MOTION SICKNESS OR TRAVELLING SICKNESS AND HOMEOPATHIC MANAGEMENT

                                       MOTION SICKNESS OR TRAVELLING SICKNESS

               

                Motion sickness or travelling sickness is a type of sickness that affects certain individuals during sea, land or air travel.

AETIOLOGY OR CAUSES:-

-          The cause is remains unknown.

-          Repeated stimulation of the vestibular apparatus may be responsible.

-          Persons suffering from migraine, diabetes mellitus or nephritis.

-          Pregnant women are more susceptible.

SYMPTOMS:-

-          The affected person starts feeling unwell while travelling.

-          Headache.

-          Excessive salivation.

-          Nausea and vomiting.

-          Visual disturbances (e.g. diplopia).

-          The face is pale, the skin is cold, pulse Is rapid and the blood pressure is low.

-          In case of severe attack, the person may faint or even collapse.

-          On discontinuation of the journey, the symptoms usually subside within a few hours but may persist even for days in susceptible individuals. Motion sickness is, however, not fatal.

DIETS:-

-          Avoid heavy food or heavy meals while before travel.

-          Use more of liquid foods, fruits or fruit juices.

-          Chew bubble gum or chocolates while travelling.

-          Glucose powders or ors powders will be helpful.

TREATMENT:-

-          Susceptible persons should take due precautions while travelling.

-          The affected person should rest quietly with minimum possible movement.

-          A rich carbohydrate diet or frequent sugar drinks are advisable.

-          Cyclizine hydrochloride 50 mg three times a day prevents or diminishes the severity of symptoms.

-          Dimenhydrinate 25 mg thrice daily is equally effective.

HOMEOPATHIC TREATMENT:-

1.       COCCULUS INDICUS:-

Vertigo, nausea, especially when riding or sitting. Headache in occiput and nape; worse, lying on back of head. Sick headache from carriage riding cannot lie on back part of head. Opening and shutting sensation, especially in occiput. Pupils contracted. Pain in eyes as if torn out of head. Nausea from riding in cars, boat, etc., or looking at boat in motion; worse on becoming cold or taking cold. Aversion to food, drink, tobacco. Sea sickness. Sensation in stomach as if one had been a long time without food until hunger was gone.

2.       PETROLENUM:-

Sensitive, as of a cold breeze blowing on it. Motion sickness. Headache, must hold temples to relieve; provoked by shaking while coughing. Vertigo on rising, felt in occiput, as if intoxicated, or like sea-sickness. Dim sight; far-sighted; cannot read fine print without glasses; blennorrhea of lachrymal sac; marginal blepharitis. Ringing and cracking in ears. Nausea, with accumulation of water in mouth.

3.       SEPIA:-

Stinging pain from within outward and upward mostly left, or in forehead, with nausea, vomiting; worse indoors and when lying on painful side. Feeling of goneness; not relieved by eating. [Carb. an.]. Nausea at smell or sight of food. Nausea worse lying on side. Nausea in morning before eating. Disposition to vomit after eating. Acid dyspepsia with bloated abdomen, sour eructations.

Some of other drugs for motion sickness and travelling sickness are given below.

1.        CALC CARB.

2.       CALCAREA PHOS.

3.       CYCLAMEN.

4.       HEPAR SULPH.

5.       IRIS.

6.       LYCOPODIUM.

7.       MAGNESIUM CARB.

8.       NUX MOSCHATA.

9.       NUX VOMICA.

10.   TABACUM.

11.   THERIDION.

LOBAR PNEUMONIA AND HOMEOPATHIC MANAGEMENT

                                                               LOBAR PNEUMONIA

DEFINITION:-

Consolidation or solidification of the lung due to inflammation of the lung alveoli is known as pneumonia. Consolidation of one or more lobes of the lung caused by pneumococcus is known as lobar pneumonia or pneumococcal pneumonia. It is the commonest type of pneumonia.

AETIOLOGY:-

-          The causative agent is pneumococcus in that commonest being ‘streptococcus pneumoniae’.

-          Infection spreads from person to person by droplet infection, overcrowding.

-          Sudden exposure to cold is a strong predisposing factor.

-          The disease more common during winter months and in condition like nephritis or chronic alcoholism.

-          The disease more common in ‘adults’ in the age group of ’15-40 years’.

