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Homeopathyin Intensive Careand Emergency Medicine
Homeopathyin Intensive Careand Emergency Medicine
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VII
Table of contents
VIII
Table of contents
IX
II Intensive care medicine | 5.2 Acute renal failure (ARF) 5
Case 5.2-1: Acute kidney failure Homeopathic treatment
Michael Frass Repertorisation I
COMPLETE REPERTORY
Anamnesis Chest – inflammation – lungs – right – upper
A 68-year-old male patient develops acute kidney
Generalities – fistulas
failure after suffering severe respiratory insuffi-
Rectum – fistulas
ciency. The patient’s case history includes a ton-
Head – sweating – night
sillectomy in his childhood and a cholecystectomy
Generalities – carcinoma
performed at the age of 42 due to cholecystolithia-
sis. The patient also has recurring bouts of Crohn’s Differentiation between remedies
disease, which first manifested at the age of 47. The Silicea could be considered in terms of differen-
patient was operated on for fistulae and underwent tial diagnosis; however, the location of the shadow
several partial resections. However, at the time of does not indicate this remedy. Calcarea carbonica is
the acute event he had no symptoms and was not the main remedy indicated on repertorisation; this
taking any medication. The patient was diagnosed also includes nocturnal sweating of the head as a
with diabetes mellitus type II three years previ- symptom.
ously. This is being treated with metformin (e.g.
Prescription
Glucophage®).
On day 3, the patient is given 1 dose of 5 globules
Acute event Calcarea carbonica 200C.
The patient was admitted to hospital with pneu-
Progress
monia. In the general chest x-ray, a shadow was
observed at the apex of the right lung. On the gen- The shadow in the upper lobe of the right lung
eral ward, the patient suddenly developed dyspnoea subsides rapidly over the next four days; the seda-
and was transferred to ICU with acute respiratory tives are stopped. On day 5, the respiratory pres-
failure (day 0). An endotracheal tube was inserted, sure is adjusted to pressure support with a FiO2
he was sedated and controlled artificial respiration of 40%. The signs of sepsis subside at the same
was given (BIPAP, FiO2 of 75%, pressures: 30 and time. Surprisingly, acute renal failure (ARF) sets
10 cmH2O). He also showed signs of sepsis with a in on day 6. The plasma concentration of creati-
focus suspected in the lung. His temperature was nine and BUN increase dramatically over the next
39.2°C, he had tachycardia (heart rate 95/min.), his few days. A cloudy sediment is observed in the
leucocyte count was 15.6 g/l. One striking symp- patient’s urine. Continuous venovenous haemo-
tom was profuse sweating of the head at night. filtration seems inevitable in view of his declin-
ing kidney function. As the homeopath was tem-
Diagnoses porarily absent, the patient was not able to begin
Acute kidney failure, Crohn’s disease, pneumonia. homeopathic treatment until day 16. The patient
Conventional treatment reported pain in the kidney area radiating into the
It was found that the patient had anaemia, ele- thighs.
vated beta 2 microglobulin and elevated C-reac- Repertorisation II
tive protein (CRP); a computed tomography of the COMPLETE REPERTORY
abdomen was consequently performed, raising the Kidneys – pain – extending to – thigh
suspicion that he had an abdominal tumour. Histo- Urine – scanty
logical examination of the biopsy revealed that he Urine – sediment – cloudy
had abdominal non-Hodgkin lymphoma (NHL).
