Dr S G Biju
It is a saying that Homoeopathy is more concerned with chronic disease than acute ones. But for a beginner in this branch of medical science have to face lot of acute diseases especially when he starts practice in rural areas. Even senior and veteran practitioners are facing acute exacerbation of chronic disease and acute diseases in chronic cases.
In Kerala only few Govt. hospitals are working round the clock. All most all private sector service will be withdrawn by 8 to 9 PM. So, most of the acute exacerbation of chronic disease and intensified symptoms and emergencies of acute diseases are being managed by allopathic doctors.
People still believe that Homoeopathy is not suited for Acute Emergencies and Allopathy is not nice for chronic diseases. To rewrite this concept Homoeopathy has to strive hard by convincing people about the effectiveness of Homoeopathic medicines in the management of acute diseases.
Homoeopathy is the only system of medicine that treats patients with internal medicines. Even for Ayurveda there are lots of auxiliary methods to treat patients. We have dynamic medicines to treat patients and seldom use the material doses. We randomly call our weapons in the armamentarium as Drugs, Medicine and Remedies as we know Drugs, Medicines and remedies are different entities.
- Drug is a substance that can alter the state of Health.
- Medicines are proven drugs &
- Remedies are those medicines that effect cure (permanent) after administration.
We can’t call a drug as a medicine or a medicine as a remedy. If so, which case is to be treated with drugs and which one with medicine or remedy should be a question in our mind.
Stalwarts of Homoeopathy advised us to keep off our hands from treating the result of diseases. Result of disease means advanced pathological conditions. Richard Hughes advised to consider pathological symptoms for selection of medicines as it is also one of the criteria for selection of similimum. But in this new era it is believed by the people that Homoeopathy can reverse pathology. All most all well known practitioners are concentrating on advanced pathological conditions and they have been winning in their endeavor. Such leading practitioners are making documents of treated cases and thus won the heart of public as well as collegues. Skeptics all over the world are scared of such documents and still trying to defame Homoeopathy by denying such proofs. This international scenario indicates the need of treating advanced pathological condition.
Those who have a passion to treating acute cases and advanced pathological conditions should know the protocols for treating the same. Before that we need an assessment from patients. In acute diseases patients are in need of relief from symptoms. In advanced pathological conditions patients are in need of an arrest in the progression of pathology and reversal of pathology if possible. They may be ready to suffer from few of their symptoms as they know the pathology is advancing.
We shall go back to Drugs, Medicines & remedies.
Drug: There will be alteration of health while we are giving drugs to patients. This alteration shall be either in the form of worsening or in the form of an improvement. Any way after administering drug, a change in the state of health is guaranteed. In our Materia Medica there are lots of symptoms related to pathology and few of them are strictly related to acute diseases only. Drugs are related to certain symptoms or precipitations of disease in terms of pathology. Drugs are usually prescribed in low potencies and are to be given in repetitions. We can see few examples of drugs.
- Ars Iod 3x in repeated doses can reduce ESR. (But the disease or the cause of ESR will be there)
- Uranium Nitricum 3x in repeated doses can bring back Blood Glucose level down. (But there is no cure for Diabetes Mellitus).
- Myristica Q in repeated doses can control infection (but patient will be prone to infection even there after.)
- Iodoform 1x can act as a Broncho dialator but it can’t cure Bronchial Asthma.
- Strophanthus Q can make changes in cardiomyopathy but it can’t cure the same.
- Berberis Q can reduce serum Cholesterol level but it can’t abolish the tendency for hypolipoprotenemia.
- Urtica urenus in lower dilutions can reduce S. Uric Acid but it can’t change uric acid diathesis.
- Urea 3x repeated doses can reduce blood urea level but it can’t cure renal failure.
- Thymol: is a drug for Ankylostomiasis but it can’t prevent the tendency for worm trouble
There are even so many such drugs in our Materia Medica.
Aforesaid drugs are to be used if you want to arrest pathology or to relieve acute complaints. Though these drugs are not curative ones they are useful in the management of acute disease and in pathologically advanced cases. We cannot assure a curative action even from constitutional remedy in certain condition where pathology or complicated and intense symptamatolgy supercede dynamic nature of diseases.
Medicines are proven drugs. We know all potentized Homoeopathic medicines are proven drugs. Our medicines are the only medicines proven in human beings. But in the management of acute diseases and pathologically advanced cases, a proven drug means a drug that has been found effective in managing certain diseases. Certain medicine possesses the exact symptamatology of certain diseases. Such medicines shall be called as nearly specific for certain disease. Such medicines shall cut off the duration of acute illness and such medicines can prevent complication too.
