Abstract: Common injuries are dealt in this article, especially common injuries to different structures of the body which are met in daily life. Specific diagnosis of the injury cases and the extent of injury are very much subjective, which varies from patient to patient. Some commonly encountered drugs of injury are discussed with their respective fields of indication and pathogenesis. Management of various types of wounds and infections following injuries is a challenge to various specialities of Medicine where Homoeopathy may act as a pivot.
Arnica Montana is a first line drug for any injury including deep tissue, muscle and bone injury. Of paramount importance for Head and Brain injury as well as sequelae occurring from concussion brain. It is also a drug par excellence to start a case where there is a history of previous injury. Potency which is preferred by me is 1M usually, 200 CH is preferred in old age as I observed in practice. This drug is very often combined with either Calendula (in case of injury associated with cut, laceration or external wound), Rhus Tox (Trauma with bruise and contusion of muscle and joint structures resulting in a ‘sore’ feeling), Hypericum (case of mechanical trauma to spine especially coccyx), Ledum, Ruta, Argentum Metallicum (trauma to the tendon sheath and ligament), and Bryonia (especially injury to joints except in shoulder injury cases where Rhus Tox and Arnica are the first line agents to start with). I would like to draw an analogy between Arnica, Rhus Tox and Bryonia. All three drugs are good for injuries, where Arnica having the broadest application, complementing action of Rhus Tox in muscle, tendon and Joint injuries. Bryonia is almost a specific first line drug for joint injury especially big joints and again complementing Rhus Tox. Bryonia and Rhus Tox are the two drugs which complement and augment action of each other if continued alternately together. Another very important trio is Arnica – Rhus Tox – Calcarea Carbonica. A very well known trio to complete cases of injuries in clinical practice. Only in cases of Head injury, Arnica competes with Natrum Sulph, Helleborus, Sulphuric Acid and a few others where it is an exception to Arnica – Rhus Tox and Calcarea Carb sequence.
Arnica is routinely prescribed by me after delivery either by a normal labour or by cesarean section to prevent infection, suppuration and promote early healing. Here, I must consider few aspects. If it is a recent delivery, my first prescription is Arnica 1M and Calendula 1M three to four times daily alternately at least for seven to fourteen days depending upon the soreness and sequelae of trauma present. Arnica and Calendula together act brilliantly to heal episiotomy wound quickly without complicating the wound. Not only this, I have also found these drugs efficacious where the wound of episiotomy or cesarean section are slow to heal and there is localised infection and pus formation. Calendula and Echinacea Angustifolia tinctures mixed equally are also used externally for cleansing and debridement of such wounds. Staphysagria 200 CH or 1M is preferred when the delivery related wounds are not of very recent origin and there is prolongation of recovery. In such cases, I differ with many as Arnica and Calendula come much earlier before Staphysagria in my practice.
Carbo Vegetabilis is a relatively lesser known injury drug prescribed by me often in practice as it possess a remarkable power to reactivate the whole system thus helping in faster healing and recuperation. Potency preferred is 30 CH.
Calendula is a sovereign drug for most of all types of wounds. It is a routine prescription given by many homeopaths. There are a fair number of situations where Calendula may be safely prescribed, it is an exceptional healing agent used in cases of gaping, incised, lacerated, torn and jagged looking wounds. Very often, I have verified from my clinical practice that, Calendula heals those wounds fast which are inflamed and suppurated, wounds those are old, neglected and ulcers formed from a slight wound or injury which is not healing and there is much sloughing and unhealthy granulation tissue formation. A drug of prime importance in old ulcers and wounds which are opened again. In these cases, Calendula should be repeated until healthy tissue formation begins which can easily be understood by observing the wound. Calendula is perhaps the most important homoeopathic antibacterial drug used in my practice.
For clean wounds which is bleeding, Calendula is preferred in 200 CH or 1M potencies. Lacerated, wound with irregular margin and exuberant granulation tissue formation with a slow tendency to heal is very well yielded by Calendula in 1M potency repeated three to four times daily for at least ten to fifteen days. Calendula is an exceptional healing agent also when used externally either in tincture or as an ointment. It is a remarkable healing substance which helps the wounds heal by first intention and this indication is practiced with success in cases of surgical wounds where union may be delayed and suppuration becomes inevitable sometimes. Calendula prevents pyogenic infections of wounds and regenerates epithelial tissue promptly.
Carbolic Acid is another very effective drug in crushed and lacerated fingers with slow healing where there is much sloughing of the wound and the surrounding tissues. Carbolic Acid 200 CH is usually prescribed by me.
Regarding potencies of Ledum, Rhus Tox and Hypericum, I prefer 200 CH or 1M. For cases of children, I sometimes prefer Hypericum 10M also. Use and repetition of high potency is a routine method of my daily practice and I have seen these drugs act very fast when prescribed in high potencies and repeated often, especially in cases of injuries of children. I would always prefer to advise parents of school going children and toddlers to keep Arnica and Calendula with them.
