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Monday, June 6, 2011

Get ready to Manage Monsoon Diseases.


Get ready to Manage Monsoon Diseases.
Dr.S.G.Biju BHMS MD (Hom)
The Homoeopathic Multi Speciality Hospital, Cahnganacherry- 1
Within few days Kerala is going to welcome monsoon. Schools will be re-opened with new hopes, new books and new dresses. Homoeopaths are also in preparation to manage their clinics with more vim and vigor as they are expecting another “season”. RAECH (Rapid action epidemic Control Cell in Homoeopathy) is also revamping its armamentarium. Japanese Encephalitis and Chikun Gunyea made a short visit at Alappuzha District as a pilot vehicle! Are we really prepared to face the health challenges of monsoon is the question of the hour. Modern medicine and health workers are doing their routine works and meeting regularly and making discussions regularly. We hope that new Govt. and health minister will take time to study things properly. Any way, we have to get prepared at least in this monsoon to face health challenges effectively. Let us discusses about main visitors of monsoon. Dengue Fever may be the villain of 2011 too. It may strike northern districts of Kerala sparing southern districts. If at all it occurs in southern districts it will be more damaging with dengue hemorrhagic. Cochin will welcome both Dengue and CG through its traditional resource of mosquitos. We hope that Alappuzha District shall keep its tradition as the capital of Epidemics! Preparing the armamentarium with weapons against Chikun Gunyea may make desperation as majority of population achieved natural immunity against CG. Gastroenteritis, dysentery, ADD (acute Diarrhea Diseases) etc. shall also be expected. Fogging, awareness programmes, mosquito net distribution, central expert committee visit, blood sample examination at virological institute, political victimization of new health minister, and request for more central fund, crisis management committee, panics creation and propagation by Media etc. shall expect as usual. Responsibility of a Homoeopath is very high as most of the expected diseases are viral. Bacterial diseases like tonsillitis, bronchitis, bronchiolitis, and dysentery may occur sporadically. We, Homoeopaths must have formulate a treatment protocol for the monsoon diseases.

A treatment protocol for Monsoon diseases.


                        To differentiate bacterial and viral diseases we shall send patient for a routine blood examination. If TC is increased it will be a bacterial infection and if it is coming down it will be a viral infection. Platelet count will be between 10,0000 and 1,500,000 in most of viral diseases. By this simple investigation technique one shall identify whether it is a case to be treated only by Homoeopathic medicine or shall be treated by any systems of medicines.  If it is a viral disease it is to be treated with Homoeopathic medicines and Homoeopathic medicines only. Our focus in management of Monsoon diseases is to reduce the duration of illness, to reduce the intensity of symptoms and to prevent complications. 
  • Better to select a plant remedy in viral diseases.
Viral diseases will occur in sensitive patients. Sensitivity is the theme of plants. History of treatment of viral disease reveals the success story of plants
Chikun Gunyea – Eupatorium Perfoliatum. Dengue Fever – Eupatorium Perf,
Conductivities – Euphrasia,  Chicken Pox – RhusTox, Measles – Pulsatilla, Mumps – Jaborandi, Viral Hepatitis – Nux Vomica.
All are viral infections and all the effective medicines are plants.
  • In bacterial infections minerals are found effective.
Bacillary dysentery – Merc sol, Tonsilitis – Baryta Carb, Bronchitis – Phos,                         Staphylococcal diarrhea-Mag carb,   Impetigo contagiosa/bullosa – Acid Nit etc. are few examples.
  • Selection of Preventive medicines: one should be careful in selection of preventive medicines because members of other schools of medicines are still skeptics about the effectiveness of our preventive medicines. Simple protocol of selection of preventive is to consider only the initial symptoms of the epidemics. Whole totality of an epidemic may represent a curative medicine but not a preventive because we are producing an artificial disease of which can represent the initial stages of an epidemic. In almost all epidemics, initial symptoms will be same or similar. After few hours or days symptoms will vary according to the miasmatic constitution of each individual. It is the duty of each and every Homoeopath to inform RAECH about local Genus Epidemicus. Then only the aims and objectives of RAECH will be fulfilled. 
  • Red Flag symptoms of Epidemics: Certain conditions need Hospitalization and auxiliary management and even Antipathic treatment. Such conditions will always precede by” red flag” symptoms. Usual complications are occurring either in CNS or in Respiratory system in the form of Meningitis and pneumonias. Homoeopaths are blamed for wrong diagnosis in such cases. Lot of people  quitted Homoeopathic treatment for epidemics because of the same reason. Let us see some red flag symptoms
CNS (Meningitis)
Respiratory (Pneumonia)
         Convulsions: A life-threatening condition if occurred during treatment of epidemics..
         Any young infant with convulsion during the present illness should be considered seriously ill.
         May not be tonic-clonic movements.
         Repetitive jerky movements of the eyes, lip smacking, a staring look.
         BULGING FONTANELLE in infants: Look at & feel the anterior fontanel when the infant is not crying and held in an upright position.
         Bulging fontanels may be a sign of meningitis.
         Infections of the CNS may present clinically with 1 or more of the following 5 neurological findings.
         Presence of any one should stimulate the search for the other 4.
         Altered consciousness
         Convulsions
         Severe Persistent vomiting (raised intracranial Pressure)
         Paralysis: Focal paralysis, Unequal pupils, Facial paralysis & ocular paralysis in TB meningitis
          Signs: NECK RIGIDITY, BRUDZINSKI NECK SIGN, BRUDZINSKI LEG SIGN,KERNIG’S SIGN

