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Name: Mrs SK.

Age: 45 years

Sex: Female.

Occupation: Housewife.

Presenting complaints:

1. Painful swelling and ulceration of the abdominal wall.

2. Fever with chills since several days.

Details of the Presenting complaints:

The complaints started before two weeks. Initially there was a painful boil on the abdomen. Next day, the patient herself removed the pus by squeezing without taking any aseptic precautions; hence there was swelling and tenderness in the area due to secondary infection. Consulted a modern medical doctor, and he prescribed some medicines including some ointments for external use. But the condition was getting worse day by day even after 12 days. Finally there was huge ulceration with discharge of pus. The whole area was very tender, and hence it was difficult to do the household works. As a result of secondary infection, there was high fever with chills.

Since there was no response from medical treatment, the case was referred to a surgeon. Finally, as usually done by most of our patients, they decided to try Homoeopathy before going to the surgeon. Hence I was consulted 3-9-12.

Past history: History of breast abscess before 5 years, which was managed surgically. Patient was also operated for Hiatus hernia before two years.

Family history: Husband and children are having good health except some allergic problems. Father is having DM.

Vital signs: Pulse: 110/min; Temp: 101°F; RR: 22/min; BP: 120/80 mmHg.

Local examination:
Deep ulceration on the abdominal wall with discharge of pus. The edges of the ulcer look unhealthy with no signs of granulation tissue. Even the fatty tissue is visible. There is hardness and tenderness around the ulcer due to cellulitis. Pus was sour smelling.

Physical generals
Appetite – Poor
Thirst – Normal
Bowels – Irregular
Urine: Burning urination
Desires: Warm food items
Thermal: Aggravation by cold, wants covering.

Mental Generals: Very irritable. Usually overpower family members.

Life space investigation: Basically from a poor family, but now husband is having good financial situation. Living happily with husband and four children. She is over worried about the health of family members.

Notable symptoms:
· Open abscess with discharge of pus.
· Sour smelling pus.
· Very sensitiveness to touch.
· Highly chilly.
· Easy suppuration from a small boil.
· Irritable.

Disease diagnosis: Abdominal wall abscess with cellulitis.

Remedial diagnosis: Hepar Sulph.

Prescription:

First visit (3-9-12): Hepar sulph 200, 3 doses per day, for 7 days.
Patient was advised to keep the area clean. Avoid tight dressing. Also informed them to inform the changes on regular basis, especially about temperature and the condition of ulcer.

Second visit (10-9-12): The ulcer looks very healthy with the presence of granulation tissue. No pus, except watery oozing. Fever is also reduced. Given placebo.

Third visit (13-9-12): The healing process is good, except a small portion at the center. Patient started doing household works. Placebo continued.

Fourth visit (16-9-12): Scab formation has taken place. Patient has slight itching occasionally. Placebo continued.

Fifth visit (19-9-12): The lesion is completely healed with a slight discoloration at the sight. (Photo was not taken)

[Pictures of 1st, 2nd, 3rd and 4th visits are given]

Discussion:
No repertorization was done for this case. Hepar Sulph was selected on the basis of presenting complaints. There was hypersensitivity, irritability, thermal modality, and even the smell of pus was sour smelling like old cheese. When the lesion started improving, placebo was prescribed, and asked the patient to report the progress. The patient is fine till date.

Copyright with Dr Muhammed Rafeeque

Views: 583

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Replies to This Discussion

this is a gem of a case

Appreciable

As expected, you did it again! 

Keep up. 

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