1. Homoeopathic Management of Pseudo Surgical cases
Re Orientation Presentation by
Dr. Deepti Chawla

2. Discussion Agenda Pseudo Surgical diseases Homoeopathic approach
Detailed overview
Homoeopathic Management of Tonsillitis
Common Medications
Conclusion

3. ‘Pseudo’ Surgical cases
Conventional classification
Surgical
Non Surgical
Treated by mechanical intervention
Treated with medications
Pseudo Surgical: Cases classified as surgical by specialist but respond well to Homoeopathic medications

4. Hahneman’s classification

5. Hahneman’s classification
Local Diseases
One sided diseases which appear on external or local parts of the body
External Cause
Internal Cause
Local diseases due to some external cause such as an injury , fracture etc. may be treated with surgery followed by a suitable homoeopathic medicine
Local diseases due to internal cause which have been triggered by some immediate exciting cause.
Cases falling under this category may be classified as pseudo surgical cases

6. Local Diseases of Internal Cause
Pseudo Surgical cases
Interpretation of Pseudo Surgical cases in light of Hahneman’s classification
Local Diseases of Internal Cause
Internal cause : Altered immune status
Exciting cause: Exposure to pathogen

7. Management of Pseudo Surgical Cases
Formation of complete picture of disease
Exact character of local affection
All observable changes in health , symptoms
Symptoms present before any medicine was used
Selection of homoeopathic remedy corresponding to the totality
Acute totality to be tackled first ( in case of acute affection)
Anti miasmatic treatment, once the acute state has subsided

8. Common Surgical conditions in which Homoeopathy has a role to play:
Tonsillitis
Adenoids
Urolithiasis
Warts
Uterine fibroids
CAUTION: Not ALL cases of the above conditions can be treated without surgical intervention. Practitioners are advised to follow guideline protocols in identifying cases suited for homoeopathic management

9. Tonsillitis
Inflammation of tonsils (tonsillitis) can be bacterial or viral
Symptoms of tonsillitis include:
Tonsils visibly red and swollen
Patches of white discharge on infected tonsils
Severe sore throat
Difficult or painful swallowing
Headache
Fever and chills
Enlarged, sore glands in the jaw and neck
Changes in or loss of one's voice

10. Tonsillitis Clinical Signs
Source:

11. Adenoids
The nasopharyngeal tonsil when hypertrophied so as to produce symptoms is called Adenoids
This leads to symptoms of nasal obstruction such as:
mouth breathing
noisy breathing
nasal tone of voice
persistent nasal discharge
deafness due to obstruction if Eustachian tubes.
Inflammation of Adenoids may cause persistent nasal discharge, post nasal drip, cough or otitis media

12. Adenoids
Source:

13. Conventional Treatment of Tonsillitis and Adenoids
Medication:
Tonsillitis resulting from a streptococcal infection is usually treated with an antibiotic
Unfortunately, there is currently no medication for the viruses that cause tonsillitis
Surgical removal of Tonsils:
In general, a patient may be a candidate for tonsillectomy if he or she meets one of the following criteria:
Seven or more episodes of tonsillitis in one year
Five or more episodes of tonsillitis each year over a period of two years
Three or more episodes of tonsillitis a year for a period of three years
Tonsillitis that recurs despite treatment with antibiotics
Airway or swallowing obstruction due to swollen tonsils

14. Drawbacks of conventional treatment
In day to day practice we encounter Surgery is advised arbitrarily even to patients not meeting the previously stated criteria
Surgery can never be without its accompanying risks, morbidity and complications
Post operative haemorrhage
Infection in some cases
Ear Pain
Poor oral intake of fluids
Lower immunity hence overall increase in susceptibility to infections
Iatrogenic complications
Removing tonsils may reduce the risk of throat infections, it won't necessarily prevent them completely .
Surgery is expensive.

