Clinical Cases

Venous Ulcer in a Man of 48

Last modified on September 27th, 2018

Sept  Pravin
Pravin Pente
Written by Pravin Pente

Dr. Pravin Pente treats a venous ulcer from a burn six years prior. Burning pain better for rubbing was an important clue.

Name:  S. D.

Date -15/06/2017

Age-48years  –  Sex-Male

Occupation – Retail Store

Married

Diagnosis- Venous ulcer since 6 years

Description of case

This is a case of unhealed venous ulcer for the last 6 years. His doctor advised him to go for amputation of a limb because it can lead to gangrene. He is als diagnosed with:

– Diabetes Mellitus since last 10 years,

-Hypertension since last 10 years.

-Hypothyroidism since 6 years.

-Venous ulcer since 6 years.

Chief complaint 

He consulted me for severe burning pain in the ulcer on right lower limb.  He sat on the examination table and was continuously rubbing his affected leg with his hand.

Dr. please do something for this burning pain. Since last night I couldn’t sleep due to this burning pain in my right leg. I was doing this rubbing since last night- burning is so severe as if someone has put some red pepper on my ulcer.I am rubbing continuously since night and now it’s intolerable. Do something for this burning.

D- How did it start?

P- I have my own vegetable shop and yesterday; I had hard work in shop so there is swelling over the limb and pain increased. It happens every time whenever I do hard work but this time it increased a lot.

D- Since when is this ulcer from?

P- More than 6 years. Actually I was traveling by bike and I had an accident so that time there was a burn and since then my injury never get healed. Afterwards it turns to ulcer and I took many medicines but no result.

Modality-

Aggravation- Night, touch, walking, standing,

Amelioration- rubbing, upright position of a limb

Observation– Ulcer has thin watery discharge from it, offensive odor, yellow debris in it, sensitive to touch, painful on touch.  He was not able to narrate any symptoms due to severe burning pain.

PAST HISTORY- Jaundice 2 years back.

FAMILY STORY  :FATHER- Died due to Heart attack

MOTHER- Asthma and HTN

PHYSICAL GENERALS:-

APPETITE- Good              DESIRE- spicy +++, sour+++                  AVERSION- sweet++

THRIST- thirsty+++         URINE- n                                                STOOL- hard stool

SLEEP- disturbed due to pain

DREAMS- no

THERMALS- Hot

Perspiration – profuse and yellow stain on clothes

Rubrics-

Skin; Burn; fail to heal, or ill effects

Skin ulcer; old

Skin, pain, burning smarting, night

Skin, pain burning, smarting, touch on

Pain. Burning, smarting, peeper, as from

Generalities, pain, run, rubbing, massage, amel

Skin, ulcers, discharging, suppurating, watery

Understanding and Analysis of the case-

In any acute pathological case the following points are important:

Etiology, diagnosis, observation, modality, mental state.

Following points are important:

  • Etiology- burn (old)- fail to heal
  • Diagnosis– Ulcer due to burn not a venous ulcer.
  • Observation– thin/watery discharge from the ulcer
  • Modality

Amelioration-   Rubbing,

Aggravation- touch, night, walking

Burning pain and amelioration rubbing by hand

References for the differentiation of remedies between Causticum and Arsenic Album. Book :Phatak Materia Medica.  One of the best remedies in unhealed ulcer is Causticum.

15/06/17Considering above understandingCausticum 200+6+1dr

3 doses a day

21/06/17His burning is reduced.

No pain at night and he has sound sleep at night. Edema over the limb is reduced. Ulcer is becoming dry.

Sl+6+1dr
23/06/17He is feeling better. Burning pain is reduced, irritability is also reduced, if he walked for a long distance then there is a swelling on the leg otherwise it’s better than before. RBS- 252mg/dl.

Acidity since morning and heart burn.

Sl+6+1dr
25/06/17No pain at all and dryness over ulcer- no discharge. Swelling is reduced.Sl+1/2dr
28/06/17He is feeling better. He started exercise. Mid gastric accumulation due to non-veg food.Sl+6+1dr
07/07/17Mild burning pain around the ulcer but edema over leg is on and off. Irritability increased. He had fight with one costumer since then anger increased.Caust200+6+1dr
12/07/17He is feeling better. no acidity, ulcer is reduced.Sl(visit)
19/07/17Ulcer is reduced. No burning pain- edema is reduced- no pain while walking- sleep is sound. Appetite is good.Sl+6+1dr
27/07/17He is feeling good- he feels confidence about ulcer- it will get cure. Irritability is reduced. RBS- 211mg/dlSl+6+1dr
10/08/17Edema is increased but ulcer is reduced – no swelling, mild itching and dryness around the ulcer- skin become shiny and healthy.SL+6+1DR3d
08/09/17He has swelling on the lower limb- no burning sensation in it, mild itching in it but no any pain.Sl+6+1dr2d
27/10/17Mild burning sensation in the limb due to over work- yesterday night he was working in the shop and he had lifted heavy thing since then there is swelling over the limb.Sl+6+1dr2d
14/11/17No burning sensation in lower limb- mild twitching in the limb.Sl+6+1dr
21/11/17He is doing well. RBS is 190mg/dl.

Heaviness in the body. No pain in the leg.

Sl+6+1dr4d
12/01/18He stopped eating tobacco- feeling energetic and happy. No ulcer at all. Sometimes there is swelling over the limb.sl+6+1dr
06/05/18He is feeling better,Sl+6+1dr2d

 

About the author

Pravin Pente

Pravin Pente

Dr. Pravin Pente B.H.M.S C.C.A.H. completed his B.H.M.S. from Panchasheel Hom. Medical College Khamgaon in 2006. He did C.C.A.H. from “the other song” International Academy of Advanced Homoeopathy, Mumbai in 2013. He subsequently studied with Dr. Narendra Mehta and Dr.Rajan Sankaran. He began clinical practice in 2008 at Karanja in Vidharbha Region, Maharashtra. Dr. Pente has taken seminars at Jabalpur, Bhopal, Indore through “the other song” and won the Best Case Presentation Award in 2013 and 14. His current focus is more on pathological cases and pediatric cases. He is presently doing an F.C.A.H. fellowship course at “the other song” Academy, Mumbai.

Leave a Comment

Your email address will not be published. Required fields are marked *