructure.

*Corresponding author:

Dr. Rakesh Gupta, President of Satva Charitable Trust. HOD and Associate Professor, Forensic Medicine and Toxicology, Smt Chandaben Mohanbhai Patel Homeopathic Medical College, Mumbai, India

References:-

1. The Synopsis of Forensic Medicine and Toxicology 28^th Edition by Dr K.S. Narayan Reddy and Dr O.P. Murty. page number- 300-301
2. Materia Medica of Homoeopathic Medicines- Second edition Revised & Enlarged by Dr S.R. Phatak 2^nd Edition page no- 186-188
3. A Dictionary of Practical Materia Medica Vol1, By Dr John Henry Clarke M.D Student Edition page number- 405-408
4. Organon of Medicine 6^th Edition by Dr Samuel Hahnemann translated by William Boericke
   1. page number- 92
5. Radar opus computer program. Version 10.5, Belgium 2012.
6. Synthesis Repertory
7. Boericke’s Pocket Manual of Homeopathic Materia medica with Repertory and a chapter on rare and uncommon remedies with Indian Drugs by W. Boericke, MD 9^th Edition page number- 173- 174
8. WHO (2011), Estimates of Deaths by Causes for the year 2008 Summary Tables.
9. Modern Medical Toxicology by VV Pillay page no- 51-53.
10. The Genius Of Homoeopathy And Essays On Homoeopathic Philosophy By Stuart Close, B. Jain publishers First Edition (2008) page number- 87-121.
11. “The Evidence” Scientific studies show tautotherapy is effective treatment for drug induced and Toxic Disorders by Manfred Mueller, CCH, and RSHoma (NA).
12. Tautopathy- An Introduction by Dr Manish Bhatia, www.hpathy.com/tautopathy-medicine/tautopathy-an-introduction