Clinical Cases

Infective Suppurative Cellulitis with Latent Diabetes Mellitus managed with Homeopathy replacing Surgical Knife

Drs. Rakesh Gupta and Shetal Jaisingh present a case of suppurative cellulitis in a woman of 60. Wet aggravates, cold ameliorates, hurried were among the symptoms leading to the simillimum.

Abstract:

Homeopathic Intervention in surgical disorder is challenging because the objective of the treatment is to replace the need of antibiotics and surgical knife without the removal of disease tissue and heal the individual. Surgeons will often treat by performing the excision of the disease tissues and administering the antibiotics for infection control.

Keywords: Infective cellulitis, Latent diabetes mellitus, Mental behavioural symptom, One sided disease, Local maladies, Primary surgical disease, Secondary surgical disease, Tubercular Miasm, Latent psora, Boger’s approach

Introduction: Surgical diseases are often considered as local diseases where there is local manifestation of the generalised or localised disease phenomenon. In either way the entire individual is diseased. Modern medicine would advise the local excision or removal of the affected infected part which in no way alters the disease process established in the individual body.

The only purpose of it is to reduce the disease load or reduce the risk of future or impending septicaemia.  The same can be achieved without the surgical excision, only with the help of the perfect indicated homeopathic remedy.

CASE:

A 60-year-old female patient who was a known case of hypertension and hypothyroidism presented with painful oedema of left foot which had purplish discoloration and pus pockets.

Fig 1:  Photo of left foot infective cellulitis

INVESTIGATIONS: 4/7/19

Hb : 12.6

 

WBC : 13200

 

Platelet 251000

 

HbA1C 5.5

 

Blood Sugar levels on Glucometer: 274 mg/dL

 

Fasting Blood Sugar 114 mg/dl
S.Creatinine 0.7mg/dl

 

S.Electrolytes: Sodium:     139 mEq/L

Potassium: 4.2 mEq/L

Chloride:   104 mEq/L

 

Urine Routine: pus cells 6-8/hpf

 

Fig 2  X ray foot left AP and Oblique, there is no osteomyelitis.
LOCATION SENSATION MODALITIES Mental concomitant
Left foot

Since 3 days

 

 

§  Started with itching in foot – swelling – vesicles

§  Discharging watery fluid with bright red bleeding few drops (sero-sanguinous discharge )

§  Burning 3+

§  Throbbing3+  pulsating pain

§  Erythema with purple discoloration

No fever

No lymphadenopathy

A/F: feet getting wet (?)

> Cold fomentation3+

>Pressure

< night

Hurriedness  3+

 

Disease Understanding:

Cellulitis: It is an acute inflammatory condition of skin characterized by local erythema, pain, swelling and heat Due to any type of injury. Frequently associated with lymphangitis and fever. [5]

                    Fig 3. Joslins Manual on Diabetes [4]
               Fig 4. Joslins Manual on Diabetes [4]

DIAGNOSIS: INFECTIVE CELLULITIS of LEFT foot with Blister Formation

with Latent Diabetes.

CAUTION:

If patient is not treated at this point patient can have complications such as necrotizing fasciitis & osteomyelitis.

CLASSIFICATION OF DISEASE:

Dynamic Acute Surgical Individual Disease with ONE SIDED PRESENTATION

ONE SIDED PRESENTATION as explained by the following aphorisms

Aphorism 173

The only diseases– have– few symptoms, termed one-sided, because they display only one or two principal symptoms which obscure almost all the others.

Aphorism 177

In order to meet most successfully such a case as this, which is of very rare occurrence, we are in the first place to select, guided by these few symptoms, the medicine which in our judgment is the most homoeopathically indicated.

Aphorism 185

Local diseases – so called – not just the local part – but the individual is affected as a WHOLE

Even though local part is infected ( the left foot) there is increased WBC count & blood sugar levels indicating the involvement of the whole individual. [1]

 

Fig 5. Figure representation of Aphorism 186
Fig 6.  Representation of correlation between latent diabetes & latent psora

According to Aphorism 194, The acute disease is a product of psora which had hitherto remained latent in the interior, but has now burst forth and is on the point of developing into a palpable chronic disease.

MIASMATIC DIAGNOSIS: TUBERCULAR

  • Hurriedness at mental and physical level
    • rapid progress
  • A/f – damp weather
  • Indolent system with hypertrophic changes
  • Increased activity leading to debility
  • Stimulation of R. E. S
  • Hyperdynamic changeable w.r.t emotions, intellect, desires, response
  • Diabetic syndrome
  • Hyperactivity with debility
  • In turn causes subject to be more vulnerable to infections esp. Tuberculosis
  • Giving rise to inflammation of serous membranes, subcutaneous tissues [9]

 

Fig 7. Disease evolution & expression of tubercle – ICR SYMPOSIUM VOLUME C

Evaluation of case:

  • Susceptibility: low
  • Few symptoms at level of physical particulars and mentals
  • Old age
  • Trivial injury/exposure leading to Infective cellulitis
  • One sided presentation
  • Paucity of symptoms
  • With not much qualified physical generals or mentals

Totality of symptoms using Boger’s approach:

  1. Gen: Wet agg
  2. Gen: Cellulitis
  3. Gen: Cold amel
  4. Mind: Hurry haste tendency
  5. Extremity pain: burning
  6. Extremity pain: pulsating

Fig 8. Representation of Totality of Symptoms

Remedy Differentiation: –

ARSENIC ALBUM TARENTULA CUBENSIS LACHESIS LEDUM PAL
Sensation Old ulcers with burning & lancinations Atrocious burning or sharp stinging pains

Pungent heat of surface

Burning in spots

Sn as if hot air were passing

Throbbing pains

Ascending type of rheumatism

Local symptoms Swelling of foot hard & shiny

Burning vesicles of blue black color

Hard & indurated abscesses & carbuncles

Bluish purple discoloration

Flat ulcers or swellings with blue/ purple surroundings Edematous Swelling, ecchymosis, black  blue discoloration.

