Sunday, 24 August 2014

Cholera

What is cholera ?

 Hahnemann and microbes

 It will surprise some modern scientists to be told that the microbic theories which they now advance to explain any and every disease are by no means of recent date, and that Hahnemann was before them all in claiming for microbes the chief share in the causation of cholera.

 In a pamphlet published in Leipzic in 1831  1 he vigorously attacked Hufeland, who advocated the atmospheric and telluric theory. In the following passage he anticipates modern views of immunity as well as of infection.
 “On board ships – in whose confined spaces, filled with mouldy, watery vapours, the cholera miasm finds a favourable element for its multiplication, and grows into an enormously increased brood of those excessively minute, invisible, living creatures so inimical to human life, of which the contagious matter of the cholera most probably consists – on board these ships, I say, this concentrated aggravated miasm kills several of the crew ; the others, however, being frequently exposed to the danger of infection and thus gradually habituated to it, at length become fortified against it and no longer liable to be infected.
 

Saturday, 23 August 2014

Aneurysm of the aorta & homeopathy

Definition
 An aneurysm is a pulsating tumour due to a dilatation of an artery, with the interior of which it is connected.
 Etiology
 This is a disease of middle life, and seen most frequently among men whose work demands prolonged physical strain. The uric acid diathesis, rheumatism, syphilis and alcohol play an important part in the production of arterio-sclerosis and thus in aneurysm. In this connection obliterating endarteritis of the vasa vasorum should be mentioned. Increased blood pressure is among the exciting causes in the thoracic aorta, and traumatism in the abdominal aorta.
 Pathology
 The existence of atheroma in every case of aneurysm of the aorta leaves no doubt of the association of the two processes. During the early stages both the inner and middle coats are thickened; while later, each is atrophied to such an extent that the outer coat practically forms the covering of the aneurysm

. In cases of rupture it is the inner coat that ruptures first, then the middle, and later the outer covering ruptures. A fusiform aneurysm is a general dilatation of the aorta and is seen most frequently in the ascending and transverse portion of the arch. A saculated aneurysm is due to the giving way of a circumscribed portion of the arterial wall and may vary in size from a pea to that of a man's head. Within the aneurysmal sac the blood may be partially fluid, with old and new thrombi, the colour and consistency of the latter varying with age.

 The recent formations are soft, while later they become firmer or calcified, and of a yellow colour. Occasionally, either by obliteration of the sac from deposits of blood within, or from closure of the orifice leading to it, a cure is completed. Of the aneurysms of the aorta, three-fourths are confined to the abdominal. Of those developing from the thoracic aorta, 60 per cent to the transverse and 10 per cent to the descending portion.
 Symptoms
 Aneurysm, if small, may produce no symptoms. But when they become large, the then give rise to pain, palpitation and breathlessness. Anginal attacks are common, with pain radiating to one or both shoulders and arms, accompanied at times with fluttering and throbbing of the heart.
 Inspection
 There is apt to be the pallor so frequently seen with disease of the aorta, and a pulsation at a point where it is not normally present; this is the most positive sign of aneurysm. It must be determined that the pulsation is not due to the heart or great blood vessels being in either an exposed or an abnormal position. The apex beat may be displaced according to the site and size of the aneurysm. If there is a bulging of the chest wall, it may be localised or diffused.
 Palpation
 The apex beat may indicate hypertrophy of the heart, but not necessarily. On placing the hand on such a tumour, a pulsation is detected, which is expansible in character, and in some cases, is accompanied by a distinct thrill. By very careful examination it may be determined that the pulsation of the tumour follows that of the apex beat.
 Percussion
 Will outline the heart and show any change in its position or size, and also show a dullness, the result of aneurysm.
 Auscultation
 Reveals a low pitched second sound, which if well marked, is loud and ringing and coincident with the diastolic shock.
 The pulse
 An aneurysm gives rise to a characteristic difference between the two radial pulses. The one affected is delayed, diminished in height, its duration is longer and subsidence more gradual than normal.
 The digestive system may be affected by pressure upon the stomach does not produce any marked symptoms, owing to the movable character of the abdominal viscera. Pressure upon the thoracic dust may interfere with the blood forming apparatus and emaciation result. Pressure upon the trachea, bronchi or lung will interfere with respiration and breathlessness, dyspnoea, cough or hemoptysis result.
 Tracheal tugging is observed when the head is bent backward and the tissues on the anterior surface of the neck put on a tension; if the fingers are now places between the cricoid and thyroid cartilages it will be found that the trachea is pulled downward with every cardiac contraction. This sign, while not pathognomonic of aneurysm, is often present when the transverse portion of the arch is involved. 

