HOMOEOPATHIC MANAGEMENT
OF VARICOSE VEIN
Case
taking
Questions to be asked in a case of
varicose vein in order to make a successful prescription
(1) Inspect
whether the surrounding area is blue, black or red.
If
it is blue with well-marked dilated veins, then think of Carbo Veg or
Hamamelis.
If
it is red and inflamed then think of Belladonna and if purplish blue, Lachesis.
If black think of Ars alb.
(2) Enquire the side affinity of the varicose vein.
If it is present in both leg the enquire in which leg it first started.
If
started in right leg and shifted to left leg think of Lycopodium. If it started
in left leg and go to right leg then think of Lachesis. If the pain constantly
shift from one part to another then think of Pulsatilla.
· Enquire whether these
is varicose ulcer as a complication.
(3) Enquire whether the varicose ulcer is painful
or painless.
If
it is painful think of Hepar Sulph. If it is painless then think of Silicea.
Also
ask about the discharge from ulcer, in the case of bleeding tendency think of
Lachesis, Hamamelis etc.
(4) Enquire about the subjective sensation.
Burning
sensations-think of Sulphur, or Ars alb
If
it is sore, bruised pain then think of Arnica Montana or Hamamelis.
If
it is stinging pain then Apis Melifica or Pulsatilla.
(5) Enquire about the well-marked modality
<
Hanging- Think of Pulsatilla or Vipera
> Warm application-Ars alb,Calc
fluor
< Warmth- Pulsatilla
PLAN
OF TREATMENT IN HOMOEOPATHIC SYSTEM OF MEDICINE
Abstract:
Considering the totality of symptoms of
Varicose
vein, we have to first look for the predominant presenting complaint or enquire
about the primary symptom (symptom which appeared first) and consider the acute
totality and prescribe based on that and after subsiding the acute condition,
follow up the case with anti-miasmatic remedy (based on the stage of the
disease) which again should be completely corrected by constitutional remedy to
eradicate the tendency.
Each case of the varicose vein should be individualized by the uncommon peculiar characteristic symptom and by the well-marked modality. We must give prior importance to the peculiar symptoms in the first visit. Analyze and differentiate between the symptoms of the patient and common symptoms of the disease. Considering the symptoms of the patient give more weightage to the side affinity, (in which leg the
varicose vein first appeared), the well-marked modality and subjective
sensation of the patient.
Differentiation
of Acute and Chronic presentation
Consideration of acute presentation
Varicose vein may present a spectrum of clinical symptoms alone with the symptoms of its complications. But the patient sitting before you may present one or two prominent symptom. In the first visit we should first analyze whether the presenting complaint is acute and severe. If it is severe especially with pain and complications like ulceration then we have to aid and suppose to ameliorate the acute symptom. In such conditions, the choice of remedy will be those having predominant action on varicose vein or the ulcer as the case depend.
Consideration
of chronic presentation
On the other hand, if the patient present with
dilated vein, but not have any severe subjective sensation or pain and also
along with it the patient have a number of complaints of mild severity
affecting other systems of body then we have to consider the totality of
symptoms by extracting the uncommon peculiar characteristics of the patient.
This may cover the miasmatic tendency or the constitution of the patient and
thus ameliorate the whole symptom picture along with the symptoms of varicose
vein.
Medicines
in Series.
In case of acute presentation of varicose
vein; first we have to select the medicine covering the most distressing
symptom of the varicose vein that is covering the acute totality.
Medicine covering the acute totality must be
selected based on
(1)The subjective Sensation
(2) The side affinity of varicose veins or on
which leg it first started.
(3) The exact time modality of subjective
sensation.
If there is ulceration, the objective symptoms
can be extracted and prescription can be done with certainty.
After subsiding the most distressing symptoms
of the acute presentation, the patient had gone back to a chronic stage with
mild symptom presentation. In this stage we should analyze the miasm at which
the patient now reached. Prescribe anti miasmatic remedy and go to the
constitutional remedy to correct the tendency of the disease.
Sometimes the medicine selected based on acute
totality during the first visit may also cover the miasmatic and constitutional
picture of the patient. This is a rare situation in which the first selected
remedy itself will correct the whole case; and no change of medicine will be needed.
The higher potencies of the same remedy may completely clear the case.
MIASMATIC
DIAGNOSIS OF DIFFERENT STAGES OF VARICOSE VEIN AND THEIR TREATMENT
Stages
of varicose vein
1. Psoric (Inflammatory )
2. Sycotic
(Proliferative)
3. Syphilitic
(Ulcerative)
1. Psoric miasm
[ Inflammatory stage]
Patient
complaints of aching pain in the whole leg. On examination there will not be
any evidence of incompetent valves or blow out. Patient may complain of pain
aggravated by prolonged standing and cramps in legs. It is most common in patients having
transparent skin, with visible vein, but not yet dilated. In this case we
should suspect for a future occurrence of varicose vein. If it is leaved as
untreated it may progress to a fully-flourished case of varicose vein.
In
such condition, as the pathology has not yet established, consider the presenting
acute totality, [that is the subjective sensation and its predominant modality]
and prescribe acute, short acting medicine. After subsiding the
distressing acute symptom, we should prescribe the anti-psoric remedy for
correcting its miasmatic tendency. The excellent antipsoric remedy covering the
burning pain and aggravation standing position is Sulphur. Prescribe higher
potency ie Sulphur 1M and observe the changes in the follow up.
2. Sycotic
miasm [Proliferative stage]
In
this stage there will be visible dilated vein, the intensity of the blow outs has
no relation to the intensity of the pain. The incompetency of the vein leads to
accumulation of venous blood in the superficial veins and cause blow outs.
Prescribe based on acute totality by considering, the objective symptom [like
side affinity, discoloration] and subjective symptoms [sensations and well-marked
modality]. After subsiding the acute symptoms, prescribe anti sycotic remedy in
higher potency ie Thuja or Medorrhinum 1M [both should be differentiated and
prescribe according to symptom similarity].
3. Syphilitic
miasm [Degenerative stage]
Patient
may complain of varicose ulcer with pus and surrounding ischemic change. This
indicates syphilitic stage.
Here
we have to first heal the ulcer, prevent infection by cleaning and dressing the
ulcer with all aseptic precaution. Prescribe based on symptoms of ulcer
[considering discoloration of surrounding area, nature of discharge, absence or
presence of pain]. Medicines that cover this acute stage are Hepar Sulph,
Silicea, Fluoric acid, Lachesis, Hamamelis or Merc sol.
Recurrent occurrence of ulcer and discharge of
pus indicates combination of psoric and syphilitic miasms. Medicine to avoid
this recurrence of ulcer is Tuberculinum 1M.
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