A burn is a tissue injury from thermal heat or cold application or from the absorption of physical energy or chemical contact.
Burns are classified as follows.
Scalds – Result from partial-thickness or deep dermal skin loss.
Fat burns – Usual full-thickness skin loss.
Flame burn – Patches of partial and full thickness.
Electrical burns – Full thickness with deep extensions.
Cold injury – Ice formation, tissue freezing, vasospasm.
Friction burns – Heat plus abrasion.
Ionising radiation – Early tissue necrosis, late or tissue dysplastic change.
Chemical burn – Inflammation, tissue necrosis, systemic effects.
Burn depth depends, in thermal injury upon:
-The temperature of the burning agent.
-The mode of transmission of heat.
-The duration of the contact.
Superficial burns :
The have the ability to heal themselves by epithelisation above. Epidermal burns look red, are painful, blisters are not present, and they heal rapidly without sequel. Superficial dermal burns are, blistered and painful they should by epithelisation within 14 days without scarring, but sometimes leave long-term pigmentation changes.
Deep burns :
These have lost all adnexal structures and if left can only heal by second intention
with scarring they may be blistered and have a blotchy red appearance with no capillary return on pressure and absent sensation on pinprick.
Effect of burn injury :
Tissue damage – cell necrosis or direct cell rupture.
Inflammation – cellulitis
Infection – by Beta haemolytic streptococci, Septicemia, Bacteremia.
Regional problems in burns :
Circulation – Damage to limb vessel in high tension electrical burn causing oedema and leads to venous obstruction.
Systemic Effects :
Multiple organ failure of renal or hepatic function or heart failure.
Inhalation injury – inhalation of products of combustion or a hot gases causes thermal burn to various part of upper respiratory track and chemical burn to the bronchial tree and lungs.
Systemic complications – occurs in association with burns such as Curling’s (gastric or duodenal) ulcer that may result in acute haematemesis, urinary tract infection, deep vein thrombosis, pulmonary embolism, septic complications.
Clinical Features / Effects of Burn Injury :
Pain – immediate, acute and intense in superficial burns. Little pain in deep burns.
Acute anxiety – severe at the time of injury.
Fluid loss and dehydration – tachycardia from fluid loss
Local tissue oedema – superficial burns with blisters and deeper burns develops oedema in subcutaneous spaces.
Special sites – Eyes may be involved in explosion injury or chemical burns and nasal airway, mouth and upper airway in inhalation injury.
General Management :
• Stop the burning process.
• Cool the burned surface immediately for 20 minutes.
• Emergency examination performs the order of priorities in the management of a major burn injuries.
A – airway maintenance
B – breathing and ventilation
C – circulation
D – disability, neurological status
E – exposure and environment control – keep warm.
F – fluid resuscitation
Homoeopathic Management :
Aconite (2) – use immediately after the accident to counteract the nervous shock or when reaction has taken place, and there is dry, burning heat of the skin, heat hot and painful, face is red, pulse hard, frequent and contracts. There is great restlessness, panic and fear of death.
Anrica (1) – Helps prevent sequel :
Such as shock after severe, deep burns and prevent septicemia. Inflammation of skin and celluler tissue with extreme tenderuess and pain. Pattend does not want to approach and tell every one present they are all right and wants to be left alone.
Arsenicum (3) – Deep burns with vesicles and infected flesh that turn black showing tendency towards gangrene, Inflammatory swelling, with burning, lancinating pains. Infection from dead tissue remaining in the wound great anguish and restlessness, changes place constantly. Fents death and being left above. Thinks it is useless to take medicine. Prostration which may seem out of proportion with the situation colic after severe burn.
Calendula (2) – This remedy is useful for minor superficial burns caused by fire or the sun. Calendula also prevents gangrene and promotes granulation as well as prevents disfiguring scars. Prevents loss of blood and excessive pain. It is a good remedy to use to promote healing after specific acute remedies have removed the shock, pain and immediate symptoms. Use this remedy internally in potency and externally as a lotion.
Cantharis (3) – If used early it will prevent the formation of blisters. This is the most used remedy for scalds, burn and sunburns with vesicular character, blisters and superficial ulceration. Small blisters coalesce to form large blisters. Burns and scald with rawness and burning > by cold applications, followed by undue inflammation. Tetanic or epileptiform convulsions followed by coma. Extensive burns cause a renal complication. Patient is < by touch, approach and > rest. Use internally and externally in lotion.
Carbolic Acid (1) – Useful for the ill effects of deep burns as well as old burns do not get well. Chemical burns and scalds. Intensely sympathetic, thinking of complaints aggravate them.
Rhus tox (2) – After burns and scalds with vesicles, bullae (large blisters), Pustules. The burns are extensive burn more superficial although there may be erysipelas with typhoid like symptoms, sensorium become cloudy.
Sol (2) – This remedy is made form potentised sunlight. It is useful in sun burn both as a preventive in those who are extremely sensitive to the sun and as well curative in overexposure. May be useful reducing the amounts of UV radiation in the skin.
Urtica urens (3) – For simple burns involving the skin, superficial burns. Intense burning and itching. Useful is chemical burns caused by poisonous plants use internally and externally.
BURNS, in general – Acon, Arn, ARS, calen, CANTH, Carb-ac, Caust, Rhust, Sol, URT-U.
Ailments from burns – Carb-ac, Caust, Pic-ac.
Black, deep burns turns gangrene – ARS.
Bullae (large blisters) – Rhus-t.
Prevent from arising – CANTH, Kali-m.
Small vesicles colesce to form large blisters-canth.
Chemical burns – Caust.
Anguish and restlessness, changes place constantly – Ars.
Fears death – Acon, Ars.
Fears alone, and being-Ars.
Nervous shock- Acon.
Panic shock – Acon.
Shock after severe, deep burns-Arn.
Sympathetic, intensely, thinking of complaints aggravates them – Caust.
Useless thinks it is, to take medicine – Ars.
Old burns do not heal – Carb ac, Caust.
Infection and promotes granulation – CALEN
Disfiguring scars – Calen
Superficial burns that burns and itch intensely- Urt-u
1) 23rd edition of Short practice of Surgery – Bailey & Loves Page no. 189 – 199.
2) Gems of Modern Homoeopathy by Dr.J.D.Patil & Dr.P.S.Chindak
3) Homoeopathic therapeutics by Dr.Samuel Lilienthal
4) 6th edition Repertory of Homoeopatic materia medica – Dr.J.T.Kent
5) Clinical materia medica – by Dr.E.A.Farrington
Dr.Pawan Chandak . Maharastra