 Deglutition may be difficult, due to pressure upon the oesophagus. In some cases a localised perspiration is noticed, as well as areas of increased cutaneous temperature. The nervous system presents a variety of symptoms described as weight, tightness, soreness and pain; and paralysis of the laryngeal muscles, from pressure upon the vagus or recurrent laryngeal nerve is met with. The left vocal cord is the one most frequently affected, as that recurrent laryngeal nerve winds about the transverse portion of the arch of the aorta. If the right sub-clavian artery is involved, a similar condition may be met with on the right side.
 Unilateral paralysis of the diaphragm may result from pressure on the phrenic nerve. Changes in the size of the pupils from pressure upon the sympathetic nerves are common occurrences. The sternum and ribs in front, and the spine and ribs behind, may undergo erosion and necrosis from pressure. When the aneurysm is confined to the ascending portion of the arch of the aorta, it gives rise to a pulsating tumour in the second and third intercostal space, to the right of the sternum. In those cases where the sac develops upon the posterior surface, the pulsations are not present. The apex beat is usually to the left and downward from the normal point. Palpation over the region of the sac gives two impulses, the first may be a thrill.
 Percussion outlines an increased area of dullness, while auscultation reveals, usually, a systolic murmur followed by a short sound. The aneurysm may press upon the superior vena cava or right sub-clavian, and oedema of the right side of the face and arm result. If the tumour is very large it may interfere with the inferior vena cava and oedema of the lower extremities result.

 Pain is a constant symptom and is dull and aching in character; should the aneurysm press upon a bone, it is boring, if upon a nerve trunk, it is neuralgic in character. The pain may be severe in the right arm and the muscles become atrophied. Aphonia is present at times, due to the implication of the right recurrent laryngeal nerve. Cough, dyspnoea and breathlessness appear if there is much pressure upon the corresponding lung. When it is the transverse portion of the arch that is involved, the symptoms are more intense than in that just mentioned. This is due to the narrow antero-posterior diameter and as a result, greater pressure upon the structure by the aneurysm. Posteriorly there is the trachea and oesophagus, which, when pressed upon, gives rise to cough, dyspnoea and dysphagia. If the bronchi be pressed upon, bronchorrhea and dyspnoea result. The recurrent laryngeal nerve on the left side may be implicated and aphonia result. If the aneurysm extends upward it may effect the sympathetic nerves, causing dilatation of the pupil if there is simple irritation, or contraction, if there is paralysis. It may press upon the thoracic duct and induce emaciation. Should it extend forward it will press upon the manubrium which becomes eroded and necrosed.
 Aneurysm of the descending aorta, if close to the diaphragm, gives rise to a diffused pulsation which is accompanied by a thrill that is easily determined. Percussion shows the extent of the aneurysm; while auscultation usually shows a single sound or late systolic murmur. There is apt to be difficulty in swallowing, and dyspnoea due to pressure on the left lung; if the pressure is marked there may be a bloody expectoration, increased vocal fremitus, comparative dullness, bronchial breathing and other signs indicative of consolidation.

 Aneurysm of the abdominal aorta is accessible to physical examination, and as a result, it is not so difficult to make out the symptoms. The pulsating tumour may be seen and felt. Auscultation will reveal a systolic murmur. The digestive function may be interfered with as well as the intestines. If it should press upon the liver, icterus is often present.
 Diagnosis
 The recognition of an aneurysm connected with the thoracic aorta is often difficult. The diagnosis must be based upon the symptoms as already enumerated. The presence of arterio-sclerosis in an individual from thirty to forty-five years of age; whose occupation demands prolonged muscular strain; when taken in connection with those symptoms that result from pressure upon different structures, as pain, dyspnoea, aphonia, cough with bronchorrhea, oedema and physical signs of a pulsating tumour; the increased area of cardiac dullness; a systolic murmur with a systolic and diastolic shock, are sufficient to pronounce it a case of aneurysm. Tracheal tugging may be noticed, but it is a symptom of secondary importance, as it is present with other conditions. The diagnosis is especially difficult when the aneurysm is small, where there are no symptoms apart from those of pressure, and in those cases where the symptoms are not constant.
 Differential diagnosis
 Mediastinal tumours produce all of the pressure symptoms of an aneurysm, but they are not apt to produce the bulging or pulsation, found in aneurysm.

 When they do produce pulsation, it is quicker and not so heaving and steady as in aneurysm, and they do not possess the systolic and diastolic shock of aneurysm, nor is the heart necessarily affected. Mediastinal abscess gives the history of fever and evidence of septicaemia.
 Pulsating empyema is situated on the left side at the base of the lung, extends over a large superficial area and there is no murmur or double shock as in aneurysm. The pulse and pressure symptoms of aneurysm are wanting. In pulmonary tuberculosis the fever and emaciation are more pronounced, the bacillus tuberculosis are present in the sputum, and the cardiac-vascular symptoms indicating aneurysm are absent. It should be remembered that cases of hypertrophy of the pancreas may compress the abdominal aorta and give rise to a murmur heard in the line of the aorta, below the point of compression. It also gives rise to pain in the region of the stomach, felt immediately after eating; there are also pains due to pressure upon nerve roots, that may give rise to the sensation of a girdle. A pulsation is noticed in the region of the stomach, due to the action of the aorta upon the enlarged pancreas.
 Prognosis
 This is never good, but depends upon the situation of the aneurysm, the direction in which it extends, its shape, and whether it is extending slowly or rapidly. Aneurysms of the intra-pericardial portion of the aorta are especially dangerous. There is but little to support the aorta at this point and it has a greater degree of movement than in other parts; as a result, rupture of the aneurysm takes place early.