Arnica is for all types of trauma, even in eye trauma, it is efficacious if administered alternately with Symphytum. Here, I must mention a very important aspect. In any case of trauma especially to vital organs it is essentially required to get the patient checked by expert respective physician to exclude danger as it happens in clinical practice that symptoms and signs get masked sometimes as we all know there might be a time interval before the development of warning signs and symptoms in head injury cases which is known by the name ‘Lucid interval’.
Cases of injuries to fingers are well managed by Hypericum, potency preferred is 1M or 10M. Nail bed injuries are also well controlled by Hypericum. Sometimes, a pain remains in fingers after injury, which shoots up and this symptom may serve as a specific indication of Hypericum in finger and nail bed injury cases. Ledum is preferred choice if there is any punctured or penetrated wound to any surface of body including fingers, near nails and nail beds. If the foreign body remains in situ, the choice of drugs are Silicea and Ledum in most of the cases, where Ledum is used for a considerable time period until the wound heals and Silicea 1M few (four to six) doses are administered. In any case of injury when Ledum is indicated, I prefer 200 CH or 1M.
Hypericum and Ledum are drugs of utmost importance for punctured wounds of hands, palms, and soles. Hypericum is also beneficial after lumbar puncture. Ledum and Hypericum together act well after venesection or inflammation with infection of injection site following intravenous procedures.
Cellulitis and Lymphangitis often result following injury to soft tissues. Both these being non suppurative yet invasive and spreading infections need to be checked promptly. Bufo Rana has been used by me with success when the seat of insult is finger and patient complains of shooting pain up the fingers which clinically looked like precipitating lymphangitis. Cellulitis following prick injury near the nail bed is well controlled by using Hepar Sulph 10M, Myristica 200CH and Ledum 1M. All these three drugs are used alternately and the author advocates frequent repetition. Abscess in wounds following injury may be well managed by Myristica, Calendula, Pyrogen and Silicea.
In all cases of suspected suppurative infection, it is preferred to start the treatment soon after the injury as a suppurative wound infection may delay for upto ten days to develop. In this regard, it may be well understood that prophylactic therapy by homoeopathic drugs before and soon after the surgical procedures may help minimize wound infections.
Retention of urine during trial labour is commonly found where a gynecologist or attending nurse put a catheter to ease the bladder discomfort and retention. Arnica could relieve retention, if used.
It is very important to look after the whole situation at the outset along with quick and correct assessment of every injured victim which readily saves lives and morbidity associated with injury. Often it is necessary to take emergency management including shifting the patient to emergency with the aid of advanced life supporting measures to save the life of injured victim.
I frequently meet with sports injury cases in my practice. Most of the injuries are injuries from playing football, cricket or badminton. As we all know, football is a body contact game, so the chance of various types of injury is manifold in this game. Most of the injuries I come across are joint and muscle injury to different parts of the body and sometimes there is an ankle sprain and ligament-tendon injuries. I have occasionally seen cases of Hemoptysis occurring after chest trauma following direct body contact between players while playing football. Here, if the patient reports me at the very beginning of the situation when the history of contact trauma to chest is present only but there is no hemoptysis by then, my first prescription is Arnica Montana 1M or 10M/ two-three or four times daily for at least five days. After five days, if a patient comes to me with Hemoptysis and there is soreness which persists in chest, Millefolium 200 CH or 1M along with Ruta Graveolens 200 CH act well. I have seen Millefolium acting well in Hemoptysis after mild to moderate chest trauma which gets manifested after few days of trauma and Ruta clears the chest soreness. Both of these drugs act synergistically and bring quick recovery. In cases of suspected tendon and ligament injury occurring in sports, Ledum, Ruta and Argentum Mettalicum are preferred.
For players, gymnasts and dancers, injury often gives a psychological impact to their suffering as injury makes them incapacitated for certain period of time. Using the injury drugs alternately with each other gives good and quick results as I believe these drugs act synergistically. I give two examples to explain this. In a case of an ankle sprain injury with bruises and soreness, my prescription is Arnica 1M, Rhus Tox 1M and Ruta 200 CH. I usually prefer using these potencies. Patients are advised to take each drug at a time but taking all three drugs in a day three times each taking alternately. The reason I state here for such regime and repetition is – Arnica checks the immediate traumatic effects of the affected part including the joint, muscles around and minimises inflammation and extravasation of tissue fluids in and around the joint space. Rhus Tox will help aiding the recovery of ankle joint as well the sprain happened to ankle joint by trauma and twist of the ankle. Lastly, Ruta has very specific action on ‘Achilles Tendon’, helping the healing of it. I give a second example. For injury by blunt trauma to the eye (in sports, in school and by physical abuse or by accident, eye injury may happen), my prescription is Arnica, Ledum and Symphytum, all in 200 CH potencies mostly (1M is used sometimes). Now to explain this, I consider Arnica as a first line agent for trauma, Symphytum being very specific to eye structures, and Ledum helps when this injury ultimately leads to a condition known as ‘Black Eye’ with extravasated blood in conjunctiva with ecchymoses to lids and chemosis of eye. Here, I must mention that examination by an ophthalmologist is very much necessary for assessment of the injury to the important structures of the eye.
