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Leg ulcer - please help

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
  Bambi on 2005-12-12
This is just a forum. Assume posts are not from medical professionals.
One of the best remedies for this --- IF -- there is a slight purple mottle to the leg skin is Lachesis

Potency -- start with the 6x and work upwards in intervals of 3 weeks to allow effects to show up.

Other remedy to consider - because of night problems , which point to the syph miasm , is Mercury .
walkin last decade
I have treated a few similar cases in senior citizens with Arnica 30c in the water dose taken 3 times daily.

In the case of your 70 year old lady, it may be necessary to first treat her with antibiotics to deal with the infection as I doubt that homeopathy can help her from your description of her symptoms which seem extreme.

After treatment with antibiotics she can take Arnica to help increase the circulation in her legs which is the cause of her present condition.

All my patients take Arnica twice daily and two of them who had been hospitalized on 3 previous occasions are now perfectly well and have not had any recurrence of their symptoms for over 2 years.
Joe De Livera last decade
Thank you very much,

I actually already gave Merc, for two weeks in water. I also gave her Calendula tincture to wash in, and Echinacea tincture against sepsis, and because she also has a bacterial infection, i forgot to say. She has Staphyloccoci and two others. She had a lot of antibiotics for it, but it didn't work. I will wait for couple of weeks, which is one more week now and see how she does. If she is not better i will definitely consider Arnica and Lachesis.
Regarding Lach, it does cover most of the symptoms, and i have to admit, it was my second choice. But, there are other remedies that have bluish or purple tinge, and she hasn't got any other Lach traits. Do you Mr. Walkin, still think it would help anyway?
As regard to Arnica, Mr Livera, I didn't understand, is that something that you would regularly give in leg ulcers, or is it that this ulcer picture point to Arnica? I mean, is it some kind of a specific for leg ulcers?

I posted the same question to a few forums and it is interesting that almost everybody's reply was different. There was another person that suggested Arnica (i had no idea Arnica was good in such cases, and tips like this are what i always welcome!). Others have suggested Lach, Merc, Graph, Caust, Ars.

I would like to ask you a question. If she has Calc carb constitutional traits, would you go for Calc or Sulph as complementary (Sulph covers the ulcer symptoms better)? Also how does Graph seem to you?

It is great to get suggestions, but it is me who has to decide in the end, so that is why i am asking more questions. I also like to understand why am i giving something as best as i can.

Thanks a million
All the best
Bambi last decade
You stated that she was given a lot of antibiotics but you did not indicate what she took.

In the case of the patients whom I am currently treating I was informed that they had IV drips of Augmentine as the standard antibiotics did not help. They were hospitalized for over 2 weeks during which time they had to keep their legs suspended above head level to reduce the swelling.

It was after they were discharged that I took over with Arnica and they did not get any relapses of their ailment which used to recur every 6 moths to a year.
Joe De Livera last decade
Dear Bambi,
I am surprised that why you did not give your patient ARS ALB, simply repertorising the whole case i prescribe ARS ALB, in 30 potency, thrice a day for 3 days, then stop and i think you will observe the improvement. also report me.
drsajid last decade
The only reason I didn't prescribe Ars is because she is worse for warmth. Locally and generally.

As regards to antibiotics, the doctors said they can't do much more for her..
Bambi last decade
Sulphur would be a good complementary choice for all the symptoms you describe. As she is a down to earth country-type person then sulphur may help her a lot anyway.
lachesis is generally very good for ulcers in this area and esp. indicated if she is noticeably sensitive to bandages and even bedsheets, not just touch.
as regards ars alb, do not be too distracted by the 'not better for warmth' as this could be misleading as a symptom - after all you do not know that she is better for cold either, she has only assumed she 'may be'.
whatever you choose go on your definite symptoms - if they are not definite then do not use them as symptoms.