         Helleborus 30 1 or 2 doses shall prevent Meningitis before signs established.

·                     Fast Breathing:
·                     Respiratory Rate
·                     Age     < 2 months     60 or more
·                     Age     2 m – 1 year  50 or more
·                     Age     1 yr –  5 yrs      40 0r more
·                     This indicates pneumonia.
·                     Chest In drawing: The definite inward movement of the bony structure of the lower chest wall with inspiration.
A useful sign of severe pneumonia.

NASAL FLARING - Widening of the nostrils when the young infant breathes in.

Diagnosis of pneumonia is clinical rather than biochemical. Chest X – Ray P A view may help to confirm the diagnosis.

         Pneumonia: Auscultation is not a major component for diagnosis of pneumonia. The sensitivity of diagnosing pneumonia by auscultation is only 50%. Auscultation is useful to diagnose complications like pleural effusion & pneumothorax.
         Inability to breast feed ,drink, Drowsiness( abnormally sleepy/ difficult to wake)Noisy Breathing/ stridor, Wheeze, Cyanosis, Grunting are pointers towards pneumonia.


VERATR VIR 200 in repetition shall prevent pneumonia in congestive stages.  

If you are able to diagnose Meningitis and pneumonia in proper time then you won’t be blamed by other schools and patients. It can be done without any laboratory investigations and invasive procedure if you are able to observe the signs and read it along with the symptoms of patients. One must get ready to face the challenge of Meningitis & Pneumonia or refer patients in time. In this epidemic monsoon we must won the heart of people by increasing our cure rate.

  • We must offer a little Extra
 All patient reaching at our clinic with an upper respiratory viral infection should get one guarantee, “it should never go down for a LRTI (lower respiratory tract infection)”. NAJA 30 and Dulcamara 200 are effective medicines to prevent LRTI. Or one may go to MURPHY’s Repertory Chapter nose and rubric

Nose - CORYZA, general – descending – then select the best similimum out of 9 medicines.

We must focus on cough too because usually cough appears immediately after fever. PULS 200 and Sanguinaria Nit 30 are found effective in controlling cough after fever. Though these things are minute things comparing with potentials of Homoeopathy, these are the acid tests for general public to decide the effectiveness of Homoeopathic Medicines.

  • Auxiliary methods:  Don’t hesitate to use auxiliary methods as it is not the monopoly of any system of medicine.
         Fever: Increased fluid intake, Sponging or hydrotherapy.
Environmental modifications
 Increased fluid intake
Sponging or hydrotherapy
Minimal clothing

Dress the child in only one layer of clothing
This enhances heat loss.

Do not cover the child with too many clothes or blankets.
The most common mistake made by the parents is to bundle the child in heavy clothes.

Keep the child in cool & airy environment

Open a window slightly or turn off the heat in the room or use a fan

Coolness will bring the fever down
                     Extra fluid intake is advised in febrile patients
                     Give plenty of cool, clear liquids to replace the water loss.
                     For each 1C of increase in temperature, a 10% increase in fluid intake is recommended.
                     Gently massage the body to dilate the cutaneous blood vessels.

                     The mainstay of non-pharmacological antipyretics.
                     Tepid sponging with lukewarm water is very beneficial to reduce fever.
                     Studies have shown that tap water is the best as it is physiological, less discomforting, causes less crying
                     Sponging should be done by continuous wiping of the body from head to toe for 15-20 minutes.
                     Tepid sponging acts by conduction of heat from skin to cooler water.

Temperature > 41degree F ( > 106 degree F ). Rapid cooling is very important
by immersion of the child in cold water or by gastric lavage / enema with ice cold saline.

Fever is of course a good sign but it is our duty to get patients out of panic going to create by media.
Wish all my brothers & sisters a nice monsoon practice!


3 comments:

  1. "VERATR ALB 200 in repetition shall prevent pneumonia in congestive stages."
    VERATR.ALB OR VERATR.VER?....

    ReplyDelete
  2. Sorry It is Veratrum Vir 200
    will correct it now Thanx for the commend

    ReplyDelete
  3. Good article sir. Will keep checking for more.. Hope you keep sharing!

    Thanks. Dr Radha.

    ReplyDelete