Punctured wounds

Side affection Right sided Left sided Left sided Left shoulder & right hip
Causation

and

Modalities

< Bathing , straining ,

< Grief, fright

> Heat

< cold

< getting wet

< night

Injuries,

< heat

< grief , vexation

Puncture wounds

< night

< warmth

> cold

MIND ANGUISH

RESTLESSNESS

Cant sit in a place

Nervous restlessness

Hurry Haste

Insupportable anxiety

indolence with dislike for any labor

Anger

Dissatisfied, hates & avoids company

 MATERIA MEDICA REFERENCES:

Bogers Synoptic Key states that in Tarentula the seat of disease is cellular tissue. Onset of the disease is rapid with alarming prostration, atrocious burning or sharp stinging pains, sepsis, fidgety, purple discoloration, pungent heat of the surface.

Robin Murphys repertory mentions in the chapter Generalities “Cold Amel” Tarentula H. and Tarentula Cubensis remedies.

John Henry Clarke states: abscesses ending by mortification of the integuments over it, and having small openings, discharging a thick, sanguinous matter containing pieces of mortified cellular tissue, fasciae and tendons.

Phatak’s Materia medica states that Tarentula cubensis is toxaemic medicine useful for septic conditions, atrocious burning, bluish abscesses, Bluish abscesses, painful abscesses,

Boericke’s Materia medica states that Tarnetula Cubensis has septic condition, malignant suppuration, purplish hue and burning stinging pains.

Fig 17. Boericle materia medica [7]
Fig 9. Doctrine of signature of Tarentula Cubensis Spider

REMEDY PRESCRIBED:

  • TARENTULA CUBENSIS 200, half hourly.
FOLLOW

UP

SYMPTOMATIC ON EXAMINATION Rx
DAY 2 q Pain and heaviness in left foot reduced

q Burning and stinging decreased

q Oozing of fluid and blood reduced

q Tenderness mild

q Edema present but erythema reduced

q HGT: 175 mg/dl

Tarentula cubensis 200,

2 hourly

DAY 5 q Pain only on touch not otherwise

NO Burning and stinging

q No erythema

q Edema reduced

q On examination: No oozing no discharge

HGT: 98mg/dl

CBC : WBC count 10300

Tarentula cubensis 200,

2 hourly

Fig 10. Photo of the left foot after treatment
Fig 11. Blood Sugar levels Normalised on treatment

Figure 12: Day 7 Complete Recovery, Photo of Left foot, No signs of infection

References:

  1. Samuel Hahnemann. Organon of Medicine, 6th Edition, Indian Books & Periodicals Publishers, New Delhi, 2005, 260, IB0405
  2. Samuel Hahnemann., The Chronic Diseasse, Their Peculiar Nature And Their Homoeopathic Cure, Theoretical part with word index, Rearranged & augmented edition, U.P., India, 2005
  3. Cyrus Maxwell Boger – A Synoptic Key of the Materia Medica: A Treatise for Homeopathic Students: Rearranged & Augmented Edition: 1
  4. Krall, L. and Beaser, R., 1989. Joslin diabetes manual. Philadelphia: Lea & Febiger.
  5. Loscalzo, J., Fauci, A., Kasper, D., Hauser, S., Longo, D. and Jameson, J., n.d. Harrison’s principles of internal medicine.
  6. Clarke, J., 1900. A dictionary of practical materia medica. London: Homoeopathic Pub. Co.
  7. Boericke, W., 2005. Pocket manual of homeopathic materia medica & repertory. New Delhi, India: B. Jain.
  8. Phatak, S., 2005. Materia medica of homoeopathic medicines. 2nd ed. New Delhi: B. Jain.
  9. Dhawale, M., 1978. Symposium on Hahnemannian totality. 3rd ed. Bombay: I.C.R. – Symposium Council.

About the author

Rakesh Gupta

Dr. Rakesh Gupta MD(Hom) Practice of Medicine, MBA (HCS), FLP (KPMG), SCR. HOD Forensic Medicine and Toxicology, Smt Chandaben Mohanbhai Patel Homeopathic Medical College, Mumbai, India. President, Satva Homeopathy and Satva Charitable Sanstha, Mumbai, India.

About the author

Sheetal Jaisingh

Dr. Sheetal Jaisingh - Consultant Satva Homeopathic Clinic and Clinical Coordinator Satva Charitable Sanstha, Mumbai, India.

Leave a Comment

Subscribe
Homeopathy for Everyone
Learn homeopathy with the world's greatest experts every month - for FREE!
World's No.1 Homeopathy e-Journal - for the community, by the community.
No Thanks!
close-link