 In those situated above the attachment of the pericardium the prognosis is better, especially in those that extending backward on account of the possible pressure upon the root of the lung, vena cava or pneumogastric nerve. When the transverse portion of the arch is involved there is the danger from rupture, also from pressure upon important structures, and asphyxia and pulmonary collapse result. If the aneurysm extends forward there is not so much danger.
 Sacculated aneurysms, while they develop rapidly and may prove fatal, the mouth of the sac does not develop so rapidly, as a result the current of blood is lower within the sac and a deposit of fibrin may take place. The development of the aneurysm is thus checked and a cure may result. In the fusiform variety, while the development is slower its shape does not permit of a deposit of fibrin and as a result there is no tendency to repair.
 Treatment
 This is not satisfactory. The object is to render the blood pressure as low as possible, to slow the  circulation and render it equable. In order to accomplish this, absolute rest in bed for at least two months is imperative. If the use of the bed pan causes much straining it may be advisable to have the patient use a commode, but he should not be allowed to sit up for anything else.
 The rest should not only be physical but mental.
 Careful attention should be devoted to the diet. The liquids should be reduced as far as possible, not more than forty ounces being taken in twenty-four hours. The amount of food taken at each meal should be about the same, that there may be no excessive repletion and depletion, and as a result, no marked change of circulation.

 The food taken should be concentrated, at least not bulky, like potatoes. The object being the reduction of the volume of blood, that the pressure within the aneurysmal sac may be lessened and the blood fibrin readily deposited. Constipation must be avoided as its effects are very injurious to these patients. Insomnia at times is very annoying and will tax the physician's therapeutically resources. When as the result of the pressure, pain is severe, venesection will be found to afford an immediate relief by lowering the blood pressure within the aneurysm, and allowing a deposit of fibrin. The introduction of a coil of wire into the sac or the employment of the pole of a galvanic battery is attended with danger of embolism. The iodide of potassium has been used with a degree of success in increasing doses of from twenty to forty grains three times a day; just how its beneficial effects are produced is difficult to say, but probably it is by depressing the action of the heart, promoting diuresis and inspissation of the blood.
 Remedies
 Veratrum viride
 This drug has the power of reducing the pulse rate when given in five-drop doses of the tincture every three hours.
 Gallicum acidum
 In one half drachm doses, three times a day, has cured in a few cases.
 Ergotinum
 This has been used with a degree of success in aneurysm. When used it has been injected around the tumour.
 Baryta muriatica
 This remedy and the other preparations of baryta are reported to have cured cases of aneurysm. In their proving they have developed palpitation, dyspnoea, oppression with irregular and forcible action of the heart.
 Other remedies
 Aconite, digitalis, Gelsemium, Laurocerasus, have often of service, but must be used in full doses.

 Compression has benefited many cases, an account of its use may be found in any surgery.
 When the pain cannot be relieved by other remedies, five grains of lactucarium at night, will often give a good night's rest with but little, if any, bad after effects.

Tuesday, 19 August 2014

Tracheitis & its treatment in homeopathy

Tracheitis is a catarrhal inflammation of the mucous membrane lining the trachea. It may be acute or chronic and is usually associated with a similar inflammation in the larynx or bronchi, but may exist independently.

 Etiology

 It is caused by the same influences – exposure with lack of resistance or the inhalation of irritating matter – that would excite a laryngitis or bronchitis, or may occur secondarily by extension of either of the latter.

 Pathology

 Tracheitis passes through the usual phases common to catarrhal inflammations elsewhere. A first stage of dry congested and swollen mucosa and the second stage of relaxation, free mucous or muco-purulent secretion, with which the inflammation subsides.

Sunday, 13 April 2014

Homeopathic medicine useful in Multiple neuritis

The cause should be sought out and correct if possible, absolute rest is of importance whether the case is dependent upon alcohol or not. As the case advances splints are of service to prevent contractures and help allay pain. Massage and electricity may be employed when the acute symptoms have subsided; a weak galvanic current, the positive pole applied to the painful part, will relieve the pain.

 The diet should be plain, but not stimulating in any way. To relieve the pain, a hot water bag or hot cloths will be of service.

 Belladonna

 The pain is severe and the parts are red and congested, and extremely sensitive to pressure.

 Arsenicum album

 The burning pain is present. The stomach is complained of; there is nausea and vomiting.

 Rhus toxicodendron

 There is a history of exposure. The restlessness is allayed temporarily by motion. Dampness, cold and damp weather aggravate the condition.

Aphasia- Treatment in homeopathy

These cases should be treated symptomatically. Much has been accomplished by educating the patient in the use of the speech center on the opposite side of the brain. No doubt but in a large percentage of these cases that a condition of irritation or congestion is present and not an organic lesion. Under the carefully selected remedy many of these cases improve.
 Surgical methods must be introduced in case of tumor, abscess, etc.
 In the selection of a remedial agent the general symptoms of the patient must be considered.

 Arnica montana

 This remedy should be studied in case of aphasia following injury.

 Glonoinum

 This remedy should be remembered when there is an acute congestion of the brain.