Homoeopathy in the management of Paronychia

Dr Sowmya Ashok

Paronychia is a soft tissue infection around a fingernail that begins as cellulitis but that may progress to a definite abscess.

paronychia

Paronychia of the big toeThe term is from Greek para, “around” and onukh-, “nail”. Paronychia is also sometimes called ‘whitlow’. This is commonly seen in children due to finger sucking and nail biting.

PATHOLOGY:

Because of repeated inflammation, swelling and fibrosis nail folds become round and retract. Protective layer of nail is lost. So, there is persistent retention of moisture. If this micro-organism persists in nail they further multiply and infection spreads further. With time blood supply is lost.

AETIOLOGY:
In Acute paronychia the causative organism is bacteria staphylococcus aureus. Other bacteria that are less commonly involved are Streptococcus species and Pseudomonas species. Chronic paronychia in earlier times was believed that is caused by Candida but now it is said due to repeated irritation such as exposure to water and detergents.

SIGNS AND SYMPTOMS:
Inflammation & pain usually starts from the sides of the nail in case of in-growing nails, whereas in the case of infection, it arises from the base of the nail. Normally, it will subside within 5-7 days, but can persist for weeks or months. Also sometimes, it may annoy the sufferer with its recurring tendency. The common symptoms are

  • Pain and being sensitive to touch
  • Redness and swelling in nail bed
  • Discharge of pus when it opens
  • Fever may accompany in case of development of complications/inner spreading abscess

INCIDENCES:
Nail/nail bed problems can affect any person of any age group, but it is commonly seen more in females than males, the reason is not clearly understood. Anyway, researchers point to constant usage of water as the main causative factor. Likewise, those who bite their nails and those who suck their thumb are susceptible to this infection. It is also commonly noted along with diabetes, psoriasis and other autoimmune disorders. Also, it is more commonly seen in immunosuppressive treatments.

GENERAL MANAGEMENT:

  1. Keep fingers or toes dry and clean
  2. Elevate the infected finger to make good venous drain and reduce pain
  3. Hot water fomentation usually comforts by enhancing the blood circulation and diluting infection and by quickening the healing process.
  4. Trim in-grown nail from edge-to-edge in semi-lunar manner to avoid getting wound and infection
  5. Wear gloves while there is risk of injury or chemical contact
  6. Control sugar levels in case of diabetes

HOMOEOPATHIC MANAGEMENT:
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a detailed individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution, family history, presenting symptoms, underlying pathology, possible causative factors etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. A homeopathy doctor tries to treat more than just the presenting symptoms. The disease diagnosis is important but in homeopathy, the cause of disease is not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness are also looked for. Nowadays, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathic remedy tries to correct this disease predisposition. The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology is not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can be greatly improved with homeopathic medicines. Homoeopathy proves its efficacy by controlling, curing the disease & preventing the disease by raising the immune power against that disease, so that recurrence can be surely avoided. Also, in Homeopathy, there are medicines to bring out the pus without using the scalpel (surgical knife).

HOMOEOPATHIC THERAPEUTICS:

ANTIMONIUM CRUDUM
It is helpful in treatment of  fungus causing distorted nails and toenails. It is suited to a person who is very irritable and has thickly coated white tongue. Symptoms are worse by heat and cold bathing. He has tendency to grow fat. It is given when nails are brittle and grow out of shape.

SILICEA
Silicea is very helpful for nail fungus with pus, infection and sharp pains in toenails. It is given to patient who has affection of finger nails. It is given especially if white spots are present on the nails. It is very good remedy for ingrowing toe nails. Patient has icy cold and sweaty feet. Patient has suppurating sensation in finger tips.

GRAPHITES
Graphites is given when patient has nail fungus when nails crack. It can also be given when patient has stiffness and contraction of toes. His nails are brittle and breaks easily. It also treats when patient has deformed nails which are painful, sore, thick and crippled.

BUFO RANA
It is given when patient has pain in extremities. It is given when patient has fungal infections of the nails and toenail which appear bluish or blackish in colour. It is given when patient has swollen skin around the nails and has pus.

FLOURIC ACID: It assures positive results in cases where the nails grow very fast and are crippled with fungus infection.

BELLADONNA: Very useful for nail infection when onset is sudden with throbbing pain, red hot inflammation.

RUBRICS RELATED TO PARONYCHIA:

Phatak’s Repertory

  • Nails – painful – Caus, Grap, Merc, Nit-ac, Sil, Sul

William Boericke’s  Materia Medica with Repertory

  • Locomotor System – Fingers – pains, at root of nails – All-c, Berb, Bism, Myris
  • Skin – Whitlow – felon, panaritium – All-c, Alum, Am-c, Anthraci, Apis, Bell, Bry, Bufo,Calc-f, Calc-s, Calen, Crot-h, Dios, Fl-ac, Hep, Hyper, Led, Merc, Myris, Nat-s, Ol-myr, Phos, Sil, Tarent-c

Frederik Schroyen’s Synthesis Repertory

  • Extremities – Abscess – Fingers  – androc, bufo, Fl-ac, Hep, hydrog, Lach, Mang
  • Extremities – Abscess – Fingers – Nail,around – hydrog
  • Extremities – Inflammation – Nails – Calen, kali-c, moni
  • Extremities – Inflammation – Nails – Around – con, hell, kola, moni, Nat-m, Nat-s, ph-ac, sil, tritic-vg
  • Extremities – Inflammation – Nails – Roots – Hep, kali-c, Stict
  • Extremities – Inflammation – Nails – Under – sil

Robin Murphy’s Homoeopathic Medical Repertory

  • Hands – Inflammation – Fingers – nails, around – con, hell, hep, kali-c, nat-mur, nat-s, ph-ac, stict
  • Hands – Nails,fingernails – Inflammation – AM-C, ANTHR, APIS, DIOS, FL-AC, HEP, NIT-AC, SIL, TARENT-C

JT Kent’s Repertory of Homoeopathic Materia Medica 

  • Extremities – Abscess – Fingers – Fl-ac, hep, lach, mang
  • Extremities – Inflammation- Fingers – nails – kali-c
  • Extremities – Inflammation – Fingers – nails – around – con, nat-m, nat-s, ph-ac
  • Extremities – Inflammation – Fingers – nails – root of – Hep, stict

REFERENCES:

  1. Clinical Dermtology by Thomas P. Habif
  2. TB of Surgery by Sri Ram Bhat
  3. TB of Medicine – Golwalla
  4. Clarke’s Dictionary
  5. Allen’s Keynotes
  6. Pocket Manual of Homoeopathic Materia Medica – William Boaricke
  7. Homoeopathic Therapeutics – Samuel Lilienthal
  8. The Chronic miasms – Allen J H
  9. A concise repertory of homoeopathic medicines – Dr S R Phatak
  10. Boericke’s new method of homoeopathic materia medica with repertory – William Boericke
  11. Synthesis Repertorium Homoeopathicum Syntheticum – Dr Frederik Schroyen
  12. Homoeopathic Medical Repertory ( A modern Alphabetical and Practical Repertory) – Robin Murphy
  13. Repertory of Homoeopathic Materia Medica – J T Kent.

Dr Sowmya Ashok (Md Part 1)
Organon of Medicine & Philosophy
Father Muller Homoeopathic Medical College
Mangalore, Karnataka.

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