3 ‘Pseudo’ Surgical cases Conventional classificationSurgicalNon SurgicalTreated by mechanical interventionTreated with medicationsPseudo Surgical: Cases classified as surgical by specialist but respond well to Homoeopathic medications
5 Hahneman’s classification Local DiseasesOne sided diseases which appear on external or local parts of the bodyExternal CauseInternal CauseLocal diseases due to some external cause such as an injury , fracture etc. may be treated with surgery followed by a suitable homoeopathic medicineLocal 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 casesInterpretation of Pseudo Surgical cases in light of Hahneman’s classificationLocal Diseases of Internal CauseInternal cause : Altered immune statusExciting cause: Exposure to pathogen
7 Management of Pseudo Surgical Cases Formation of complete picture of diseaseExact character of local affectionAll observable changes in health , symptomsSymptoms present before any medicine was usedSelection of homoeopathic remedy corresponding to the totalityAcute 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: TonsillitisAdenoidsUrolithiasisWartsUterine fibroidsCAUTION: 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 TonsillitisInflammation of tonsils (tonsillitis) can be bacterial or viralSymptoms of tonsillitis include:Tonsils visibly red and swollenPatches of white discharge on infected tonsilsSevere sore throatDifficult or painful swallowingHeadacheFever and chillsEnlarged, sore glands in the jaw and neckChanges in or loss of one's voice
11 AdenoidsThe nasopharyngeal tonsil when hypertrophied so as to produce symptoms is called AdenoidsThis leads to symptoms of nasal obstruction such as:mouth breathingnoisy breathingnasal tone of voicepersistent nasal dischargedeafness due to obstruction if Eustachian tubes.Inflammation of Adenoids may cause persistent nasal discharge, post nasal drip, cough or otitis media
13 Conventional Treatment of Tonsillitis and Adenoids Medication:Tonsillitis resulting from a streptococcal infection is usually treated with an antibioticUnfortunately, there is currently no medication for the viruses that cause tonsillitisSurgical 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 yearFive or more episodes of tonsillitis each year over a period of two yearsThree or more episodes of tonsillitis a year for a period of three yearsTonsillitis that recurs despite treatment with antibioticsAirway 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 criteriaSurgery can never be without its accompanying risks, morbidity and complicationsPost operative haemorrhageInfection in some casesEar PainPoor oral intake of fluidsLower immunity hence overall increase in susceptibility to infectionsIatrogenic complicationsRemoving 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 SurgeonsAll 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 exposureincreased thirsttendency for every cold to settle in throatM/G:the child appeared to be shy++dull expressionaccording to the attendant her concentration and memory were poorO/E-single pus follicle in right tonsilerythema++The following prescription was made on the basis of acute totalityMerc. sol 200 x TDS x 2 daysBelladonna 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 betterO/E-erythema>>no pus focus seenNo gain of weight in the last 2 years despite normal appetitePrescriptionTuberculinum 200 x 2 dosesBaryta carb 30 x T.D.S x 5daysFurther improvement over the next 3 months during which placebo was prescribedPatient reported with sore throat and dry coughPatient was afebrile and symptoms were much milder than earlierO/ETonsils were enlarged but less as compared to previouslyslight erythemano 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 ofTuberculinum 200 and Baryta carb 30Subsequently 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 blockageMouth breathing especially in sleepCough off and on with yellow expectorationSnoringPast history:H/O mouth breathingRecurrent attacks of sore throatO/E:Tonsils enlargedErethema +InvestigationsX- 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 statAgraphis 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 beforeAgraphis Nutans 30x TDS was repeated over the next two weeksPatient continued to improve and placebo was prescribedFollow-up:Child was reported to be breathing normally through nose in sleep within four weeks of starting treatmentThere was no snoringOn examination, tonisllar enlargement was markedly less than previously observedFollow-up was continued for approx 6 weeks after the condition improvedPatient 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/opain throat since two daysfeverpain right ear < swallowingP/H:Recurrent episodes of sore throat with fever almost every days.Patient continued to improve and placebo was prescribedFollow-up:Child was reported to be breathing normally through nose in sleep within four weeks of starting treatmentThere was no snoringOn examination, tonisllar enlargement was markedly less than previously observedFollow-up was continued for approx 6 weeks after the condition improvedPatient 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 FootnoteOn 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).