CHOLERA AND HOMEOPATHIC MANAGEMENT

                                                                        CHOLERA

DEFINITION:-

     Cholera is an acute  infectious disease caused by vibrio cholera (‘coma vibrio’) and characterized by severe watery diarrhoea ’rice water’ fluid, severe dehydration and electrolyte depletion and features of acute circulatory collapse.

CAUSES AND TRANSMISSON:-

    Cholera is mainly caused by bacteria vibrio cholera (‘coma vibrio’).

-          The organisms are present in faeces of infected persons.

-          Infection spreads mostly through flies that contaminate food and water.

-          More commonly occur in places of pilgrimage or fairs where a large population assembles at a time without proper sanitary arrangements or proper food and water supplies.

-          Hot and humid season is suited for cholera.

-          Factors responsible for spread of cholera are food, fingers, flies, fluids and fairs.

PATHOLOGY:-

    The incubation period is short, usually 1-2 days. The organism rapidly multiply inside the lumen of the small intestine but do not invade the wall of gut. They produce an exotoxin that stimulates secretion of alkaline fluid from the mucosa. There is severe watery diarrhoea with consequent dehydration, depletion of sodium and potassium and acute circulatory collapse. Renal failure is likely to set in.

SYMPTOMS:-

    The classical variety is known as ‘Asiatic cholera’.

-          The onset is sudden with profuse watery diarrhoea.

-          The stools are dirty white in colour, the so called ‘rice water stools’.

-          Diarrhoea is associated with profuse vomiting but no pain or colic. These leads excessive loss of water and electrolytes and patient soon passes into stage of collapse or shock.

-          When dehydration sets, patient complains of increase thirst and restless. The tongue, skin is dry, eyes sunken, the cheeks are hollowed and expression is anxious.

-          Loss of sodium causes severe muscular cramps.

-          Loss of potassium causes extreme weakness and distension of abdomen.

-          Pulse is rapid, weak or thread in severe cases, urinary output falls markedly.

-          The patient may develop remittent type of fever or he may even have hyperpyrexia leading to coma and death.

DIAGNOSIS:-

    Microscopical examination of the stools will decide the diagnosis.

TREATMENT:-

    Confine the patient to bed immediately upon the sign of cholera, better give him no food whatever until the disease is under control, then only nutritious liquid food, ice may be allowed in moderate quantities. Disinfect all discharges; as soon as patient becomes cold apply artificial heat. Some advise the injection into the rectum of several pints of water.

PREVENTIVE METHOD:-

-          The hand must be washed clean before taking food.

-          The fly population should be destroyed. All foods must be kept covered and protected from flies.

-          Drinking water should be properly disinfected.

-          Proper disposal of faeces should be undertaken with strict measures.

-          Vaccination provides only temporary protection for a period not more than 6 months.

HOMEOPATHIC REMEDIES:-

1.      ARSENICUM ALBUM:

Sudden prostration with sinking of the vital forces, violent vomiting and purging. Surface of the body cold, internally the patient is very hot, burns like fire. Great anguish, restless, fear of death. Thirst drinks little and often. Dyspnoea, suppression of the urine. Cholera, with intense agony, prostration, and burning thirst. Scanty, burning, involuntary.

2.       CAMPHORA:-

 Asiatic cholera, with cramps in calves, coldness of body, anguish, great weakness, collapse, tongue and mouth old. Onset sudden and the disease rapidly becomes worse, even before the diarrhoea sets in the skin is cold and blue, yet does not want to be covered, extreme prostration and perhaps a nausea and vomiting, burning in the abdomen with great anguish.

3.       CARBO  VEG:-

In the later stages, with symptoms of collapse. The diarrhoea, vomiting and cramps have stopped and the patient lies as if dead, no signs of reaction. The face is pale, the lips blue, body cold, even the breath may be cold, the pulse is hardly perceptible, thread like. Wants to be fanned

4.       CUPRUM MET:-

When the diarrhoea, vomiting and cramps are severe. The body is cold; the skin is blue, terrible dyspnoea. Symptoms of paralysis of the organism. Gurgling and rumbling in the bowels, particularly when the diarrhoea is stopped. Cold water relives the vomiting. The best remedy for the cholera cramps, and vomiting also, when this is a prominent feature.

5.       HYDROCYANIC ACID:-

The only remedy when along with pulselessness, the respiration is slow, deep, gasping or difficult and spasmodic, taking place at long intervals, the patient appearing dead in the intermediate time. If any remedy is entitles to be spoken of as a charm. It is this. It would seem at times to restore animation to a corpse.

6.       SECALE CORN:-

 Cholera-like stools, with coldness and cramps. Involuntary stools; no sensation of passing faeces, anus wide open. Burning in stomach and abdomen; tympanites. Pale, pinched, sunken face. Retention, with unsuccessful urging. Burning sensation; better by cold; wants parts uncovered, though cold to touch.

7.       VERATRUM ALBUM:-

The attack begins with vomiting, purging and violent cramps. Terrible weakness, especially after vomiting. The patient is cold, covered with cold sweat, particularly on the forehead. Most important remedy for cholera. Pulse small, almost imperceptible. Thirst for cold water. Cutting pain in the abdomen. Cases marked by profuse vomiting and purging, with coldness indeed, but without deadly collapse and lividity.

Some of other drugs are kali bich, nux vomica, podophyllum, rheum, phos, and sulphur.