Visual pathway and visual field defects

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.