15. Homoeopathic Management of Tonsillitis & Adenoids : Case Studies
Three case studies in all of which Tonsillectomy or adenoidectomy were recommended as the treatment of choice by ENT Surgeons
All were treated effectively with homoeopathic medicines.
Needless to say surgery was no longer required in any of them

16. Homoeopathic Management of Tonsillitis Case Study 1 : Tanshi 6/C
A six year old female child presented with complaints of cough, sore throat and pain in swallowing solids, accompanied by fever at night. She had a past history of recurrent episodes of acute tonsillitis with a frequency of an episode almost every two weeks.
P/G:
marked tendency to take cold easily on the slightest exposure
increased thirst
tendency for every cold to settle in throat
M/G:
the child appeared to be shy++
dull expression
according to the attendant her concentration and memory were poor
O/E-
single pus follicle in right tonsil
erythema++
The following prescription was made on the basis of acute totality
Merc. sol 200 x TDS x 2 days
Belladonna 200 x TDS x 2 days

17. Homoeopathic Management of Tonsillitis Case Study 1 : Tanshi 6/C
On follow up the patient reported general improvement. She was afebrile and sore throat and cough were better
O/E-
erythema>>
no pus focus seen
No gain of weight in the last 2 years despite normal appetite
Prescription
Tuberculinum 200 x 2 doses
Baryta carb 30 x T.D.S x 5days
Further improvement over the next 3 months during which placebo was prescribed
Patient reported with sore throat and dry cough
Patient was afebrile and symptoms were much milder than earlier
O/E
Tonsils were enlarged but less as compared to previously
slight erythema
no pus follicles seen

18. Homoeopathic Management of Tonsillitis Case Study 1 : Tanshi 6/C
There was swift recovery with a repetition of the previous prescription of
Tuberculinum 200 and Baryta carb 30
Subsequently follow up was continued for six months during which patient did not present with acute tonsillitis.
The patient’s weight gain is now satisfactory

19. Homoeopathic Management of Adenoids Case Study 2 : Lakshya 10/C
A ten year old male child presented with c/o:
Persistent nasal blockage
Mouth breathing especially in sleep
Cough off and on with yellow expectoration
Snoring
Past history:
H/O mouth breathing
Recurrent attacks of sore throat
O/E:
Tonsils enlarged
Erethema +
Investigations
X- Ray nasopharynx: Soft tissue shadow nasopharynx, obstructing airway. Suggestive of adenoids.
Adenotonsillectomy had been recommended by ENT surgeon. The following prescription was made:
Silicea 200, 3 doses stat
Agraphis Nutans 30 x TDS x 3 days

20. Homoeopathic Management of Adenoids Case Study 2 : Lakshya 10/C
On follow-up, general improvement was noted in cough and sore throat, expectoration was white. Mouth breathing and snoring were same as before
Agraphis Nutans 30x TDS was repeated over the next two weeks
Patient continued to improve and placebo was prescribed
Follow-up:
Child was reported to be breathing normally through nose in sleep within four weeks of starting treatment
There was no snoring
On examination, tonisllar enlargement was markedly less than previously observed
Follow-up was continued for approx 6 weeks after the condition improved
Patient has ever since remained asymptomatic

21. Homoeopathic Management of tonsillitis Case Study 3: Akanksha 5/C
A five year old female child presented with c/o
pain throat since two days
fever
pain right ear < swallowing
P/H:
Recurrent episodes of sore throat with fever almost every days.
Patient continued to improve and placebo was prescribed
Follow-up:
Child was reported to be breathing normally through nose in sleep within four weeks of starting treatment
There was no snoring
On examination, tonisllar enlargement was markedly less than previously observed
Follow-up was continued for approx 6 weeks after the condition improved
Patient has ever since remained asymptomatic

23. Conventional Treatment of Tonsillitis and Adenoids
Surgical removal of tonsils and/or adenoids has remained the mainstay of treatment in conventional allopathic school of medicine. However, even minor surgery can never be without its accompanying risks, morbidity and side effects. There may be post operative haemorrhage, infection in some cases and since swallowing is painful after surgery, there may be poor oral intake of fluids.

24. Footnote
On August 24, 2005, Prince Charles commented that up to 480 million pounds could be saved by the UK government if one in 10 family doctors offered Homeopathy treatment to their patients as an alternative to standard drugs - The Times newspaper. It is well-known that traditionally the British Queen's family favours and follows Homeopathy. Prince Charles always insists that the UK government provide Homeopathy treatment in the National Health Services (NHS).