193
5 II Intensive care medicine | 5 Kidneys
194
13 III Emergency Medicine | 13 Intoxication
Case 13.3-3: Anaphylactic shock Her cheeks seem to be itching, as she keeps scratch-
Martin Bündner ing them. She then convulsively stretches her whole
body backwards. After a few minutes, she relaxes
Anamnesis
and appears to return to normal. Half an hour later,
The eight-month-old girl suffers from a milk
she falls asleep at a time which is unusual for her,
allergy and severe neurodermatitis. The milk
and wakes up half an hour later. She now appears to
allergy manifests as massive vomiting after she eats
be back to her old self. The evening proceeds abso-
a little milk pudding. Subsequently, hives form on
lutely normally; she seems to have come through it
her face and on the areas which came into contact
safely. The homeopathic doctor treating her advises
with the vomit; the child scratches herself in these
the mother just to breastfeed her for the time being
places. After licking an ice cream, her right eyelid
without giving any additional food. At the mother’s
swells and hives form around her mouth and on her
wish, the child remains at home and is not taken
cheeks. After eating milk chocolate, hives form on
to a clinic for monitoring, contrary to the doctor’s
the areas of skin which were smeared with choco-
advice. The parents are then told to contact the
late. They also form on the skin under the choco-
doctor immediately if the slightest sign of another
late stains on her T-shirt. The parents avoid giving
reaction appears.
her foods which contain milk. As yet, it is unknown
There are no unusual occurrences in the night. How-
whether she is allergic to egg white, but the parents
ever, next morning, the girl is found to be sweating
are currently trying to avoid foods containing egg
profusely on her back and the back of her head, al-
white equally strictly for fear of another allergy.
though she is no more warmly dressed than on the
One evening, the baby is given a small piece of pasta
previous nights and there has been no change in
with home-produced fresh egg. After the meal, the
room temperature. Her nappy is found to contain
girl suddenly begins to scream uninterruptedly at
greenish-brown stool, which smells fermented and
quite a low pitch, which is completely untypical.
374
III Emergency Medicine | 13.3 Poisoning with industrial and household substances 13
extremely sour. The consistency is soft and it con- case. The skin manifestation is characterised more
tains food remnants, presumably from the pudding. specifically by the heat over the rash.
Suddenly, the mother sees large, red, hot hives ap- The rolled-in eyes are merely an unusual local
pear at the lower edge of the nappy; the skin is raised. symptom. However, this cerebral involvement is
She is using the same brand of nappy as usual. The unusual for an allergic reaction and therefore very
homeopathic doctor is notified immediately and he important for finding the right remedy, which is
sets off right away to make a house call. Before he why this symptom along with the opisthotonos
arrives, the situation worsens dramatically within a and the comatose sleep is given precedence over
few minutes: the hives spread rapidly upwards over the other general symptoms during the repertori-
the abdomen, armpits, throat, neck and face. The sation process.
baby cries shrilly and scratches herself all over, caus-
Repertorisation
ing the hives to increase in size. Suddenly her face
KENT’S REPERTORY
turns ashen, then as white as chalk; even her lips are Perspiration – single parts – lain on
affected. The girl’s eyes roll inwards and she loses
Back – opisthotonos
consciousness. She collapses, stops crying, no longer
Sleep – comatose
responds when spoken to. She appears lifeless; only
Eye – turned – inwards
her shallow breathing shows that she is still alive. The
Generalities – pain – appears suddenly
mother panics and is about to call emergency ser-
vices when the homeopathic doctor arrives. As the Skin – eruption – urticaria
baby is still alive, the situation is evaluated quickly. Skin – heat – without fever
It would take more than ten minutes for emergency Differentiation between remedies
services to arrive. However, with these clear symp- Belladonna is the only remedy listed in all these
toms, a homeopathic remedy is quickly found. The rubrics, where it is invariably weighted doubly
emergency services are not ideally equipped to deal or triply. The only exception is the heat rubric, in
with this special case of anaphylactic shock in a baby; which except for two doubly weighted remedies,
transport to the nearest clinic would take about half the remaining 24 remedies (including Belladonna)
an hour even if special rights were utilised. There are are weighted singly. Aconitum and Pulsatilla might
no corticoids or adrenaline available, as a result of also be possible.
which the doctor decides to administer emergency However, Aconitum does not have the typical rash
homeopathic treatment taking all circumstances and Pulsatilla is not a perfect match because it does
into consideration. not cover the neurological symptoms sufficiently.
Diagnosis The upward movement of the symptoms is typical
Anaphylactic shock. Neurological symptoms. Neu- of Belladonna. This is not mentioned in the reper-
rodermatitis. Multiple allergies. Atopic diathesis. tory but can be found in the materia medica, pos-
sibly in connection with another symptom, when
Homeopathic treatment working up the case.