- Baptisia Q: is a medicine for typhoid it can cut short the duration of typhoid and prevent complications and sequale of Typhoid.
- Merc Sol 200: is a medicine for Dysentery and this can reduce duration of illness.
- Crotaus Hor 30: is a medicine for ulcerative colitis and can space episodes of spouts of bloody dioarrohoea.
- Merc Sol 200: is a medicine that covered almost all symptoms of Rheumatoid Arthritis and thus it can reduce symptoms of Rheumatoid Arthritis.
- Acid Flour 30: is a medicine for osteoporosis and thus can reverse pathology of osteoporosis.
- Nux Mos 200 & Acid Phos 200: are medicines that cover almost all symptoms of Diabetes mellitus thus it can arrest the progress of Diabetes Mellitus.
- Iris Versicolar 1M: covers almost all symptoms of classical migraine thus it can prevent recurrence of migraine.
- Theridion 30: covers most symptoms of Meniere’s Disease so it can abort an attack of vertigo in patients.
All the aforesaid medicines shall be called as ‘prepaid’ medicines. We have a guarantee about the effectiveness of such medicines in said diseases. In diagnosed cases such medicines shall be given as a similimum even without case taking. In acute emergencies such ‘prepaid’ remedies will save our time.
Which case is to be treated with drug and which is to be treated with medicine is crystal clear. Pathologically advanced cases should be treated with drugs and diagnosed dynamic cases with intolerable symptoms should be treated with medicines. There are 12 intolerable symptoms. Patients are not ready to wait for a long time with an intolerable symptom.
To manage the intolerable symptoms we have our own ‘pre paid’ guaranteed medicines. To give relief to patient, one can follow the following chart.
Tarentula Cub 30
Lateroduct Mac 30
Mag Phos 1M Belladonna 1M
Ars Alb 0/3
Acid Phos 30
Cuprum Met 30
Veratrum Alb 1M
Eel Serum 30
Cardus Mur 0/3
Cactus G Q
Mag Phos 6x
Carbo Veg 1M
Ant Ars 30
Trillium Penf Q
Carc Carb 0/3
Merc Cor 30
Tarentula His 1M
Mag Carb 200
Dolichos P 30
Tarentula H 200
Urtica Uren Q
Calc Carb 200
Ledum pal 200
Kalmia Lact 200
Avena Sativa Q
Chinninum Ars 30
Tarentula Cub 30
(* This is not a Remedy Chart only a drug/Medicine Chart)
Sir Willam Osler once said “Humanity has but three great enemies; fever, famine and war; of these, by far the most terrible is fever”.
If we are able to manage fever cases we will be known as an acute disease manager, among people. We can say that fever is a good sign, but we can’t bear it if it occurs to our child!
37degree C is not an absolute cut-off point, but an average normal temperature.
Some variation of temperature occurs normally also, the maximum being not more than 37.7 degree C ( 100 degree F)
According to American College of Emergency Physicians, fever is defined as a rectal temperature > 38 degree C (>100.4 degree F)
• Celsius to Fahrenheit
• t x 1.8 + 32
• Fahrenheit to Celsius
• t – 32
50 to 60% of fever cases shall be managed with auxiliary methods only. If you hesitate to treat fever with our medicines or drug it is better to turn in to auxiliary methods. Patients have the right to get rid of fever especially if they are children because it is a disturbing thing for his/her parents too.
Auxiliary methods to manage fever
Do not cover the child with too many clothes or blankets.
The most common mistake made by the parents is to bundle the child in heavy clothes.
A single sheet or no cover is best, except for a child with severe chills as in malaria, or UTI
Keep the room cool. Open a window slightly or turn off the heat in the room or use a fan
Coolness will bring the fever down.
Give plenty of cool, clear liquids to replace the water loss.
Fluid requirements increase by 10% for every 1 degree C rise in temperature above baseline.
The body may be massaged gently so that the cutaneous vessels dilate and body heat is dissipated.
Tepid sponging with lukewarm water is very beneficial to reduce fever.
An adsorbent towel should be soaked, rinsed and place on the legs, trunk, forehead and the folds.
