Abstract- A male age 34 years diagnosed clinically with “carbuncle” cured by homoeopathic medicine, Calcarea sulphurica.

Keywords- carbuncle, Calcarea sulphurica, homoeopathy

Abbreviations- HTN – hypertension, B.P- blood pressure, mm Hg- millimetre of mercury, amel. – amelioration, agg.- aggravation, BD- 2 times a day, B.A. –  Bachelor of arts, ^oF – degree Fahrenheit, Cal. sulph. –  Calcarea sulphurica, QDS – four times a day

Introduction

Carbuncle is a superficial infective gangrene, involving the subcutaneous tissue, caused by staphylococcal infection. ⁽¹⁾ It is commonly seen among the diabetic patients. The initial lesion is similar to boil in the form of hair follicle infection with perifolliculitis. ⁽²⁾ Generally, it commences with painful and stiff swelling which later spreads with marked induration. Surface is red, angry looking like red-hot coal. ⁽²⁾ Later, the central part of swelling turns into vesicles which finally transforms into pustules, that subsequently burst allowing the discharge to come out in multiple openings in the skin producing a sieve-like or cribiform appearance (a pathognomonic of carbuncle). ⁽³⁾ The opening coalescence to make bigger crateriform ulcer, the base of the ulcer lies a greyish slough. 

CASE STUDY

Chief complaints

A male patient of age 34 years complaints of pain and swelling with pus formation on the left hip region since last 3 months, agg. by touch; amel. Uncovering.

History of present illness

It appeared suddenly and he previously took allopathic medicine with no relief.

Past history

Not specific

Family history

Father was suffering from HTN

Personal history

Education- B.A.                      Occupation- businessman                   Diet- non- vegetarian

Habits- tobacco chewing

Physical and mental generals

While enquiring about the mental generals, he said that he always wanted to do his work hurriedly⁺⁺ whenever he was given any task. He wished to stay alone.

His appetite was good and he liked to take cold food. Thirst was moderate, he usually drank 2-3 litre of water in a day. He had a desire for sweets⁺⁺. Patient used to sweat profusely on his head. He was sensitive to hot⁺⁺. He usually slept for 6-7 hours and was refreshing.

Vitals

• Pulse- 80/minute
• Temperature – 98.4 ^oF
• B.P. – 120/70 mm Hg

Examination-

On inspection, redness and thick, yellow pus accumulation was seen over the swelling.

Diagnosis

Diagnosis was based on clinical history and physical examination. ⁽⁴⁾

Analysis and evaluation of the case

S.No	Symptom	Symptom type	Intensity
	Hurried in nature	mental general	++
	Wished to stay alone	mental general	+
	Desire for sweets	physical general	++
	Pus – thick and yellow	physical general	+++
	Perspiration on head	characteristic particular	++
	Uncovering amel.	physical general modality	++
	Pain on swelling	common symptom	+

Totality of symptoms

• Hurried nature.
• Sweet desire.
• Perspiration on head.
• Thick and yellow pus.
• Uncovering amel.

Repertorial totality

6 symptoms which were prominent including mental, physical, and particular symptoms are taken into consideration and repertorisation was done with the help of Complete Repertory in HOMPATH CLASSIC 8.0.

Symptoms	Rubrics
Hurried nature	[C] [Mind] Hurry, haste: tendency:
Sweet desires	[C] [Generalities] Food and drinks: sweets:desires:
Perspiration on head	[C] [Head] Perspiration, scalp:
Pus – thick	[C] [Generalities] Discharges, secretions:thick:
Pus – Yellow	[C] [Generalities] Discharges, secretions:yellow:
Uncovering amel.	[C] [Generalities] Uncovering:amel:

Repertorial sheet ⁽⁵⁾

Prescription

Prescribed on 15/01/2020

Calcarea sulphurica 6,

1 drop in 100 ml aqua, 5ml of the above solution repeated 4 times in a day for 5 days and report after 5 days.

On repertorisation, remedies such as Pulsatilla nigricans, Calcarea carbonica, Mercurius solubilis, Sulphur came in the top.

Calcarea sulphurica 6 ^(6) (7) was finally selected as per the thick and yellowish discharge of the pus which is a characteristic of Calcarea sulphurica.

Selection of dose and repetition ⁽⁸⁾

The medicine was repeated as per the intensity of the symptoms, and moreover in §247, it has been said that the medicine may be repeated as early as 5 minutes interval if the disease is of acute nature.

Figure 1: 15/01/2020

Follow up

Date	Symptoms	Prescription	Changes in swelling
20/01/2020	Pain – Mild reliefMild rednessAppetite – GoodSleep- DisturbedThirst- Moderate	Calcarea sulphurica 30 – BD for  3 days

Advise

Patient was advised to clean with fine cloth regularly.

Conclusion

As it is known, no disease is external without being diseased internally, hence in order to bring out the cure, the only way is by giving internal dynamic homoeopathic medicine.

References

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2.	K.R Shenoy AS, editor. Manipal Manual of Surgery. 4th ed. New Delhi: CBS Publishers and Distributors Pvt. Ltd.; 2012.
3.	Das S. A Concise Textbookof Surgery. 7th ed. Kolkata: Dr. S. Das; 2012.
4.	World Health Organization. ICD-10. 5th ed. Geneva: WHO Press; 2016.
5.	HOMPATH 8.0.
6.	Boericke W. Boericke’s New Manual of Homoeopathic Materia Medica and Repertory. 9th ed. New Delhi: B. Jain Pvt. Ltd.; 2014.
7.	Phatak SR. Materia Medica of Homoeopathic Medicines. 2nd ed. Noida: B. Jain Publishers (P) Ltd.; 1999.
8.	Hahnemann S. Organon of Medicine. 56th ed. Noida: B. Jain Publishers Pvt. Ltd.; 2016.

About Author:

Dr Anjan Das, BHMS
• Dr Shimul Jamatia, BHMS, PG Scholar, Dept. Of Organon of Medicine, Naiminath Homoeopathic Medical College Hospital and Research Centre, Agra-283202
• Dr Azizul Islam Khadim, PG Scholar, Dept. of Practice of Medicine, R.B.T.S Govt. Homoeopathic Medical College and Hospital, Muzaffarpur