PATHOLOGY:-

The pneumonic process passes through 3 stages. Stage of hyperaemia, stage of consolidation and the stage of resolution. During the stage of hyperaemia there is exudation of inflammatory exudates (consisting of fibrin, leucocytes and red blood cells)into the lung alveoli. During the subsequent stage of consolidation the exudation get solidified and solidified lung looks like liver. Hence the stage is often called the stage of hepatisation. Initially there is red hepatisation followed by grey heaptisation. During the stage of resolution, jelly like solidified exudates are once again liquefied by the action of macrophages. The liquefied exudates are thereafter either absorbed or coughed out and the normal stage of lung alveoli is restored back. Occasionally, the incomplete resolution may lead to fibrosis or bronchiectatic changes in the affected part of the lung.

SYMPTOMS:-

-          The onset is sudden.

-          The temperature rises to 103 F  or higher, often associated with rigors and vomiting.

-          Initially the cough is unproductive and dry, harassing but later, during the stage of resolution, it is associated with expectoration.

-          The sputum is thick and tenacious initially but later turns rusty in colour .the sputum maybe tinged with frank blood.

-          Pain may felt in the shoulder on the affected side or the upper abdomen if the diaphragmatic pleura is involved.

-          Dyspnoea, breathing is rapid and shallow due to the associated chest pain.

-          Headache, malaise, body ache, anorexia and weakness are other notable symptoms.

-          On examination, the patient looks toxic, dyspnoic and often cyanosed.

INVESTIGATIONS:-

-          There is marked leucocytosis with increased polymorphonuclear cell count.

-          Culture of sputum shows presence of pneumococci.

-          X-ray – shows a homogenous opacity confined to the affected lobe or lobes.

COMPLICATIONS:-

1.       PULMONARY COMPLICATIONS:-

-          Suppurative pneumonia or lung abscess.

-          Creeping pneumonia or double pneumonia.

-          Pleural effusion or empyema.

-          Respiratory failure.

2.       CARDIVASCULAR COMPLICATIONS:-

-          Peripheral circulatory failure.

-          Pericarditis.

-          Endocarditis.

-          Deep vein thrombosis.

3.      GASTROINTESTINAL COMPLICATIONS:-

-          Jaundice.

-          Meteorism.

-          Paralytic ileus.

4.       NEUROLOGICAL COMPLICATIONS:-

-          Meningism.

-          Pneumococcal meningitis.

5.       BONES AND JOINTS:-

-          Osteomyelitis.

-          Suppurative arthritis.

6.       MISCELLANEOUS;-

-          Septicaemia.

-          Oliguria and uraemia.

-          Acute suppurative Otitis media and mastoiditis.

TREATMENT:-

-          The patient should be confined to bed.

-          If dyspnoic, he should kept in a propped up position. Oxygen inhalation is needed if the patient is cyanosed.

-          Benzyl penicillin should be injected intra muscularly in every 6 hours. Ampicillin 500 mg IM 6 hours once, erythromycin should be given.

HOMEOPATHIC TREATMENT:-

1.       ACONITE:-

Acute, sudden, and violent invasion, with fever, call for it. First remedy for inflammations, inflammatory fevers. Hoarse, dry, croupy cough; loud, labored breathing. Child grasps at throat every time he coughs. Cough, dry, short, hacking; worse at night and after midnight. Cold sweat and icy coldness of face during fever. Thirst and restlessness always present.

2.       ANTIMONIUM TARTARICUM:-

Great rattling of mucus, but very little is expectorated. Rapid, short, difficult breathing; seems as if he would suffocate; must sit up. Coughing and gaping consecutively. Bronchial tubes overloaded with mucus. Cough excited by eating, with pain in chest and larynx. Pulse rapid, weak, trembling. Dyspnoea relieved by eructation. Cough and dyspnoea better lying on right side - (opposite Badiaga). Coldness, trembling, and chilliness in fever. Intermittent fever with lethargic condition.

3.      ARSENICUM ALBUM:-

     For any dryness, when due to some organic trouble, particularly of the heart, or with emphysema, the cough is violent and dry, with shortness of the breath and suffocative spells, worse at night.raipid emaciation and debility, restlessness, anguish and fear of death.

4.       BRYONIA ALBA;-

Dry, hacking cough from irritation in upper trachea. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored

sputa. Difficult, quick respiration; worse every movement; caused by stitches in chest. Expectoration brick shade, tough, and falls like lumps of jelly. Coming into warm room excites cough. [Nat. carb.]. Chill with external coldness, dry cough, stitches in fever.

5.       CHELIDONIUM:-

Very quick and short inspirations; pain on deep inspiration. Dyspnoea. Short, exhausting cough; sensation of dust not relieved by cough. Whooping-cough; spasmodic cough; loose, rattling; expectoration difficult. Small lumps of mucus fly from mouth when coughing. Constriction of chest.

