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Old 11th December 2005, 08:57 PM
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Question Leg ulcer - need help

Hello,
I am a beginner homeopath and i really need some help with a case. I (and my patient) would appreciate it a lot!


A woman 70 years of age has a leg ulcer that won't heal. It started with a scrach 3 years ago, and in the last year it has spread all around the leg, 12 cm wide! It is on the right lower leg. The way it spreads is that multiple blisters form, around the edge of the initial ulcer, filled with clear fluid, and when they break, raw skin is left. The ulcer is quite superficial, except on the starting place where it is a little bit deeped. Colour of the raw skin in the ulcer is red mixed with yellowish -white (i suppose that is what they called lardaceous base, but i'm not sure). In couple of places there is some growing flesh - proud flesh of red colour. She is in a lot of pain, she cries with the pain, and it is burning and sometimes pricking or pulsating. Tha pain is worse in the evening and when she goes to bed, till midnight. She is compelled to get up then and walk around or sit. She says neither hot nor cold feels good on it but if had to choose would prefer cold applications. There is a clear fluid oozing from the ulcer. There is not much of a smell. The edges are not swollen, the skin on the edge is hard and bluish-purple one cm in width, all around the ulcer.
Her both legs are swollen with edema. She has problems with the circulation in her legs and her knees are cold. She doesnt have any other health problems, she is obese, hot person but not sweaty and good natured.


Please let me know if you have any tips. I don't have much experience in treating leg ulcers. The books are not very detailed about them either (anybody knows any good books on them?). I also can't decide if I should treat it therapeutically or constitutionally? She is not the best patient to talk about her personality as she is an old, countryside woman that worked a lot all of her life and didn't have much time to think about it or just doesn't know how to explain things.

Thanks a million
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Old 12th December 2005, 04:10 PM
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Probably a venous ulcer,as from the location and fast spreading.
This may of deep venous insufficiency or superficial as in varicose ulcers, where you can observe varicosity. Also see whether the patient is diabetic.

This is a chronic condition and needs prolonged treatment as they tend to reappear. So after the healing of ulcer you have to study case in whole extend and prescribe for the patient.

Please study for Lachesis,Ars,Phos,Anthr,Syph,Sysig etc to cure the present condition.We can cure the acute state by correct prescription.

What about the state of Homoeopathy in Croatia? about Homoeopathic education?

regds,
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Old 18th December 2005, 12:50 PM
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Thank you.
I couldn't open this website for a few days for some reason.

How do you know that it is varicose ulcer? How would i know it? Nobody ever tought me that. She doesn't have enlarged veins, or pain in legs because of veins, she doesn't have hemorrhoids and she is not diabetic. These are the first things i asked her.
I talked to her daughter on the phone for a few minutes and asked her some questions, and it all confirmed my thinking - that she is a Calc type of person. I was thinking of giving her Sulph as it covers more the ulcer picture then Calc, and they are complementary.
Also, Merc and Lach seem close.
Anthr, Ars are better by warmth, she is worse.

Maybe I sound a bit confused, but i don't have much experience with leg ulcers. I know they can be dangerous. I already gave some Echinacea to the lady while i am thinking about the case, to prevent sepsis, and help with bacteria. She has three bacteria, Staphyloccocus and two others.

In Croatia there are not too many homeopaths, especially not in my town. There is a school that has english teachers, and it is a two year school.
I graduated in an irish school, which lasted 4 years, and we didn't do much therapeutics, and hands on work with deep pathology cases. I eould like to come to India some day and learn a bit more about that. It seems that it is the best place to go to.

Thanks a million
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Old 18th December 2005, 03:56 PM
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I only wrote the probability. The ulcers are of many types and many tend to chronic and recurrent nature. By mere observation itself we can understand many things about ulcers. Look for the edge, base, type of granulations and colour of base,discharge,surroundings for pigmentations,any varicosities and age of the patient etc

In case of leg ulcers there are many types. Venous ulcers, Arterial ulcer, Erythrocynoid ulcers,Gummatous ulcers, Martorell's ulcers, infective ulcers, Meleney's ulcers, Ulcers complicating various diseases,Tropical ulcers and yaws etc.

