Re: Bullae
Posted: Thu Oct 27, 2005 11:41 am
by Jean Doherty
They burst and leak air. An attempt made in past to make lung adhere to
cavity . This being so I would imagine thiosamine out as may dissolve
adhesions. Breathing would become impeded by partial lung collapse.
??Carbo Veg would be useful to have in reserve
Rubrics exploredClinical; Bullae (1) : pop-c.
Clinical; Pneumonia (39) : acon., all-c., am-m., ant-ar., ant-i.,
ant-t., ars., ars-i., bell., bry., cac., calc-s., cann-s., carb-ac.,
chel., chin-b., corn-f., cupr., elaps, ferr-i., ferr-p., hep., hyos.,
kali-n., kali-p., lach., lyc., meli., ol-j., phos., podo., rhus-t.,
seneg., squil., sul-ac., sulph., sumb., verat., verat-v.
Respiration; SUFFOCATION (35) : KALI-I., LACH., MEPH., Aur., Bell.,
Camph., Cedr., Cub., Cupr-acet., Dros., Guai., Lact., Laur., Nat-m.,
Nux-m., Nux-v., Spong., Stram., Tab., tarent., zing., agar., anan.,
arum-d., arum-m., arund., atro., calc-s., cham., chlor., coff., ferr-m.,
hydr-ac., meli., vesp.
Internal Chest; Adhered; to chest, lungs had (8) (8) (8) : cadm-s.,
gad., kali-n., lac-c., mez., ran-b., seneg., thuj.
Internal Chest; Expand; lungs had no room to (1) (1) (1) : nat-m.
Skin; Chilblains; vesicles or bullae, with (11) : RHUS-T., Nit-ac.,
carb-an., mag-c., phos., ant-c., bell., chin., cycl., sep., sulph.
I will keep thinking about it but need to know more about him, Thank
you Jean
Re: Bullae
Posted: Fri Oct 28, 2005 10:47 am
by AH
>>>On 27 Oct 2005, at 07:54, Jean Doherty wrote:
Where I wonder could I find rubrics to cover small bullae apex
of lungs which burst and produce a pneumothorax. Not severe enough
at moment to admit {prepared at any time for that possibility] but
uncomfortable with a dry cough worse with cold air in evening.
I would think on brief exploration Carcinocin most likely
constitutional., maybe Tuberculin but had no rebellion ever.
((( Dear Jean, Here are two data points for Bryonia. Of course most often
an acute rx, but can it be ruled out as the chronic or lesional in this
case... Best, Andy
Mangialavori additions to Bryonia:
MIND, ANXIETY, money matters, about
GENERALITIES, OBESITY
LINKS 1994 Case:
T.L., male, born February, 1944.
"According to the lung specialist I need surgery. Can you cure me so
that I don't have to have surgery?" Diagnosis: Infected emphysematous bulla
in the right lung with a large fluid level. (See Chest X-ray 3rd June, 1992
and 9th June, 1992). Blood tests on 1 June, 1992 show:
- Erythrocyte sedimentation rate (ESR): 79 (normal 0-15)
- Leukocytes: 10.940 (3.500-9.000)
History
Report of the lung specialist to the family doctor on 12th June, 1992.
"Your patient, T.L., was under treatment in our department from 3rd
until 13th June, 1992. Nine days before hospitalisation he started having
bronchial symptoms with coughing, yellow sputum and pain in the apex of the
right lung. You started therapy with Rulid (Roxithromycine) (antibiotics of
the macrolide group). The patient began working again after a few days, but
the fever increased to 39C. Due to this you started Augmentin (Amocicillin,
a broad spectrum antibiotic), which brought the fever down to 37.8C. On the
chest X-ray of 3rd June, 1992 we could see fluid in a large emphysematous
bulla. Haematological examination at the time of the hospitalisation:
- ESR: 90 mm/m
- Leukocytes: 10.600
Examination of the sputum showed pseudomonas fluorescens.
Therapy: Combination therapy with antibiotics Augmentin and
Netromycine. Following the antibiogram, Pipcil (Piperacillin, broad spectrum
penicillin) and Peflacine (Pefloxacine, fluoridated quinolonderivation)
antibiotics were given.
