A female patient, aged 55 years, from a remote village, works at agriculture fields, came with complaint of chronic non healing ulcer on the right heal, from 7 months (feb 2020). Complaint started after she got injured by unintentionally placing her foot on broken glass piece. The glass splinter entered her heel at a deeper level, she somehow managed to remove it with safety pin. Slowly the injury turned into ulcer, and started oozing pus. Pain is aggravated while walking, and at night. She used allopathic medicine from a local doctor but is not relieved.
No significant physical generals elicited from the patient.
On examination- no H/o of fever. Vitals – BP- 120/80 mm Hg.
Local findings- discharge present- pus.
Ulcer has everted, hard, jagged edges.
X ray findings- no osteomyelitis changes seen. There is calcaneous spur underneath.
1st prescription – as no prominent constitutional symptoms are elicited, prescription was given purely based on local symptoms.
Silicea 1M one dose, and CF 6X for one week.
Silicea was selected based on the injury- glass splinter and pus discharge. Calcarea fluor was given because of calcaneal spur irritation, leading to pain along with the ulcer. Discharge stopped, but healing is not taking place actively.
Considering slow healing of process in sycotic miasm, one dose of Thuja is prescribed as miasmatic prescription, after repertorising Graphitis 200 one dose was given, with CF 6X. After 2 weeks the ulcer healed completely, pain has completely relieved, and the skin around the ulcer peeled off by itself, and surrounding skin appeared very healthy.
Rubrics taken for reepertorisation are-
Extremities – ulcer foot- heel
Skin ulcers- indolent
Skin ulcer- indurated
Skin ulcer- jagged margins
Skin ulcer painful, night time
Skin – hard callosities, like
Inference: Miasmatic prescription intervention is necessary in chronic non healing ulcers. After one dose of Thuja, the healing was quick.