6.      FERRUM PHOS:-

Bronchitis of young children. First stage of all inflammatory affections. Congestions of lungs. Short, painful tickling cough. Hard, dry cough, with sore chest. Expectoration of pure blood in pneumonia. [Millefol.]. Cough better at night. During fever Chill daily at 1 pm. All catarrhal and inflammatory fevers; first stage.

7.      IPECAC:-

Dyspnoea; constant constriction in chest. Yearly attacks of difficult shortness of breathing. Cough incessant and violent, with every breath. Chest seems full of phlegm, but does not yield to coughing. Suffocative cough; child becomes stiff, and blue in the face. Bleeding from lungs, with nausea; feeling of constriction; rattling cough. Intermittent fever, irregular cases, after Quinine. Slightest chill with much heat, nausea, vomiting, and dyspnoea in fever.

8.       PHOSPHOROUS:-

Cough from tickling in throat; worse, cold air, reading, laughing, talking, from going from warm room into cold air. Sweetish taste while coughing. Hard, dry, tight, racking cough. Congestion of lungs. Pneumonia, with oppression; worse, lying on left side. Sputum rusty, blood-colored, or purulent. Nervous coughs provoked by strong odors, entrance of a stranger; worse in the presence of strangers; worse lying upon left side; in cold room.

9.       PULSATILLA:-

 Dry cough in evening and at night; must sit up in bed to get relief; and loose cough in the morning, with copious mucus expectoration. Expectoration bland, thick, bitter, greenish. Short breath, anxiety, and palpitation when lying on left side. [Phos.]. Smothering sensation on lying down. Chilliness, even in warm room, without thirst in fever. Chill about 4 pm.

10.   TUBERCULINUM:-

Hard, dry cough during sleep. Expectoration thick, easy; profuse bronchorrhoea. Sensation of suffocation, even with plenty of fresh air. Hard, hacking cough, profuse sweating and loss of weight, rales all over chest. Deposits begin in apex of lung. (Repeated doses). Shortness of breath. Post-critical temperature of a remittent type. Here repeat dose every two hours. (Macfarlan).

Some of other drugs are ammonium iod, ammonium mur, antimonium ars, belladonna, iodum and kali carb.

SEBORRHOEIC DERMATITIS AND HOMEOPATHIC MANAGEMENT

                                                   SEBORRHOEIC DERMATITIS.

               

                This type of dermatitis that occurs consequent upon excessive secretion of sebum (seborrohoea). Obviously, it occurs at places where sebaceous glands are numerous (e.g. scalp, axillae and the glands). The dry form is characterized by the presence of patches covered with fine, browny and creasy white scales. When this type of seborrhea is associated with erythema and follicular papules, the condition is called seborrhoeic dermatitis.

AETIOLOGY OR CAUSES:-

                 Excessive secretion of sebum may be due to several factors. Such a person has large sebaceous glands especially around the nose, face and the axillary folds.

Some of predisposing factors for these conditions are below.

-          Hormonal imbalance.

-          Continued anxiety.

-          Excessive consumption of fat and carbo hydrates.

-          Infections with micro organisms over the skin surface.

TYPES:-

1.       GREASY FORM:-

The greasy form (seborrohoea oleosa) affects the face and the scalp. The affected person has large sebaceous glands at these sites. Patchy erythematosus areas covered with greasy scales or crusts are present over the affected site. Hair roots, especially those over the vertex and the eyebrows are affected resulting in patches of alopecia. Acne vulgaris may be associated.

2.      DRY FORM:-

The dry form (seborrohoea sicca) is characterized by the presence of patches covered with fine, browny and greasy white scales. When this type of seborrohoea is associated with erythema and follicular papules, the condition is known as seborrhoeic dermatitis.

 Seborrhoeic dermatitis usually occurs at 3 different sites – the scalp (seborrhoeic capitis), face and the flexures.

-          Seborrhoeic dermatitis of the scalp is full of white scales (commonly known as dandruff or scurf).

-          The scales are in fact, exfoliations derived from the horny layers of the epidermis. When scaling is associated only with erythema, the condition signifies a milder form of seborrhoeic dermatitis.

-          In more severe type of seborrhoeic dermatitis, the erythematosus patches are greasy due to oozing of sebum.

-          In the severest type, greasy erythematosus patches covered with crusts are spread all over the scalp.

-          Seborrhoeic dermatitis of the face affects the eyebrows, nose and the ears.

-          Seborrhoeic dermatitis of the flexures affects the axillary folds, groin and the under surface of the breasts. Greasy erythematosus papules are present at these sites.

