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Leg ulcer - please 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
 
  Bambi on 2005-12-12
This is an internet 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.
DR SAJID MAHMOOD
 
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?

Thanks
 
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

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