Conclusion: Because there was a big emphysematous bulla, which had
already produced complications in the past I contacted the thoracic surgeon.
In the meantime antibiotic therapy must continue until the day of operation.
Just before the patient was discharged from hospital the ESR was 82mm/m."
Report from the thoracic surgeon to the family doctor, 23rd June, 1992
"The patient has no fever and few complaints and is reluctant to
undergo surgery. I have tried to explain the possible disadvantages of a
conservative approach:
1. Short-term:
- Overflow of the fluid of the bulla into the bronchi
- Recurrent pneumonia's
- Spontaneous pneumothorax
2. Long-term:
- Progressive increase in size of the emphysematous bulla and
increasing dyspnoea. I also explained that emphysema is a "progressive
disease" and it would be best for him to stop smoking. In July the patient
will see the consultant for pulmonary disease."
Hom¦opathic consultation, 14th June, 1992
Blood tests at the time of the Hom¦opathic consultation:
- ESR: 71 (0-15)
- Leukocytes: 11.900 (3.500-9.000)
- Iron: 44 (50-165)
- Total iron binding capacity: 261 (260-385). Signs of a chronic
infection
6 years ago her had an operation for a rectal fistula. Towards the end
of May 1992 he developed a cough and fever, symptoms of the acute state
which had disappeared in the meantime:
Rubrics from Kent's Repertory:
CHEST, Pain, Lungs, right, p.848: Bry, elaps, echi, rumx, sulph
There was a stitching pain accompanied by fever. CHEST, Pain,
stitching, fever, during, (p.864): Acon, Bry, kali-c, nux-v.
The pain was stitching and extending backwards: CHEST, Pain, stitching,
extending to back,
(865):...bry,...canth,...carb-v,...kali-c,...lyc,...phyt,...sep,...sil,
Sulph.
The pain, cough, fever and a generalised flu-like feeling accompanied
by pain all over started after having worked on a roof. He had been
perspiring and afterwards was in a draft of air. GENERALITIES, Pain, sore,
heated walk and rapid cooling, after, (p.1385): Bry, Rhus-t.
Stitching pain worse while coughing. CHEST, Pain, stitching coughing,
(p.864):...Bry,...chel,...ferr,...kali-c,...kreos, lach, lyc, Merc,...phos,
psor, puls,...sep,...Squil,...stann,...sulph.
Summary:
In the acute state the Hom¦opathic remedy Bryonia seemed to be
indicated. We observe a rather pale patient with a clear tendency to breathe
deeply now and then. RESPIRATION, Deep, desire to breathe, (p.766): Bry,
Cact, Calc,...Ign,...Lach,...Nat-s,...Sel,...Sulph.
The most peculiar symptoms are a very dry mouth, with a tendency to
press the lips together plus a kind of chewing motions of the mouth. FACE,
Chewing motion of the jaw, (p.356): Acon, asaf, bell, Bry, calc, cham, cic,
fl-ac, gels, hell...merc,...phos,...stram.
The patient complains about a dry mouth and is very thirsty. MOUTH,
Dryness, thirst, with, (p.403):...bar-c,...Bry,
camph,...carb-x,...chin,...lach,...lec,...merc-c,...nat-c,
Nat-m,...nux-m,...phos, rhus-t,...stram...
The thirst is very prominent and he drinks an average of 8 litres a
day, which is a very prominent symptom. He drinks large amounts in one go.
STOMACH, Thirst, large quantities, for: often for, (p.529): Bry, cop,
lac-c, nat.-m.
He doesn't tolerate certain foods very well, for example chocolate.
GENERALS, Food, chocolate aggravates,(p.596 Synthesis): Borx, bry,
calad, caust, coca, kali-bi, lil-t, Lith-c, Lyc, ox-ac, prot, Puls.
He also has a lot of flatulence from beans. GENERALITIES, Food, beans
aggravates, (p.1362): Ars, Bry, calc, carb-v, chin, cupr, hell, kali-c, Lyc,
nat-m, petr, puls, sep, sil, verat.
Strangely he generally prefers warm drinks. STOMACH, Desires warm
drinks, (p.486): Ars, bell, Bry, calad, carb-v,...chel,...Lac-c,
lyc,...sabad, sulph.