Cases of abdominal operation and surgical procedure on deep tissue structures are very well managed by Calendula and Bellis Perennis in potencies 200CH -1M. Sometimes, patients complain of sore, bruised feeling after abdominal operations (Cesarean, Hysterectomy, Laparotomy for various upper abdominal and pelvic pathologies) in which Bellis Perennis and Calendula act well.
For cases of dental procedures especially after surgical and mechanical extraction of tooth, Arnica, Calendula and Hypericum in 200 CH potencies are used together. Calendula checks hemorrhage post extraction when Arnica checking excessive local oedema, extravasation, inflammation and pain. Hypericum takes care of the injured nerves which might have been caused by mechanical maneuver during extraction. Not only these, remote and persistent pain at the site of extracted tooth along the course of the affected nerve following tooth extraction often greatly benefited by Hypericum.
Patients going for mountain hiking, trekking and cycling in hilly areas, I routinely prescribe Arnica Montana 200 CH and Rhus Toxicodendron 200 CH. I advise them to take Arnica before and after the journey at night along with Rhus Tox. Most of the patients get benefit from it. Needless to mention here that Arnica is great for muscle fatigue which is a normal consequence of such mountain activities and patient gives me feedback that after taking Arnica at night before sleep they get freshness in the morning without any fatigue so that they could start the new day afresh. Rhus Tox soothes muscles and joints from overexertion.
For singers, vocalists and musicians using flutes and different wind instruments, I prefer to prescribe Rhus Toxicodendron 200 CH and instructed them to take three doses daily, one at least one hour before performance, one just after the performance and the 3rd dose at night before sleep. This regime helps.
For cases of fracture, first line drugs are Arnica and Calendula. Arnica checks extravasation and excessive oedema while Calendula complements it. For compound (open) fractures, Calendula is the drug of choice as this type of fracture often results in infection of bone, skin and surrounding structures. In both the cases, 1M is preferred.
For cases of Dislocation and Subluxation, Rhus Toxicodendron is preferred drug which may be used in 200 CH, 1M or even 10M potencies with good results. Symphytum helps in proper union of bone.
Burn and Scald injuries are also common in household and industrial setup. There are many types of burns. Superficial epidermal burns often respond to Hypericum 200 CH. Superficial dermal burn leaves blisters and are painful which is helped by Cantharis 200 CH and Urtica Urens 30 CH using alternately. If the blister gets discharged, Calendula 200 CH or 1M is preferred. Deep tissue burn often heals by secondary intention and scarring. In deep tissue burn, there is loss of sensation and absent sensation to pin prick. In such cases, healing is delayed and chance of infection is high. Calendula 1M and Causticum 200 CH are the preferred choice in such cases, in which Calendula is repeated two to three times daily until healing and Causticum is used two to three times daily for three to five days repeating every fortnight if required.
Now a few words about the chronic effects of injuries and their respective management. For sequelae of head injuries, Helleborus, Natrum Sulph, Acid Sulphuric are considered as per their symptomatology. Case of trauma to spine either by fall or over strain resulting in chronic stiffness, pain and restricted movement yield well by Hypericum. Hypericum is specific for spine and coccyx injuries in which it acts in acute as well as in chronic sequelae. For back injuries following fall, where the history of fall has passed few days, Natrum Sulph 200 CH or 1M is added to Hypericum to foster recovery.
Carbo Animalis and Strontia Carb are two important drugs used often for the remote effects of ankle and wrist sprain cases. If there is a swelling especially at ankles persisting long after injury and patient feels pain in ankle while stepping and using stairs, Strontia Carb helps. Chronic wrist pain following wrist sprain often gets benefited by Carbo Animalis, Ruta and Ledum Pal. In such cases of wrist sprain, I prefer Carbo Animalis 200 CH two to three times daily for three days followed by continuing Ruta and Ledum, each giving two times daily for at least fifteen days.
Conclusion: Injury cases are common in day to day practice. Prompt, correct assessment and evaluation are of paramount importance in every case of injury. Homoeopathy has a specific zone of comfort in such cases which if used properly can speed up recovery. In this article, the author intends to ponder and gives indications of different drugs considering his personal view and experience from his clinical practice.
Questions, comments, and discussions are welcome.
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