-          In chronic seborrhoeic dermatitis the lesions are more erythematosus and more oozing than simple seborrhoeic dermatitis.

-          The lesions are covered with greasy crusts that separate out as flakes. Oozing from the scalp lesions may be so profuse that the pillow is soaked with greasy discharge that occurs during the night.

TREATMENT:-

-          The affected part should be kept dry and non- greasy. In case of seborrhoeic capitis, the scalp should be washed with a shampoo twice a week.

-          In acute stage, soothing and astringent are advisable along with a systemic antibiotics and ant histaminic drugs.

-          In chronic cases, local application of an ointment containing salicylic acid, sulphur precipitate, liquid carbonis detergens in a non- greasy base are advisable.

-          Certain dietary items particularly sweets, chocolates, ghee and dried fruits should be avoided.

HOMEOPATHIC TREATMNET;-

Some of the medicines which acts well on seborrhoeic dermatitis are below.

1.       CHAMOMILLA.

2.       HEPAR SULPH.

3.       MERC SOUL.

4.       PULSATILLA.

5.       RHUS TOXI.

6.       SILICEA.

7.       ACONITE.

8.       APIS.

9.       ARSENIC ALBUM.

10.   AURUM MET.

11.   BARYTA MUR.

12.   KALI SULPH.

13.   NITRIC ACID.

14.   PLUMBUM MET.

15.   STAPHYSAGRIA.

16.   SULPHUR.

MALARIA AND HOMEOPATHIC MANAGEMENT

                                                                      MALARIA

DEFINITION:-

 Malaria is a communicable disease which is caused by genus plasmodium protozoa. The features of this disease are periodic type of intermittent fever which comes with rigors and subsides with sweating, splenomegaly and anaemia.

CAUSES AND SPREADS:-

-          Mainly caused by plasmodium vivax and plasmodium falciparum virus.

-          The disease is transmitted from man to man mainly by the bite of ‘female anopheline mosquitoes’.

-          The disease may be acquired by infected blood transfusion.

-          Malaria mainly occurs in tropical and sub- tropical countries where the hot and humid climate is favourable for breeding of mosquitoes. In the year 1935, it was estimated that in India alone 100 million people used to be affected every year, out of which 1 million used to die. Due to intensive efforts made by the WHO(world health organization), the incidence of malaria had declined or reduced remarkably during the years 1950-60, but flared up again since the year 1970.although the problem is not reduced, malaria is still actively prevalent in several countries including india.

PATHOLOGY:-

In human beings, malaria is caused by 4 species of plasmodium. Plasmodium falciparum, plasmodium vivax, plasmodium malariae and plasmodium ovale. Out of these four, the first two types are mainly present in India and other tropical and subtropical countries.

Whenever a female anopheline mosquito bites an infected person, it takes up gametocytes or the sexual form of the parasite from the blood of the infected person. Inside the stomach of the mosquito, the male and female gamatocytes unite to form a zygote which is converted into a ookinete. The ookinete is very motile and is capable of piercing the wall of the mosquito’s stomach. It is soon converted into  an oocyst bursts to in liberate the sporozites that find their way into the salivary glands of the mosquito. This sexual cycle of the parasite inside the body of the mosquito is completed within 3 weeks.

Sporozoites are introduced into the blood of a healthy person from the bite of an infected mosquito. From blood these sporozoites quickly reach the liver cells when the first liver cycle  or the preerythrocytic cycle is completed within 6-8 days

SYMPTOMS:-

Malaria is recognized by the clinical triad of intermittent type of fever, splenomegaly and anaemia.

-          The fever of the intermittent type appears with a definite time schedule and shoots to 102-104F or higher. The febrile episode passes through three stages – the cold stage, the hot stage and the stage of sweating.

-          During the cold stage or the stage of shivering, the patient gets severe rigors, so much so that he may be grinding his teeth. Headache and vomiting may be associated.

-          In the hot stage, the patient may be delirious, after this stage patient starts sweating and the temperature settles down to normal.

-          The spleen becomes just palpable after a few febrile episode but later enlarges further and feels firm and hard in consistency.

-          Anaemia occurs mainly due to hemolysis of the red cells. Hemolysis is greater in plasmodium falciparum infections.

-          Subsequent destruction and removal of the red cells is caused by enlarged and hyperactive spleen. The bone marrow function is suppressed.

COMPLICATIONS:-

-          CEREBRAL MALARIA – red blood cells loaded with schizonta get stuck inside the cerebral capillaries and cause obstruction to the flow of blood. Coma, hyperpyrexia, patient feels drowsy and becomes unconscious. Convulsions and twitching in muscles.

