Definition of Septic Gangrene
Gangrene is a term that describes dead or dying body tissue(s) that occur because the local blood supply to the tissue is either lost or is inadequate to keep the tissue alive. Gangrene has been recognized as a localized area of tissue death since ancient times. The Greeks used the term gangraina to describe putrefaction (death) of tissue.
Types of Gangrene
There are two major types of gangrene, referred to as- dry and wet. Many cases of dry gangrene are not infected. All cases of wet gangrene are considered to be infected, almost always by bacteria.
Common sites in Gangrene
The most common sites for both wet and dry gangrene to occur are the digits (fingers and toes) and other extremities (hands, arms, feet, and legs).
Causes of Gangrene
● Dry gangrene can result from conditions that reduce or block arterial blood flow such as diabetes, arteriosclerosis, and tobacco addiction as well as from trauma, frostbite, or injury.
●Wet gangrene can result from the same causes as dry gangrene but always includes infection. In some cases of wet gangrene, the initial cause is considered to be the infection. The case described here is of wet type of gangrene due to infection in the foot.
When wet gangrene is infected severely by bacteria, it discharges toxins into the blood stream resulting in Sepsis. It is a life threatening condition.
There are more than 1 million cases of total sepsis found each year, according to the Centres for Disease Control and Prevention (CDC). This type of infection kills more than 258,000 Americans in a year. But particularly septic gangrene cases are very less in number due to good & prompt medical facilities now a days. The chances of diabetic septic gangrene are somewhat more due to negligence of diabetic patients.
Symptoms of Septic Gangrene:
● Discolouration of the affected Skin
● Extreme offensive smell & discharges from infected skin.
● Oedema of affected & nearby areas.
● High fever above 101ºF.
● Heart rate higher than 90 beats per minute
● Breathing rate higher than 20 breaths per minute
● History of probable or confirmed infection
● Loss of Appetite
It was a hot summer month of 4 th May-2007. Around 1.30 P.M., at Maharana Pratap Homeopathic Medical College, Raipur, Chhattisgarh, I found some people carrying an old village lady of around 68 years age. They entered into the college attached hospital O.P.D and were searching the doctors for the treatment . Due to lunch time, the O.P.D was up .One of them saw me there and requested for the treatment of the patient. At that time, I was the Lecturer of Materia Medica in the college. I accepted their request and thoroughly saw the patient. This lady patient was from a rural village about 60 kms away from Raipur & extremely poor .
Case taking and First Prescription – 4 th May, 2007
On seeing and taking the detailed history of the patient, it was found,
Mrs. X, Aged about-68 years, Hindu Female
- She had a big injury by a poisonous thorn (which probably remained inside) over the left foot while going to the forest 10 days back.
- Just after one day of injury, the leg swelled with pain.
- She tried to remove the thorn but could not do it.
- Next day, she dipped that foot into boiled oils for removal of the thorn to decrease the swelling as advised by a relative.
- Immediately, there were a number of large blisters on the foot which burst to produce ulcer and it became difficult for her to walk.
- Due to illiteracy, she ignored the case, moved with bare foot and did not take any medical treatment.
- The ulcer went on increasing rapidly day by day with high fever and rigour, huge swelling of left leg up to the knee, loss of appetite, weakness, much offensive discharges from the ulcer of foot, Colour of skin-white , stool-irregular, Urine-decreased, thirst-decreased.
- She was treated with Antibiotics, Antiseptic ointments & Analgesics for the wound but without any result.
- Consultations by different Surgery specialists at Raipur advised her for immediate Amputation of Left leg below the Knee.
1. Left Foot- Swollen hugely upto the knee, big ulcer in left foot, Skin-white with gangrenous condition, Smell- very offensive from ulcer, Discharges- watery & profuse.
2. Temp – 103 oϜ
4. B.P-150/90 mm Hg.
5. Breathing rate- 26 breaths per minute
- Pyrogen–200/ 1 dose ,
To be taken immediately in empty stomach.
- Gun Powder- 3X (Tablet form) , two tablets thrice daily in empty stomach.
- Dressed with Calendula -Q .
Advised- for complete bed rest, dressing of the foot with Calendula -Q every day
& consultation after 3 days.
1 st Follow-up – 7 th May 2007
The condition of the patient had improved a little. There was no dressing of wound due to lack of trained person in their village.
- Leg swelling- decreased 10%.
- Pain- lesser
- Discharge from the Ulcer- lesser and offensiveness remarkably decreased.
- Skin colour of Ulcer- more red than before
- Body Temp-101 oF
- B.P-144/90 mm Hg.
8. Breathing rate- 22 breaths per minute
9. Appetite- Same as before
10 .Stool & Urine-regular
11. Thirst- decreased
12.Weakness- much and persist as before
Gun Powder-3X continued as before.