Also consider pyrogen or anthracinum.
erika last decade
hello doctor i am also a newer hoeopath practising in india . reading ur case what came to my mind if ur patient is diabetic? if yes i think lachesis or another remedy secale can help her? these are warm remedies and help the patient in cases where ulcers form because of poor blood vcirculation!
drsarvesh last decade
Thank you.
She is not diabetic. She only has poor circulation in legs and edema in legs. I presume she has a weak heart as she also suffers from breathlessness on ascending, and because of her obesity the heart and circulatory system is under extra pressure.
Bambi last decade
I am new to this forum.. I receive many alternative newsletters..If you want me to look up the exact procedure let me know,,,,but legs ulcers have been healed,,, clean the wound,,,pack it with sugar,,,put a pad on the wound and wrap gauze around it,,,change the dressing daily,,
SharonC last decade
I just talked to her on the phone (I am in a another country at the moment). These are the changes while on Merc 30: less pain at night, some nights she doesn't have any pain, some she still has but less. She doesn't have to get up and walk around because of it.

She thinks the swelling of the leg is more pronounced, and that it is more purple. The edge of the ulcer is now swollen as well and sensitive to pressure. The edge is burning (sometimes more sometimes less), it is better for cold application. She has pricking pains under the ulcer, on her leg just above her ankle. She has more proud flesh (she thinks, not sure), and a little bit more bleeding on an area big as a coin. She sees blood on her bandage when she takes it off.
She says when she has pain in the ulcer her whole body gets cold (she had that before as well, and less now that the ulcer is less painful).

So, I'm thinking - if it was more syphilitic before (night pains), now it is more sycotic. That is a good sign. Would you agree? So iam i suppose to tell her to keep taking Merc and call her every few days or change the remedy? Lach or something.

What do others think?

Bambi last decade
the onger you let it go on, the closer to amputation she is,,if I have time, I will detail another protocol
SharonC last decade
Jerome, a 53 year old high school teacher, was in the hospital awaiting amputation of his left leg. He,d been receiving antibiotics to treat a diabetic ulcer, a wide, oozing open wound on his ankle, but this didn,t halt the steady advance of gangrene, and he was told they had no choice but to take his leg.
Jerome called Dr. Whitaker,s clinic and asked if there was anything we could do to save his leg. I said we would certainly try. Figuring he had nothing to lose, Jerome left the hospital againt their advice.
At the clinic he was started on two procedures, IV EDTA Chelation, and second we dressed his ulcer with sugar. White table sugar was poured into the wound, wrapped up, and the dressing changed regularly. Within days there was a difference, The sores were starting to get better, the swelling had gone down. At first the leg was almost all black, then it started to get pinkish. Within three weeks, Jerome,s ulcer was healed and he was able to resume his job.
Raw, unpasturized honey works the same, and may even be a little better.
When sugar or honey is packed on top of and inside an open wound, it dissolves in the fluid exuding from the wound, creating a hyperosmotic, or highly concentrated medium. Bacteria cannot live in a hyperosmotic environment any more than a golfish could survive in a Great Salt Lake. Most bacteria cannot survive in a honey or sugar solution. It draws fluid out of the wound, which reduces the swelling. Itprovides a covering or filling and therefore prevents scabbing.
It encourages the removal of dead tissue to make way for new growth. It promotes granulation, the formation of connective tissue and blood vessels on the surfaces of a wound. Finally, it supports the growth of new skin covering the wound. The net result is rapid healing with minimal scarring.

Protocol for Treeating Wounds With Sugar:
1. Unravel a 4" by 4" piece of gauze into a long strip and coat it with Vaseline. Place it around the outside edges of the wound, like a donut.
2. Cover the wound with one quarter inch of sugar, The vaseline donut will keep it in place.
3. Place a 4" by 4" sponge on top of the wound. Bandage it firmly but not too snugly witha cling dressing.
4. Change the dressing every one or two days. Remove, irrigate with water, saline, or hydrogen peroxide, pat dry, and repeat steps 1-3.