-          Algid malaria.

-          Black water fever.

INVESTIGATIONS:-

-          Serological test.

-          Marked elevation of serum IgM levels.

TREATMENT:-

-          Use some antibiotics.

-          Control of mosquitoes by spraying insecticides in houses.

HOMEOPATHIC TREATMENT:-

1.       ACONITE.

2.       APIS.

3.       ARNICA.

4.       ARSENICUM ALBUM.

5.       CAPSICUM.

6.       CHINA.

7.       EUPATORIUM PERFORATUM.

8.       GELSEMIUM.

9.       IPECAC.

10.   NATRUM MUR.

11.   NUX VOMICA.

12.   OPIUM.

13.   RHUS TOXI.

14.   VERATRUM ALBUM.

15.   VERATRUM VIRIDAE.

SCABIES AND HOMEOPATHIC MANAGEMENT

                                                                       SCABIES

                Scabies is an itching dermatosis caused by a mite called “sarcoptes scabiei”. The common sites of infection are the webs of fingers, ulnar border of the wrists, axillae, lower abdomen and the buttocks.

AETIOLOGY OR CAUSES:-

-          It is one of the commonest skin diseases in India and accounts for 10 to 30 percent of the case in any skin out patient’s clinic.

-          The disease is highly contagious and spreads from person to person by close contact.

-          Unhygienic way of living is the predisposing factor.

-          The disease is, therefore, more common in poorer class of people especially those living in city slums or other dirty places.

-          The disease is more common during the winter months. Often all members of a family are affected.

SYMPTOMS:-

-          The common sites of infection are the webs of fingers, ulnar border of the wrists, axillae, lower abdomen and the buttocks.

-          When infection is first contracted, a female mite digs up a wavy tunnel (‘burrow’) inside it. The eggs hatch out and produce tiny mites that crawl up to the surface and burrow through fresh areas over the adjoining skin surface.

-          The basic lesion in scabies is a burrow, a zigzag tunnel 0.5 to 1 cm long in epidermis.

-          Red papular eruptions form at the top of the burrow and soon change into vesicles.

-          Itching is intense, worst during the night.

-          Scratch marks are seen with surrounding areas of redness.

-          Scratching often leads to secondary infection with pyogenic organisms resulting in impetigo or multiple boils at the affected sites.

-          Less commonly, especially in cases of long standing, eczematous dermatitis may develop or there may be lichenification of the affected part of the skin.

Diagnosis can usually be made by naked eye examination. The typical site of involvement, the burrow with papulovesicular eruptions at the top and intense itching especially during the night resulting in scratch marks around the lesions are features typical of scabies. The mites can be seen by an ahand lens as small white dots at the top of the burrows. Scrapings from the burrows may be examined under the microscope for the presence of sarcoptes scabiei.

TREATMENT:-

-          A local application of 25% benzyl benzoate emulsion is the treatment of choice.

-          The affected parts should be washed with soap and tepid water. The parts should be dried and gently scrapped with a fine brush (to open up the mouths of the burrows).

-          The emulsion should then be applied liberally all over the skin surface below the neck.

-          Sulphur ointment may be used but it is far less effective than benzyl benzoate emulsion.

-          Any secondary infection should be treated with a suitable antibiotic prior to the application of the scabicidal drug.

-          Avoid oily foods, fish, sour things and brinjal.

HOMEOPATHIC TREATMENT;-

1.       ARSENICUM ALBUM:-

Itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Malignant pustules. Ulcers with offensive discharge. Urticaria, with burning and restlessness. Icy coldness of body.

2.       PSORINUM:-

  Dirty, dingy look of the skin. Dry, lustreless, rough hair. Intolerable itching. Herpetic eruptions,    especially on scalp and bends of joints with itching; worse, from warmth of bed. Sebaceous glands secrete excessively; oily skin. Indolent ulcers slow to heal. Eczema behind ears. Crusty eruptions all over. Pustules near finger-nails.

3.       SELENIUM:-

Dry, scaly eruption in palms, with itching, Itching about the ankles and folds of skin, between fingers. Hair falls out from brows, beard, and genitals. Itching about finger-joints and between fingers; in palms. Vesicular eruption between fingers. [Rhus; Anac.]. Seborrhoea oleosa; comedones with an oily surface of the skin; alopecia.

4.       SEPIA:-

Herpes circinatus in isolated spots. Itching; not relieved by scratching; worse in bends of elbows and knees. Chloasma; herpetic eruption on lips, about mouth and nose. Ringworm-like eruption every spring. Urticaria on going in open air; better in warm room. Sweat on feet, worse on toes; intolerable odor. Ichthyosis with offensive odor of skin.

