A Case of Non-Healing Wound of Inguinal Hernia Repair
Mr.M.H aged 48 years a waiter in a local restaurant consulted me on 5th October 2018 for a non-healing surgical wound of right sided inguinal hernia repair which he had got done around six months ago. Medical report says that the surgical wound was sutured after herniorraphy with absorbable sutures.
On examination thick yellowish odourles discharge was noticed from the incised wound which one recognized as the well known 'Laudable pus' of old medical literature.The phrase 'pus bonum et laudible' (good and laudible pus) has long been discarded,it was frankly a case of a 'non-healing surgical wound' needing an advanced wound care. I made patient understand and advised to consult his surgeon but patient was willing to give homoeopathy a chance so one was.
After taking the whole case beside some other trivial complaints one noticed deep scar marks on patient's face and extremities on enquiring he informed that he had suffered from small pox at the age of 2 months while several other died in locality he managed to survive but with the stamp of disease. calendula officianalis 30 6 doses in sac lac was prescribed to be taken twice daily for three days followed by placebo.Proper instruction of wound cleaning with calendula officianalis Q was given and asked to report after two weeks.
On 3rd October
Healing has been started
Discharge was much less
To report after two weeks
On 6th November
Same as before
Considering the anamnesis of small pox Malandrinum 200 one dose was given followed by placebo and was asked to report after 10 days
Healing was Complete
no discharge now
Chronic non-healing wounds presents a significant public health burden especially in poverty stricken country like India where a majority of population strive day and night to meet their both ends, as evident the patient in case consulted me instead of going to his surgeon is mainly because of poverty poor people here in India particularly in Kolkata comprise their health as long as they can because they don't want to lose their daily wages at first place secondly the cost of treatment is high although there are government schemes for them but the public hospitals are just overcrowded going there means a loss of daily wages, the patient in the case works as a waiter in a local restaurant from 8am to 4pm and can hardly earn a respectable living so he might have thought that trying homoeopathy may save him from those difficulties I mentioned.
The case was a self-evident for the prescription of calendula officianalis and any homoeopath would have prescribe it as a first prescription but what make the case more interesting is the prescription of Malandrinum afterwards, let me discuss one by one.
As H.C Allen mentioned in his keynotes in chapter of calendula
“to secure union by first intention and prevent suppuration. In all cases of loss of soft parts when union cannot be effected by means of adhesive plaster.External wounds with or without loss of substance; torn and jagged looking wounds; post-surgical operation; to promote healthy granulation and prevent excessive suppuration and disfiguring scars. excessive secretion of pus. calendula is almost specific for clean, surgical cuts or lacerated wounds, to prevent excessive suppuration."
Here I took the pathological similimum and as Dr.J.C.Burnett once said
"The fact is we need any and every way of finding the right remedy; the simple simile, the simple symptomaticsimilimum and the farthest reach of all-the pathologic similimum, and I maintain that we are still well within the line- of Homœopathy that is expansive, progressive, science fostered and science fostering."(Preface to ninth edition of Boericke'Materia medica.) So I may be excused here for choosing my totality of symptoms.
Next cleaning of the wound may have be done with any other antibacterial or antiseptic lotion but I preferred calendula officianalis mother tincture for cleaning and dressing purpose as because of its specificity with the case and also due to the well proven antiseptic and anti-microbial action of calendula officianalis.
Finally the prescription of Malandrinum was based on anamnesis of the case. Malandrinum is a nosode prepare from disease of horses called "grease" which have a striking similarities with the pathogenesis of small pox and many of our stalwarts have used it in cases of small pox as curative as well as preventive.
I used Malandrinum based on the anamnesis that my well chosen remedy was not working to the depth.
The concept of anamesis has been well discussed by Carroll Dunham in his lectures on materia medica in chapter of “The anamesis”. Often these history of some severe acute diseases (small pox in this case) serves as the blockage for the indicated remedy which must be consider in order to affect a cure.
In prescription of nosode there is one saying which is common to all of them "when the best selected remedy fails" I have verified it more than once. The case shows the efficacy of proper homeopathic treatment in so called chronic skin wound and further establishes the internal nature of the so called external diseases. Patient was saved from further financial burden and loss of his daily wages with this simple treatment,what a godsend Homoeopathy is!