Dr Manasa K A
ABSTRACT:
Introduction : Skin carbuncle is a suppurative infection of the multiple adjacent hair follicles and their surrounding tissue. Commonly caused by staphylococcus aureus. In conventional system of medicine, treatment includes systemic antibiotics combined with invasive procedures like surgical incision and drainage. But in homoeopathic system of medicine carbuncle can be cured without any invasive procedure by administering homoeopathic medication internally along with regular dressing.
Objective: to assess the efficacy of homoeopathic treatment in acute conditions like carbuncle
Case report: A 55 years old male presented with the complaints of pain, induration, blackish discoloration along with multiple sinuses oozing purulent discharge over right suprascapular region. Attended GHMC and hospital , Bangalore OPD on 27/03/23 and it was clinically diagnosed as carbuncle, he was prescribed anthracinum 30 along with regular dressing.
Discussion: in homoeopathy, research regarding management of acute conditions are very less. This case report is an attempt to show the efficacy of homoeopathic system in the treatment of the acute condition such as carbuncle
Conclusion : this case report concludes that homoeopathy is effective in the treatment of acute conditions like carbuncle with out any invasive procedures as well as cost effective. But further research studies such as RCT should be conducted to show the efficacy of homoeopathy in the treatment of acute condition such as carbuncle.
Key words: carbuncle, homoeopathy, acute condition and anthracinum.
INTRODUCTION:
Skin carbuncle is a suppurative infection of multiple adjacent hair follicle and their surrounding tissue. caused by staphylococcus aureus, Which can spread deeply to subcutaneous tissue and it occurs commonly where skin thickness is more, such as neck, back and thighs. Occurs commonly in people with co-morbidities like diabetes mellitus, immunodeficiency disorders and in obesity and poor personal hygiene.
Neck carbuncle is very common in clinical practice as amount of subcutaneous fat is more in this region, which offers less resistance and facilitates easy spread of infection.
Clinical signs and symptoms: It commences as a painful and stiff swelling with spreads rapidly with marked induration. The overlying skin becomes erythematous, dusky and oedematous, subsequently central part becomes soft with multiple vesicles, vesicles turns into pustules and then pustules bust out causing several sinuses which produces sieve like or cribriform appearance which is pathognomic symptom of carbuncle. Ultimately sinuses coalesce to form an ulcer with floor containing ashy grey slough. Along with this there can be enlargement of regional lymph nodes. Clinically patient feels throbbing pain and may have systemic symptoms like fever, chills, headache, loss of appetite and etc.
In conventional system of medicine, treatment of carbuncle includes systemic antibiotics combined with invasive procedures like surgical incision, drainage, debridement and dressing.
But in homoeopathic treatment, carbuncle can be cured without any invasive procedure by administering homoeopathic medication internally along with regular dressing. Acute conditions remedy selection is done based on acute totality which includes fixed generals and sector totality. Fixed generals – altered generals during the condition and sector totality includes ailments from, sphere of action as well as signs and symptoms.
in homoeopathy, research regarding management of acute conditions are very less. And myth about homoeopathic system of medicine is that it is very slow hence not useful in the treatment of acute condition. So, this case report is an attempt to show the efficacy of homoeopathic system in the treatment of the acute condition such as carbuncle.
But further research studies such as RCT should be conducted to show the efficacy of homoeopathy in the treatment of acute condition such as carbuncle.
CASE REPORT:
A 55 years old male who is obese and manual labourer presented with the complaints of severe, constant burning type of pain which makes him unable to move his neck, induration, blackish discoloration along with multiple sinuses oozing purulent discharge over right suprascapular region. Attended GHMC and hospital , Bangalore OPD on 27/03/23.
15 days back he started with the complaint of pain induration and redness of the skin over right suprascapular region. Later induration and redness started to increase in size and multiple boils started to develop over that. Since 1 day boils bursted out and started oozing purulent discharge. There was no history of fever, itching etc.
On examination there was induration with blackish discoloration of skin measuring approximately about 5×7 cm along with multiple sinuses oozing purulent discharge over right suprascapular region3 to4 cm lateral to spine (figure1)and right occipital and post auricular lymphadenopathy, Height was 154 cm and weight was 72 kg, BMI was 30.35. And there was no abnormality detected on other general physical examination and systemic examination. And case was clinically diagnosed as carbuncle
Past history : nothing significant
Family history : nothing significant
Personal history :patient is non vegetarian, his appetite is good, he is thirsty drinks 2&1/2 litres of water per day, no specific craving and aversion, bowel and bladder movements are regular. Sleep is sound with out any disturbance and thermally patient is chilly. But there was no alteration in the generals along with the complaint.