5.       SULPHUR:-

Dry, scaly, unhealthy; every little injury suppurates. Itching, burning; worse scratching and washing. Pimply eruption, pustules, rhagades, hang-nails. Excoriation, especially in folds. [Lyc.]. Skin affections after local medication. Pruritus, especially from warmth, is evening, often recurs in spring-time, in damp weather.

6.       DUL CAMARA:-

Pruritus, always worse in cold, wet weather. Herpes zoster, pemphigus. Swelling and indurated glands from cold. Vesicular eruptions. Red spots, Urticaria, brought on by exposure, or sour stomach. Humid eruptions on face, genitals, hands, etc. Warts, large, smooth, on face and palmar surface of hands. Thick, brown-yellow crusts, bleeding when scratched.

7.       GRAPHITIS:-

Rough, hard, persistent dryness of portions of skin unaffected by eczema. Eruptions, oozing out a sticky exudation. Rawness in bends of limbs, groins, neck, behind ears. Unhealthy skin; every little injury suppurates. Ulcers discharging a glutinous fluid, thin and sticky. Cracks in nipples, mouth, between toes, anus. Phlegmonous erysipelas of face; burning and stinging pain.

Some of other drugs for scabies are clematis, hepar sulph, kreosotum, Lachesis, lycopodium, merc soul, natrum carb, acid phos, silicea, veratraum album and zinc met.

HERPES ZOSTER AND HOMEOPATHIC MANAGEMENT

                                                        HERPES ZOSTER (SHINGLES)

                Herpes zoster is caused by VZV virus which is the same as the chicken pox virus (varicella zoster virus).it appears shiny, pearl like vesicular eruptions typically situated along the course of one or more peripheral nerves (more commonly those in the dermatomes T3 to L3).

                Herpes zoster occurs due to reactivation of virus lying dormant in the dorsal root ganglia over since an attack of chicken pox a few years back.

SYMPTOMS;-

-          Clinically, herpes zoster is characterized by appearance of one or more groups of shiny, pearl like vesicular eruptions typically situated along the course of one or more peripheral nerves (more commonly those in dermatomes T3 to L3).

-          A zone of inflammation or redness surrounds a group of vesicles or an individual vesicle. The vesicles look like shiny pearls spread over a red velvety surface.

-          Prior to eruption of vesicles, there is burning pain followed by hyperalgesia in the area of distribution of the affected peripheral nerves.

-          The vesicles usually appear 3 – 4 days after the start of these symptoms and are likely to get confluent and subsequently dry up during the following two weeks leaving behind small scars.

-          However, the concerning cutaneous nerves remain badly injured causing severe burning pain in the affected area (as if powdered chillies have been spread over a raw area).

-          The commonest site of involvement is the thoracic region in the area of distribution of one or more spinal nerves. Involvement is usually unilateral or bilateral.

-          The ophthalmic division of the trigeminal nerve may be involved (herpes opthalmicus). In this condition, vesicles first appear over the upper part of the nose and then spread over to the conjunctiva and the cornea.

-          The geniculate ganglion of the facial nerve may be involved by eruptions situated inside the auditory meatus resulting in facial palsy (Ramsay hunt syndrome).

-          Vesicles may appear over the palate and the tonsil in case the glossopharyngeal nerve is involved.

The diagnosis can be confirmed by isolation of the virus by tissue call culture or demonstration of specific antibody by immunofluorescent technique or by ELISA test.

TREATMENT;-

-          5% solution of idoxuridine may be applied locally but the effect is not as specific as in case of herpes simplex.

-          Application of alamine lotion may be soothing; an antibiotic ointment is advisable for preventing or combating a possible secondary infection.

-          Prednisolone given orally may help to decrease inflammatory reaction and may possibly lessen the severity of the oncoming post herpetic neuralgia.

-          An analgesic drugs such as aspirin, phenacetin should be used in case of post herpetic neuralgia.

-          Acyclovir, an antiviral drug may be useful in herpes opthalmicus (500 mg daily, orally for 5-7 days.)

HOMEOPATHIC TREATMENT:-

              Some of the homeopathic medicines for herpes zoster are given below.