Continue till the body temperature comes down to 38 degree C
If Temperature > 41degree F ( > 106 degree F ) it is called Hyperpyrexia
Rapid cooling is very important
By immersion of the child in cold water or by gastric lavage / enema with ice cold saline
Drugs for Hyperpyrexia
Buthus Australis 6x
Veratrum Vir Q
And few more drugs/Medicines to control fever in children
Fever After Vaccination – Carc 200
Fever with good appetite – Phos 200
Fever with rashes – Puls 1M
Anticipating pneumonia – Verat Vir 200
Fever with H/o Pneumonia – Pneumococcin 200
Gastric Fever – Baptisia 200
Rheumatic Fever – Streptococcin 200
Fever with Tonsillitis – Streptococcin 200
A patient suffering from fever needs reduction of temperature. If doesn’t get it from Homoeopathic medicines he will do the needful at the earliest.
Another condition slips between the fingers of due to lack of auxiliary methods id diarrhea with dehydration. Here too children or infants are usual victims.
Assessment of severity of dehydration
A child’s hydration status should be classified as
Look at the child’s general condition. Is the child:
Restless and irritable?
Look for sunken eyes
Offer the child fluid. Is the child :
Not able to drink?
Drinking poorly ?
Drinking eagerly, thirsty ?
Above observation will guide us to certain medicines too.
Two of the following signs: indicates Severe Dehydration
Lethargic or unconscious
not able to drink / drinking poorly
skin pinch goes back very slowly
( > 3 seconds)
Two of the following: Indicate some dehydration
drinks eagerly, thirsty
skin pinch goes back slowly
Drugs for Dehydration
Acid Phos 30
Cuprum Met 30
Veratrum Alb 1M
The core management of diarrhea is ORT
Home available fluids
Sugar salt solutions
ORS – the best available solution for fluid & electrolyte replacement.
Food based solutions – Rice water, dal water, butter milk, lassi, soup
Sugar salt solutions
Lemon water with salt & sugar
1 two finger pinch salt
1 heaped teaspoon sugar
1 large cup or 1glass water
WHAT IS NOT ORT
Glucose water without salt
Sweetened fruit juices
Have a high osmolarity
‘Oral dehydrating solutions
Ingredients /litre of ORS Grams
ORS for prevention of dehydration
Age amount of ORS to give after each stool
< 2 yrs 50 – 100 ml
2 – 10 yrs 100 – 200 ml
10 yrs or more as much as wanted
ORAL REHYDRATION SOLUTION
Give a teaspoonful every 1-2 minutes for a child < 2 yrs
Give frequent sips from a cup for an older child
If the child vomits, wait for 10 minutes. Restart
Do not add salt, sugar, lemon
Feeding during and after diarrhea is very important.
Diarrhea worsens the nutritional status because of the decreased food intake.
Feeding does not worsen diarrhea nor increases the risk of dehydration.
Continued feeding facilitates mucosal recovery.
There is no physiological basis of resting the bowel during diarrhea
TYPE OF FOODS
Ask the mother to give one extra meal for next 2 weeks following an episode of diarrhea.
Energy dense foods rich in potassium with least bulk as small frequent feeds at every 2 – 3 hrs interval.
To make food energy rich, add fats, oil or sugar.
Eg; rice with milk/curd and sugar, mashed banana with milk, mashed potatoes with oil and lentils.
Breast feeding should be continued.
Animal milk need not be diluted during any phase of acute diarrhea
There are so many other diseases where auxiliary methods can assist homoeopathic medicines. But our medicines can do wonderful work even without auxiliary methods in such cases.
Then what is the role of remedies in the management of Acute disease and Advanced pathological conditions?
Actually constitutional remedies have no role in the management of acute stage of disease if it is selected during the acute condition or in advanced pathology. But if a patient is under the treatment with a constitutional remedy and if the remedy proved effective in that particular case previously, then the remedy shall be tried even in acute cases and advanced pathology. That remedy should effect a cure atleast thrice in the patient previously.
Acute Emergencies and advanced pathology shall be treated with drugs, medicines and seldom with remedies. But never be satisfied by the results we are getting in the form of relief of symptoms or a laboratory result showing the efficacy of our medicines. A positive dissatisfaction should be kept in mind because the ultimate destination of a Homoeopath should always be the permanent cure. But in Pathologically advanced cases our duty is to reverse pathology and in acute disease to reduce the intensity of symptoms.
Denying the right of patient to get rid of his most virulent symptom is not a good practice. And doing the same drug therapy and sticking on to favorite medicine is a medical crime too!