Dressed with Calendula -Q
Advised – complete bed rest, to drink plenty of water, simple food and for dressing of the foot with Calendula -Q regularly.
To consult after one week.
2 nd Follow – up – 15 th May,2007
Condition of the Patient- Much more improved and encouraging.
There was again no dressing of the foot done.
1.Leg swelling- decreased 40%, healing of the Ulcer started from sides of the foot.
3. Discharge from the Ulcer- little and non offensive
4. Skin, colour of Ulcer- more reddish
5. Body Temp-100 o F
7.B.P-140/88 mm Hg.
8. Breathing rate- 18 breaths per minute
10.Stool & Urine-regular
12.Weakness-persist but feels better than before.
1. Pyrogen–200/ 1 dose ,
To be taken tomorrow in empty stomach
2. Gun Powder -3X to be continued as before.
3. Dressed with Calendula -Q
Advised for complete bed rest, drinking plenty of water, simple food and dressing of the foot with Calendula -Q regularly.
Consultation after 15 days.
3 rd Follow – up – 6 th June, 2007
The Patient was much better. All things had improved.
1. Leg swelling- decreased 80%, healings of ulcer from all sides in a rapid way.
2. Pain and soreness- little, on pressure only
3. Discharge from the Ulcer- completely stopped
4. Skin, colour of Ulcer- little red, scaring of tissues found
5. Body Temp-Normal
7. B.P-136/86 mm Hg.
8. Breathing rate- 18 breaths per minute
9. Appetite- better
10. Stool & Urine-regular
The patient started walking and carried on with her routine work.
Gun Powder-6X to be continued as 2 tablets twice daily in empty stomach.
Advised not to do much pressure work and to avoid water contact. Dressing to be continued with Calendula -Q regularly.
Consultation after 15 days.
4 th Follow –up – 17 th June 2007
Now the Patient was quite all right. Healing of the ulcer fully completed. Only white spots were there. No more pain and swellings . The appetite, stool, thirst were normal. Weakness -no more. Patient was doing her work smoothly.
In this case, the medicines – GUN POWDER , PYROGEN & CALENDULA had done excellent work. They saved the life of a lady from a situation of been handicapped.
Let us discuss in detail about the role, nature and other utility of the homoeopathic drug GUN POWDER , which played an important and major role in the above case.
GUN POWDER REMEDY: AN ILLUSTRATION
This medicine can be called as a HOMEOPATHIC ANTIBIOTIC due to its multifarious effects in wound healing.
Dr. John Henry Clarke: The Prover of Gun Powder
It is a lesser known remedy but very useful in clinical practice. This is a sure, reliable and quick acting medicine which never fails if applied in proper way. Dr. Henry Clarke, M.D. has extensively described its characteristics & usefulness in his book – GUNPOWDER as a War Remedy in 1915.
Gunpowder is a black or brown explosive substance. In previous days, it was used by the soldiers in wars. It was the first and only explosive used in gunnery and blasting, until it was eventually replaced by more powerful organic nitrogen compounds. It is now used primarily to detonate other explosives.
Colour- Traditional Gun Powder is Black in colour.
This is a three-in-one remedy. So, it is much more powerful. This type of remedy combination is rarely found in any other Materia Medica drugs.
It contains – Sulphur, Carbon/Carbo veg. (Charcoal) & Potassium nitrate or Saltpetre.
Proportion-(by weight)-Approx-70-80% Potassium nitrate-10-15% each Charcoal/Carbo veg and Sulphur.
• As Gun Powder contains three important constituents like Sulphur, Carbon & Saltpetre, so it has powerful and effective action on skin problems like that of Sulphur(Inflammatory process in boils, eruptions, suppressed impurities & Sepsis, Blood poisonings), Charcoal-Carbo veg.(Disinfectant properties) & Kali Nitrate( powerful action on skin as suppuration, oedema ,opening pores etc. ).
Carbon and Sulphur with Kali nitrate are very potent antiseptic and germ destroyer. So, Gun Powder acts on blood as to render it antiseptic, or to assist/ increase its normal antiseptic action.
*Septic suppurations/gangrene – As described in the case.
*Non healing/delaying wound healings of Skin- in boils, carbuncles, abscess, and eczemas (Like Silicea but it is more effective than it).*Blood poisoning etc.
In my clinical practice, I have never been unsuccessful while treating the skin infections like- boils, abscess, non healing ulcers, moist eczema or Suppurative Otitis Media with this remedy along with Calc. sulph.
1. Clarke, John Henry.(1915), Gun powder as a war remedy.
2 .Boericke, William.(1996), . Pocket Manual of Homoeopathic Materia Medica & Repertory, Reprint ed., B. Jain Publishers(P) Ltd., New Delhi
3. www.medicinenet.com/gangrene/article.htm ,Gangrene infection causes, symptoms & treatment.
4. www.healthline.com, reference library, sepsis: symptoms, effects & causes- healthline.