Plan of treatment
Anthracinum 30,6pills tid before food and Silicea 6x 2 tabs tid after food. Along with that draining of pus from sinuses and dressing with Caledula Officinalis tincture was done regularly.
Follow up table is given in table1
| Follow up date | symptoms | Homoeopathic intervention |
| 27/03/2023 | Carbuncle with multiple sinuses oozing purulent discharge with constant burning pain | 1.Anthracinum 30
6-6-6 2. Silicea 6x 2-2-2 Along with dressing |
| 28/03/2023 | Burning pain reduced
Rest of the symptoms were same |
1.Anthracinum 30
6-6-6 2. Silicea 6x 2-2-2 Along with dressing |
| 29/03/2023 | Burning pain reduced
Purulent discharge reduced |
1.Anthracinum 30
6-6-6 2. Silicea 6x 2-2-2 Along with dressing |
| 30/03/2023 | Burning pain reduced
Purulent discharge reduced |
1. PL
6-6-6 2. Silicea 6x 2-2-2 Along with dressing |
| 31/03/2023 | Burning pain reduced
Purulent discharge reduced |
1. PL
6-6-6 2. Silicea 6x 2-2-2 Along with dressing |
| 2/04/2023 | Burning pain reduced
Purulent discharge reduced Carbuncle reduced in size and sinuses started to heal |
1. PL
6-6-6 2. Blank tablets 2-2-2 Along with dressing |
| 5/04/2023 | Burning pain reduced
Purulent discharge reduced Carbuncle reduced in size and sinuses started to heal |
1. PL
6-6-6 2. Blank tablets 2-2-2 Along with dressing |
| 9/04/ 2023 | Carbuncle healed completely |
Basis for prescription: sector totality was considered as there was as there was paucity of symptoms. Case was repertorised using murhy’s repertory and after reperterisation and referring to homoeopathic materia medica by William Boericke, Antracinum was selected as a remedy.
DISCUSSION:
Skin carbuncle is a suppurative infection of the multiple adjacent hair follicles and their surrounding tissue. Commonly caused by staphylococcus aureus. In conventional system of medicine treatment includes systemic antibiotics combined with invasive procedures like surgical incision and drainage. But in homoeopathic treatment, carbuncle can be cured without any invasive procedure by administering homoeopathic medication internally along with regular dressing.
In homoeopathy, research regarding management of acute conditions are very less. And myth about homoeopathic system of medicine is that it is very slow hence not useful in the treatment of acute condition. So, this case report is an attempt to show the efficacy of homoeopathic system in the treatment of the acute condition such as carbuncle.
Selection of homoeopathic remedies is done on the basis of law of similarity. In acute conditions remedy selection is done based on acute totality which includes fixed generals and sector totality.
As there was paucity of symptoms and no alteration in general symptoms in this case sector totality was considered for selecting similimum and anthracinum was given as a remedy.
CONCLUSION: this case report concludes that homoeopathy is effective in the treatment of acute conditions like carbuncle with out any invasive procedures as well as cost effective. But further research studies such as RCT should be conducted to show the efficacy of homoeopathy in the treatment of acute condition such as carbuncle.
CONFLICT OF INTEREST :Nil
FUNDING–Nil
CONSENT FOR PUBLICATION–written informed consent was obtained from the patient for publication of this case report.
REFERENCES:
- Liu Z, Wei J, Cao Z, Zhu X, Zhang C. Fire Needle Combined Therapy or Surgery Therapy for Carbuncle of Neck? A Case Series. Infection and Drug Resistance. 2022 Dec 31:7293-9 https://www.tandfonline.com/doi/abs/10.2147/IDR.S391381
- Das S. A Concise Text Book of Surgery. 6th Kolkata:Das S;2010.p.83-84.
- Dhawale M L. I. C. R Operational Manual. 3rd Mombai:2011.p. 175.
- Boericke W. Pocket Manual of Homoeopathic Materia Medica and Repertory. New Delhi:B jainpublishers(p)LTD. P. 54
- RADAR 10.0 Homoeopathic medical software.
Dr. Manasa K A
PG Scholar, Department of Organon of medicine with Homoeopathic philosophy
Government Homoeopathic College & Hospital Bangalore- 560079
mansakodase123@gmail.com
Under The Guidance Of
Dr Shrinidhi Hebbar
Assistant Professor, Department Of Organon of medicine with Homoeopathic philosophy
Government Homoeopathic College & Hospital Bangalore- 560079
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