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Monday, 29 July 2013

ACUTE PANCREATITIS 

As it often happens, some cases you treat simply retreat from memory until the patient comes back with some complaint or another patient many years later. Mr.S.G. aged 19 years had come to me on the night of 9th Sept. 2011 with severe upper right abdominal (Hypochondrium) pain. The boy was studying in Dharwad an education-city some 110kms from my town. The boy was diagnosed as a case of Renal colic but the treatment had no effect. Since he had come to me at 9:30pm, no investigations were possible and I gave him Berberis Vulg 30, asking him to see me the next day.

10-09-2011. 11:00 am: The boy was writhing in pain in my waiting room, clutching his abdomen. The pain was burning, intense and accompanied by cold sweat, restlessness and intense thirst. The water tasted bitter and he had vomited 3-4 times since last night. There was extreme tenderness and guarding of the abdomen.  I realized I was up against something far more serious. Pulse rate: 110/min; BP 150/90mm Hg.  His investigations were:
Hb 13.2  WBC count 13500/cu.mm; P84% Ly 16%. Serum Amylase: 3341 IU/Lt; Serum GPT 31 IU/Lt. S.Urea 33mg%; S. Creatinine 1.0mg%. USG: Bulky pancreas with altered echoes- Pancreatitis.

Given the few symptoms I had, it was obvious that the remedy was Arsenic alb. The same was given in very high potency at 2 hourly intervals - 8 times followed by placebo.

11-09-2011. 10:00 am: Patient felt subjectively better, tenderness and guarding less. PR 100/min. BP 124/80mm Hg. The patient was able to retain water. No vomiting since the last 8 hours. Tenderness +++; Guarding +. Placebo continued.

12-09-2011. 11:00 am. Patient quite comfortable. Tenderness +. No guarding.
Hb 13.2gm% TC 9340/cu.mm P50% Ly 43% M2% E 5%. GPT 42 IU/Lt; Amylase 1142 IU/Lt 
Total bilirubin 2.5mg% Direct bilirubin 1.0mg%.
 Clinical progress was continuous and rapid, the patient was monitored every day. Rx: Placebo

15-09-2013. 2:00pm. Patient comfortable and eating well. No Tenderness/guarding of abdomen. No complaints.
Hb 12.5gm% WBC 7560/cu.mm P55% Ly 41% M 4%. Amylase 700 IU/Lt. Total Bil 1.0mg% Direct Bil 0.13mg%.
 Rx  Ars. Alb 2 doses repeated

11-10-2011. Patient completely symptomless. Amylase 120 IU/Lt  Placebo continued for 10 days after which treatment was stopped, the patient had returned to Dharwad for his studies on 17th Sept..

I stress that in Acute cases a thorough and meticulous physical examination with appropriate investigations goes a long way in maintaining my confidence to treat such critical cases. A rigorous, regular and judicious follow-up can work wonders. A slip up at the preliminary stage itself may prove costly to both patient and doctor alike. Philosophical explanations are not entertained in courts of law.
CAUTION: Arsenic alb is not a specific medicine for Pancreatitis or any disease or symptom.
This article is not meant to suggest any such idea. 

Sunday, 14 July 2013

IS HOMEOPATHY A PLACEBO SCIENCE?

HOMEOPATHY IS PLACEBO - this is the favorite chant of our antagonists who take great pains to denounce our magnificent therapeutic science. They want proof' that it works! Millions of patients all over the world who take only homeopathic medicines for all their ailments are not proof enough. The thousands of allopathic doctors who take homeo medicines for themselves and family not withstanding (almost 80% of the doctors in my town)!

Two days ago I had an experience I would like to narrate. I was leaving my home for the clinic when I tripped over my pet dog and my right thumb got crushed in the door as I was shutting it. The distal phalanx started swelling almost immediately and a hematoma started to form under the nail. I rushed back into the house and applied an ice pack for ten minutes. Satisfied that this was the best I could do I left for my clinic. By the time I reached the thumb had swollen to twice its size. The entire nail bed had turned a dark red due to the extravasated blood. I took 3 doses of Arnica Montana 30 and got on with my work. By afternoon the entire nail had turned a menacing black. It was throbbing unbearably and I switched over to Sulphuric acid 30. every 2 hours - 3 doses. In the evening the thumb was so sensitive that I could not hold a pen or zip my pants!! I had to do something fast. I was tempted to take an allopathic anti-inflammatory when I remembered Boericke's or was it Kent's advice. I soaked a cotton swab in Arnica Q (mother tincture), applied it over the entire distal phalanx covering the tip of my finger, wrapped it in a thin plastic `finger stall' and taped it in place. To my surprise next morning the swelling was almost gone and the echymoses was atleast 50% less! I replaced the swab with a new one and taped it in place again. 24 hours later VOILA!! no trace of the black and blue swelling of the nail bed. Only a slight sensitiveness of the thumb tip remained!!
PLACEBO??????