An abscess is a tender mass generally surrounded by a coloured area from pink to deep red. Abscesses are often easy to feel by touching. Abscesses can show up any place on body. Abscess is painful and warm to touch. The most common sites are in armpits (axillae), areas around the anus and vagina (Bartholin gland abscess), the base of the spine (pilonidal abscess), around a tooth (dental abscess), and in groins. Inflammation around a hair follicle can also lead to the formation of an abscess, which is called a boil (furuncle)
Keywords: Abcess, homoeopathic medicines, synthesis repertory
An abscess is a localised collection of pus (dead and dying neutrophils plus proteinaceous exudate).
1. Pyogenic abscess:
It is the commonest form of an abscess. It can be subcutaneous, deep or can occur within the viscera such as liver or kidney. In this chapter, pyogenic abscess refers to soft tissue abscess.
2. Pyaemic abscess:
Occurs due to circulation of pyaemic emboli in the blood (pyaemia).
3. Cold abscess:
Usually refers to tubercular abscess due to involvement of either lymph nodes or spine.
It is usually produced by Staphylococcal infections. The organisms enter soft tissues through an external wound, minor or major. It can also be due to haematogenous spread from a distant focus such as tonsillitis or caries tooth. Pyogenic abscess can also be due to cellulitis.
• Following an injury, there is inflammation of the part brought about by the organism such as Staphylococcus.
• The end-result is production of pus which is composed of dead leukocytes, bacteria and necrotic tissue. The area around the abscess is encircled by fibrin products and it is infiltrated with leukocytes and bacteria. It is called pyogenic membrane.
The patient feels ill and complains of throbbing pain at the site. Throbbing pain is indicative of pus and is due to pressure on the nerve endings by the pus. Fever, with or without chills and rigors, can be present.
This is due to pus-producing organisms in the circulation (pyaemia). It is the systemic effect of sepsis. It commonly occurs in diabetics and patients receiving chemotherapy and radiotherapy. Pyaemic abscess is characterised by following features:
• They are multiple
• They are deep-seated
• Tenderness is minimal
• Local rise of temperature is not present.
Hence, it is called nonreactive abscess to differentiate it from pyogenic abscess. This is treated by multiple incisions over the abscess site and drainage (like a pyogenic abscess) with antibiotic cover.
• Even though it is a chronic abscess due to a chronic disease (tuberculosis), for the completeness of the chapter on abscess and for the convenience of reading, it is discussed here.
• Cold abscess means an abscess which has no signs of inflammation. Usually, it is due to tuberculosis, e.g. following tubercular lymphadenitis or due to tuberculosis of spine.
Induration of cellular tissue, abscess, bubo, and all inflammation of connective tissue in which there exists a purulent focus. Terrible burning. For the most part, the central theme of Anthracinum is concentrated upon the intolerably painful, dark-red or blackish abscesses that resolve slowly and only with difficulty, even after days of discharging.
prophylactic of pus infection. Tendency to tissue degeneration, septic conditions, abscesses that do not mature. Sore, lame, bruised feeling. Itching, burning, eruption of small pimples. Crops of small boils. Many small boils, or blood-boils; one after another, extremely sore.
The tendency to the formation of abscesses in the body in any place is a strong feature of this remedy, and is quite similar to Pyrogen. An abscess that has ruptured and is slow to heal with a continuous discharge of yellow pus, is a strong indication for this remedy. Suppurative processes come within the range of this remedy, after pus has found a vent. Cuts, wounds, bruises, etc, unhealthy, discharging pus; they do not heal readily. Yellow, purulent crusts or discharge. Purulent exudations in or upon the skin. Skin affections with yellowish scabs. Many little matterless pimples under the hair, bleeding when scratched.
Promotes favourable cicatrization, with least amount of suppuration. Has remarkable power to produce local exudation and helps to make acrid discharge healthy and free.
The tendency to suppuration is most marked, and has been a strong guiding symptom in practice. Abscesses; suppurating glands are very sensitive. Papules prone to suppurate and extend. Great sensitiveness to slightest touch. Inflamed spots, eruptions, boils or suppurations are full of sharp pains. This is so intense that it is described at times, as a sticking and jagging like sharp sticks.
Almost constantly moist. Vesicular and pustular eruptions. Another marked feature is the tendency to the formation of pus. With inflammation there is burning and stinging and the rapid formation of pus and the part is aggravated by both warmth and cold. Abscesses burn and sting; inflammation of joints is attended with pusformation; in inflammation of the pleura the cavity fills up with pus. The discharges of pus are yellow-green. A strange feature is repeated swelling and abscess formation with: out any heat. An abscess or swelling in a joint forms, and he sweats from head to foot, is worse at night, loses flesh, trembles and is weak, but there is no heat while the abscess goes on. Abscesses form when the life force is so low that there is no tendency to repair; a slow and prolonged pus formation, no irritability in the abscess, no tendency to granulate, it opens and keeps on discharging and seems dead. Merc. will warm it up, stop the sweat and favor granulation.
Ripens abscesses since it promotes suppuration. Suppurative processes. Felons, abscesses, boils, old fistulous ulcers. Pus offensive. Promotes expulsion of foreign bodies from tissues. Abscesses about the gums and face, better by warmth. Quinsy with great pain in the tonsils, one or both; threatening suppuration. Threatened abscesses of the breasts. There may be throbbing, tenderness, and weight, yet the remedy controls the pain, hastens the conclusion, and the opening comes naturally, discharges little and closes at once.
Abscess, blind – Lyco
Abscess, bleeding easily – Puls
Abscess, painful- Anthrac, Ars, Pyrog, Merc, Tarent
Abscess, painful, warm application> Ars
Abscess, painful, cold application> led, Lyc
Abscess, painful, pressure < Bell-p
Abscess, painful, pressure> Asaf
Abscess, mature do not – Arn
Abscess, slow developing- Hep, Merc, Sil
Abscess, slow to heal- Sil
Abscess, of blood vessels Ars, lach, lyc, Puls
Abscess, of cartilages- Stram
Abscess, of connective tissue-Calc-s, Phos
Abscess, of fibrous tissue- Mez
Abscess, of internal organ- Canth, Lach
Abscess, of mucous membrane- sil
Abscess of muscles- Calc
Abscess of thorax- Hep
Abscess, tubercular- Asaf, Myrica, Sil
Abscess, malignant- Tarent-c
Abscess, to absorb the pus-Lach, Phos, Sil
Abscess, to eliminate foreign body- Hep, lob, Sil
Abscess, with fistulous opening- Cal-s, Nat-s
Abscess, with oozing pus- Carb- v
Abscess, with empyocele – Kali-s, Sil, Sulph
Abscess with liver complaint – Phos
Abscess, with erysipelous – Apis, Bell
Abscess, with succession- Syph
Abscess, multiple – Vesp
Abscess, from insect stringing – Tarent-c
Abscess, fever after – Phos-ac
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Dr Terese Kavya Raju (FMHMCH)