This case is characterised by the following symp-
toms: the general symptoms are the comatose Prescription
sleep, the sudden manifestation (which can be rep- 2 doses of 1 drop Belladonna Q6.
ertorised in parallel using the pain rubric), the spe- Progress
cific location of the unusual sweating, the hives Just a few seconds after administering Bella-
moving upwards and the opisthotonos of the pre- donna, some signs of life reappear; the eyes are no
vious evening, which is part of the symptom com- longer rolled inwards but have returned to normal.
plex and must therefore be incorporated into the This good sign is hopeful and reassuring, and is
375
13 III Emergency Medicine | 13 Intoxication
confirmed by the baby’s further progress. The Bel- it acts with a rapidity proportionate to the nature
ladonna Q6 is shaken and she is given another drop. of the disorder) […]. Paleness of face […]. Sudden
Within another 20 to 30 minutes, the rash progres- paleness of face for a considerable time […]. Great
sively subsides from top to bottom in accordance dullness of head and sight, […] with very small,
with Hering’s Law and the girl’s reactions return to unequal, dark red spots, especially on the forehead,
normal. The last hives disappear during the day. swollen face […]. Red swollen face […]. Red swol-
No more doses are given on this day, as the rem- len face with staring eyes […]. Swollen face […].
edy is taking effect slowly but surely and should not The eyes […] roll about in the head […]. The eye-
be disrupted by another dose. Afterwards, the girl balls rove about in a circle spasmodically […]. The
is given long-term treatment with Belladonna (1 eyes are distorted […]. Spasms of the eyes […].
drop Belladonna Q6 daily after shaking the bottle), The eyes are distorted, with redness and swelling
which continues to have a positive effect. of the face […]. Curdled […] stool […]. Motions of
a very sour smell […]. Green stools […]. The pain
Evaluation
mounts gradually from the ankles to the hips […].
The child would presumably have died if an attempt
Head and trunk drawn quite back to the left side,
had been made to initiate conventional treatment,
so that he could not walk […]. Soporose state […].
as the time available was so short.
Very deep slumber […]. Deep sleep […]. Very deep
Critical commentary sopor, with […] pale cold face, cold hands and hard,
In this extremely dangerous situation, in which small, rapid pulse […]. Heat of the whole body,
there is hardly any time for the customary careful with violet redness of all the skin […]. Redness of
selection of the homeopathic remedy, the reper- the whole body […]. The whole body is swollen,
torisation process must begin with an elimination burning hot, and red […]. Redness and swelling of
rubric which should be not too big, nor so small the affected part […]. Chest and abdomen are cov-
that critical remedies may be omitted. ered with small, red, somewhat elevated, painless
The materia medica comparison (Hahnemann spots, that sometimes disappear and reappear, with
1830) performed later confirms the outstanding general redness of the skin […]. Blood-red spots
similarity of the remedy to this case, which ulti- all over the body, especially on the face, neck, and
mately facilitated successful treatment: chest […]. Night sweat […]. Night sweat during
Belladonna: “Belladonna, in the small dose just sleep […]. Sweat, that rose from the feet up into
described, is, if the case is homeopathically adapted, the face […].
capable of curing the most acute diseases (in which
Case 13.3-4: Food poisoning first time she has ever felt the pressure on her chest.
Martin Bündner The patient requests homeopathic treatment. The
history reveals the following symptoms:
Anamnesis
• In the morning on the day of admission, she ate
The 46-year-old patient comes to the clinic in the
a two-day-old lemon which had been cut open
evening; she is vomiting, has a feeling of pressure
and not carefully stored. Afterwards, she became
on the chest and her general condition is deteriorat-
nauseous and her general condition deteriorated
ing rapidly. The symptoms appeared in the morn-
significantly
ing and have persisted ever since. As the symptoms
• The nausea is located in the stomach and
cannot be clearly identified, she is admitted as an
improves when she drinks
in-patient to rule out a heart condition. She had no
• Eating triggers nausea
thoracic pain at the time of admission; today is the
• The patient has an appetite but is not hungry
376