Venous ulcers usually at the lower third of leg and medial side and shallow.Usually painless later, but at the begining there will be pain. Surrouding reddish discoloration, pigmentation are diagnostic. The varicosities may or may not be seen. In case of deep vein complaints there will be no varicosities.

Arterail ulcer-due to poor circulation and seen in old people.It is deep ulcer and there may be discoloration of one or more toes.

Martorell's ulcer or hypertensive ulcers- Old age group, severe pain, the region usually calf or back, deep and extending, severe pain is characteristic. Some times seen in both sides. Atherosclerosis is the reason. It will takes month to heel.

Erythrocynoid ulcer-exclusively of young women.

By diagnosis of case may not help in selection of our remedy but we can know the prognosis and the nature of diseaes.So disease knowledge is always helpful.
No doubt for complete cure constituitional internal medication is a must.
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Old 18th December 2005, 05:56 PM
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Default Leg ulcer

Zina,
This is a suggestion as One of my patient cured with Silicea and Tarentula.
As per your posting
She is in a lot of pain, she cries with the pain, and it is burning and sometimes pricking or pulsating. Tha pain is worse in the evening and when she goes to bed, till midnight.
........
the skin on the edge is hard and bluish-purple
which indicates Tarentula Cubensis.
Clinical Case cured:
A lady 5'1" height with obesity having ulceration in her thigh since last 4 years tried several medicines in Allopathy and was using external application of Neurobin powder with out any permanent improvement.
When she approched me I found- clear fluid oozing from the ulcer,colour=pink + yellow,suppuration was there,no smell. I gave her one dose Silicea-200 followed with Sac.lac for a week.oozing of fluid reduced and the lady got relief of some pain.The colour of the edge changed to purple.I gave her one dose Tarentula Cubensis 12x followed with SL for one week.She reported that now she can sleep in the night without any trouble.SL continued for next three days when she complained about burning and stinging pain next dose of Tarentual Cubensis 12 x given followed with SL for one week.The wound healed magically turning the skin normal.
So plz go through the case again and note down the peculiarity of symptoms to find out the remedy that will help you to cure the case.
Hope to hear progress from you.
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Old 19th December 2005, 09:30 AM
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Thank you both,

Actually on her diagnosis sheet from her doctor it says Ulcer cruris. Cruris is leg, right? So it doesn't say much, but i am thinking if it was varicose it would probably say so, but i am not sure? What do you think? I think it is important to know if it is varicose or not as the remedy should have the affinity to it.

Of course constitutional treatment is necessary. I know.

Some people have suggested Arnica for circulatory problem ulcers like this one. What is your thought on that?

I will also have a look at Tarentula, thank you. That case does sound a lot like mine. Was the ulcer deep or shallow, and was it spreading by itchy blisters?
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Old 19th December 2005, 11:53 PM
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Dear Zina
Yes const. presc. is best then follow up with a nosode then back to const. to finish it off.......................(you did mention staph infection)

THis is only my suggestion

Gina Tyler
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Old 20th December 2005, 04:04 PM
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The ulcer may be of infective type.
Usually the ulcer may be in three stages.
1.Spreading 2.Healing 3.Callous
Here the ulcer has thick edge with bluish surrouding. It means it is in Callous stage and no tendancy to heal. For correct prognosis and to know whether the ulcer is towards healing or worse, you have to observe the base,edge,surroudings,granulations etc.
After relief of present crisis you have to go for anti miasmatic treatment.
Night<,rest<,watery discharge etc clearly shows miasmatic tendancy.
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Old 20th December 2005, 06:18 PM
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Sorry, what do you mean by "the edge is thick"? Do you mean elevated? It is not elevated, it is the same height as the rest of the skin...
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Old 20th December 2005, 07:41 PM
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Quote:
Originally Posted by Zina
Sorry, what do you mean by "the edge is thick"? Do you mean elevated? It is not elevated, it is the same height as the rest of the skin...
You wrote:

< what do you mean by "the edge is thick"? Do you mean elevated? >
Why do you ask that question, Zina ? Or rather,what was in your mind when you asked the second question ? This trend of thoughts is relevant in view of the chronicity of the ulcer.


With regards
Lew
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