Honey and or sugar has been used to treat traumatic injuries for 5.000 years, The earliest known mention of it in writing was found in Luxor, Egypt, in 1862.
SharonC last decade
as you said that she feel relief from cold, you should try LED PAL.
drsajid last decade
Do you realize..the longer you play around with these herbs..the closer to complete AMPUTATION..this poor woman is getting closer to??
SharonC last decade
You can use a calendula ointment. It does wonders on open wounds.

My aunt had an open ulcer due to her diabetes on her toe. She went to 3 allopathic doctors with no help. She got antibiotics and pretty much it. She came into town and told me about it and I made her this ointment and within a week she had healed nicely and within 2 weeks she was completly healed. After not even being able to wear a shoe cause of the pain.
You can find this ointment just about anywhere.
jose07 last decade
Thank you everybody.

SharonC, what do you mean playing around with herbs? I'm treating her with homeopathy. Do yo know what is homeopathy at all? It is certainly not herbs, even though i believe in herbs can help a lot as well. You see, there are a lot of people who were helped by herbs, or homeopathy or hundreds of others therapies of leg ulcers. I have also heard of the honey thing. Somebody mentioned it when i was still in homeopathy school that their cat had the whole flesh off the leg, it lost it in an accident, and they wrapped it in honey and everything grew back! It is an amazing story!
But the difference here is that she didn't get it from an accident, but from the whole body being diseased. I am not saying that honey wouldn't help, maybe it would and maybe i'll try it, but my main aim is that i correct the energetic imbalance in the vital force of the patient, which is what we do in homeopathy with energy remedies. Maybe it wouldn't hurt to do both. The problem is with us begineer homeopaths that some homeopaths teach you not to do external things as the disease is coming from the inside, and others say do everything you think could possibly help.

Jose07 - She is aleady using Calendula lotion, she only started.

Mr Mahmood, Ledum sounds good. What do you think of Lach though?
Bambi last decade
I just read your whole text properly. It sounds amazing! Did you use it many times, or that once?
Thank you very much, it is very appreciated.
Bambi last decade
I mean no disrespect to your healing modality. I am just frustrated for this poor woman, and meant that something had to be done very soon or she will lose her leg. I,m sure many good things have come about through homeopathy, but in this case, you really can,t take the time to try one thing and then another. Obviously her leg is getting worse every day.
The honey or sugar treatment has been used time and time again for excellent results. Treating the body from within also is a wonderful concept,but surely in some cases as this, which is urgent, other healing modalities along with homeopathy is what is best for your patient. Your main aim is to get her well with whatever knowledge you have at hand. I know many people who have tried various treatments together and if it works it is so wonderful for the patient. Again, I meant no disrespect, I certainly hope you can help this woman save her leg. Would you be kind enough to let us know how she is coming along.

SharonC last decade
hi bambi! how r you? i just read all the discussion above after this lot of gap between. i dont know much about treatment that sharon is saying all about but she is right that bacteria won't survive in such an environment and it will help healing wound earlier. but i must say i am not convinced much with merc"s choice for the case actually you must know why not other remedy"s for thois case rather than why this one?
i must tell you the state your patient is in and the cause for ulcer should respond to reepaeted doses of lach probably in 200th potency b.d. i would like to know after so much time has elapsed how is your patient by the way?
we will meet soon but be sure if your patient has gen of merc or not. yes merc has night agg. but merc is agg by slight changes in temp up or down . for similiar ulcers lachesis has agg from heat as your patient has and lachessis is also worse at night. if she has dry mouth, thirstlessness you can go for pulsatilla and vipera aslso you should go for constitutional and therapeutic treatment both with local calendula or honey bandage whateverimpresses you. bye
drsarvesh last decade
Thank you everybody.

What happened was that I was abroad for a while and so she went to the doctors again. I am back now and i have told her if the doctors don't help, we can try again. I also told her about the honey, and also about the use of caggabe in the same way. I have heard it from a nurse that treats a lot of these wounds and she said that both work, but the cabbage is not as messy.
I also told her that even if her leg is batter with her doctor's treatment, i recommend constitutional treatment so that it does not recur.
That is all i could have done.
Bambi last decade

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