1.       ARSENICUM ALBUM.

2.       IRIS.

3.       MERC SOUL.

4.       MEZERIUM.

5.       NATRUM MURATICUM.

6.       RANANCULUS.

7.       RHUS TOXI.

8.       CANTHARIS.

9.       CAUSTICUM.

10.   GRAPHITIS.

11.   KALI BICH.

12.   SEPIA.

13.   THUJA.

14.   PETROLINUM.

15.   VARIOLINUM.

ECZEMA AND HOMEOPATHIC MANAGEMENT

                                                                       ECZEMA

                The term eczema literally means to “boil over”. When simple dermatitis “boils over” with added oedema exudation and crusting, the condition is acute eczema and when dermatitis gets associated with hyperstasia and hyperkeratosis, the condition is chronic eczema.

                In fact, clear cut demarcation between dermatitis and eczema is hardly possible. Chronic dermatitis of long standing often turns eczematous however, in case of eczema, an element of hypersensitivity to one or more allergens (exogenous or endogenous) is superimposed over and above the inflammatory reaction of simple dermatitis.

AETIOLOGY OR CAUSES:-

                Hypersensitivity reaction to a foreign protein is the root cause of eczema. The offending protein may be derived from chemicals, drugs, plants, synthetic garments or infecting microorganisms.

1.      DRUGS AND CHEMICALS:-  

       In fact, any drug can cause hypersensitivity reaction in a sensitive individual. Certain drugs more prone to produce such a reaction (e.g. penicillin, streptomycin, sulpho group of drugs, chloramphenicol chlorpromazine, B complex vitamins, liver extract, iodine, procaine and other local anaesthetic agents etc).

Certain chemicals (e.g. alkalies, solvents, soaps, bleaching agents, detergents, formalin, etc) can also cause eczema. Silimilarly, certain cosmetics (e.g. talcum powder, lip stick, nail paints, hair dyes and perfumes) can cause eczema.

2.       PLANTS:- 

      several flowers (even rose), fruits (e.g. banana, pel of orange or lemon) and vegetables (e.g. onion, garlic, carrots, etc) can cause eczema.

3.       GARMENTS:-

      synthetic clothes (e.g. nylon, terylene, terycotton), dyes used for colouring and certain accessories used in garments (e.g. nickel clips, zips or hooks, rubber or plastic acessories) can cause eczema. Rubber shoes or shoes made of other synthetic materials can cause a special type of eczema known as shoe dermatitis.

4.       SKIN INFECTIONS:- 

      chronic infective conditions of the skin such as impetigo or a patch of ringworm may undergo eczematous changes after some time.

TYPES OF ECZEMA:-

a.      EXOGENOUS ECZEMA:-

-          Eczema caused by exogenous allergens.

-          The offending allergens are derived from substances that come in close contact in day to day life.

-          Common examples of exogenous eczema are contact eczema, infective eczema and eczema caused by drugs (eczema medicamentosa).

b.      ENDOGENOUS ECZEMA:-

-          Eczema caused by constitutional factors operating from within.

-          Certain factors render a person hypersensitive to a known or unknown allergen, present even in a minute amount. Often the nature of the offending allergen in any particular case remains unknown. The factors causing this type of sensitization may either be familial or acquired. Consequently, there are two types of endogenous eczema, atopic and acquired.

1.       CONTACT ECZEMA:-   

      contact eczema is caused by hypersensitivity reaction to a known allergic substance placed in close contact with the skin for some time. The offending substance may be a drug, a chemical or a micro organism. Certain very common articles in day to day use (e.g. synthetic clothes, washing materials, cosmetics, dyes, plastic or rubber shoes, condoms, nickel straps and clips, artificial jewellery, drugs and chemicals) can cause this type of eczema.

2.       ATOPIC ECZEMA:-  

      this eczema is due to inherited hypersensitivity to a known or unknown allergen. This type only when triggered off by certain precipitating factors such as changes in humidity or temperature, trauma (cuts, abrasions or cracks in the skin), skin infections or psychological stress. Atopic eczema is frequently associated with other atopic disorders such as bronchial asthma or hay fever. Reagenic antibodies to certain common antigens (e.g. pollens, house dust, items of food, etc.) are found to be increased.

a.      INFANTILE ECZEMA:-

Infantile eczema occurs in newborn infants and young children. Face is the commonest site. The eczematous patch usually appears over one or both the cheeks and spreads to involve the forehead, scalp and the chin. Initially the affected part of the skin is red which is soon followed by papulovesicular eruptions and still later by minute cracks at the surface. Exudation of serum may occur from those cracks (weeping eczema). Still later, there is formation of crusts over the lesions, itching is severe. In most cases, infantile eczema clears out within a short time.

b.     FLEXURAL ECZEMA:-

Flexural eczema occurs in a adults and affects the flexor surfaces of the elbow and the knee joints. Occasionally the face, neck and the upper part that occurs during adulthood. The affected part of the skin assumes a leathery texture (lichenification). It is thick and dry, pale and pigmented. There is no sweating over the affected part.

c.       ECZEMA OF THE HANDS AND FEET(POMPHOLYX):-

This type mainly affects the palms and soles. Vesicular eruptions are present but the vesicles are not raised above the surface and are not likely to rupture because of the thick horny layer of the skin at the soles or the palms. They appear just as flat elevations scattered all over the palms and soles and do not exude any fluid except in an occasional severe case. This type of eczema is usually caused either by the irritating effect of soap, detergents or chemicals or as a complication of chronic ringworm infection.

d.     NUMMULAR ECZEMA:-

The lesions are typically coin-shaped. Raised patches appear over the extensor surfaces of the limbs, claves and the shins. Smaller lesions coalesce to form bigger ones. Numerous vesicles are seen erupting out of the lesions. It is a recurrent type of eczema occurring only in adults. Itching is present but is not severe.

SOME SPECIAL TYPES OF ECZEMA:-

1.      VARICOSE ECZEMA;-

Varicose eczema occurs in association with either varicose veins or varicose ulcers. Elderly and obese persons are usually affected. The lower half of the legs, particularly the inner sides are mostly affected. The eczema is due to irritation caused by chronic venous stasis. An element of contact dermatitis due to drugs used as local applications may also be superimposed.

2.       INFECTIVE ECZEMA;-

Infective eczema occurs at the site of an infective skin condition such as a wound or a patch of ringworm. Eczema occurs due to hypersensitivity reaction to the offending microorganism or their toxins. Eczematous patch that develops around the ear lobule in case of Otitis interna is a common example.

SYMPTOMS;-

-          A lesion starts either as a diffuse erythematosus patch or as a papule due to some irritation.

-          Next, an exaggerated reaction occurs with formation of vesicles or a papule over and above the existing patch of erythema with intense itching. This signifies early eczematous change.

-          Following this, there is oedema of the epidermis, exudation of serum from the vesicles (weeping eczema) and formation of crusts. These changes signify the acute stage of eczema.

-          Ultimately, the whole process becomes chronic with thickening of the skin (leathery skin), or acanthesis, increased pigmentation and scaly excoriation (lichenification). The oedema of acute stage decreases, instead, vasodilatation occurs. These changes signify the chronic stage of eczema.

INVESTIGATIONS:-

-          The skin patch test should be done in case of a suspected allergen particularly in case of contact eczema.

-          The prick test is useful in atopic eczema. The test is done by placing a drop of commercially prepared dilute antigen (a variety of such antigens are now available) and giving a prick with a needle. If the reaction is positive, a flare reaction occurs within 10 minutes. The radioallergosorbent technique (RAST) may be employed instead of naked eye observation.

-          Culture of the skin scrapings may be done to know the nature of the superadded infecting agent, bacterial, fungal or yeast.

TREATMENT:-

-           In case of contact eczema use of soap and synthetic garments should generally be avoided.

-          During the acute stage, wet dressings with either potassium permanganate solution (1:8000) or calamine lotion are more useful.

-          If secondary infection starts, a corticosteroid cream and neomycin should be advised.

-          Prednisolone should be given orally in short courses.

-          Avoid oily foods, fish, brinjal, citrus fruits.

HOMEOPATHIC TREATMENT:-

1.       ARSENIC ALBUM:-

        Itching, burning, swellings; oedema, eruption, papular, dry, rough, scaly; worse cold and scratching. Urticaria, with burning and restlessness. Epithelioma of the skin. Gangrenous inflammations. Ulcers with offensive discharge. Psoriasis.

2.      ARSENICUM IODUM:-

Dry, scaly, itching. Marked exfoliation of skin in large scales, leaving a raw exuding

Surface beneath. Debilitating night-sweats. Eczema of the beard; watery, oozing, itching; worse, washing. Acne hard, shotty, indurated base with pustule at apex. Debilitating night-sweats.

3.       CALCAREA CARB.

4.       CALCAREA SULPH.

5.       CICUTTA.

6.       DUL CAMARA.

7.       GRAPHITIS.

8.       HEPAR SULPH.

9.       MEZERIUM.

10.   PETROLINUM.

11.   PSORINUM.

12.   RHUS TOXI.

13.   SULPHUR.

14.   BOVISTA.

15.   CALADIUM.

16.   CARBO VEG.

17.   CAUSTICUM.

18.   KALI SULPH.

19.   LYCOPODIUM.

20.   MERC SOUL.

21.   SEPIA.

22.   STAPHYSAGRIA.

23.   THUJA.