His wife says that he always has to be busy, he is a busy person. MIND,
Busy, (p.10): Apis, bry, calad, calc, caps, cocc, ign, rhus-t, stram, sulph,
verat.
He goes on holidays for 1 day at the most and takes his own food along.
He does not like to spend his money. MIND, Fear poverty, (p. 46): Ambr, Bry,
calc, calc-f, chlor, meli, nux-v, psor, puls, sep, sulph.
He likes working and feels better after perspiring. GENERALITIES,
Perspiration amel. (p.1391): Ars, bov, Bry, calad, calc, Cupr, lyc, nat-c,
rhus-t.
Except for a generalised listlessness, a stitching pain in his right
shoulder and mild shortness of breath, there are no other prominent
complaints. EXTREMITIES, Pain, stitching, shoulder, (p.1139):...bry,...
The patient still has another big problem. He has sleeplessness due to
fear of a possible operation. SLEEP, Sleeplessness, anxiety, from, (p.1253):
Arn, Ars, bell, bry, carb-an, caust, Cocc, cupr, kali-i, laur, lyss, mag-c,
mag-m, merc, nat-c, nat-m, nux-v, rhus-t, stram, sulph, thuj.
According to his wife the patient doesn't tolerate any contradiction,
he gets angry. MIND, Anger, contradiction, from, (p.2):...ars, Aur,
bry,...ferr,...Lyc, nux-v...
Conclusion: The remedy which the patient needs "constitutionally" seems
to be Bryonia. The acute complaint which has now disappeared, seems to
indicate the remedy which he also needs in this chronic state. We also know
that Bryonia can be indicated in the treatment of a fistula, from which he
suffered 6 years ago).
Prescription: Bryonia M (1 tablet). Administration on 14 June, 1992.
Second Hom¦opathic consultation, 24th June, 1992
Immediately after the remedy the patient had a fever of 37.8C. This
fever continued until 22nd June. On the first day he had a kind of spastic
pain in his lung which disappeared the following day. He also had a lot of
itching on his hand and more pain in his right shoulder. A few days later
the pain in his shoulder disappeared completely and there was profuse
desquamation of the skin of the lower legs and soles of the feet. The
patient had forgotten to report that he had been suffering from a
parchment-like dry skin on his lower legs and feet. In general he feels
stronger.
Third consultation, 7th July, 1992
No particular complaints. Feels much more energetic
Blood tests:
- ESR: 8 (0-5)
- Leukocytes: 6.200 (3.500-9.00)
- Iron: 113 (50-165)
- Iron binding capacity: 270 (260-350)
Treatment: No prescription
X-ray on 22nd July 1992 shows that the fluid has been completely
reabsorbed. There is a clear regression of the bulla from a diameter of 8 cm
to that of 4 cm.
Fourth consultation, 21st September, 1992
The patient gained 5 kg in body weight. He feels very well.
X-ray of 21st September, 1992 shows further regression of the bulla in
the apex of the right lung. Regression of the cavity.
Fifth consultation, 25th January, 1993
Blood tests
- ESR: 4 (0-15)
- Leukocytes: 6.600 (3.500-9.000)
- Iron: 110 (50-165)
- Total iron binding capacity: 298 (260-385)
X-ray of 25th January, 1993 shows that the bulla in the apex of the
right lung has completely disappeared.
Sixth consultation on 14th May, 1993
X-ray of 11th May, 1993 shows a normal lung picture
The patient doesn't have any complaints and looks well. He drinks now
only 2 litres a day.
Seventh consultation, 24th march 1993
The patient has a slight cold. Therapy, Bryonia M.
26 August, 1994
The patient has remained and the radiological report of 26th August,
1994 says: "Not one trace of the original picture is left. A Perfectly
normal lung picture.
================================================================
Also--
MIND; DESPAIR; recovery, of (70) : acon., adam., agn., all-s., alum., am-c.,
anac., ant-t., Ars., aur-ar., aur-i., aur-s., bac., bapt., bar-c., bor.,
cact., calad., Calc., calc-ar., calc-s., cann-i., carc., caust., cham.,
chlol., cimic., Coloc., der., dig., germ., hell., hep., hura, ign.,
kali-ar., kali-br., kali-c., kreos., lac-c., lach., lil-t., lyc., m-arct.,
mag-c., med., merc., nat-c., nat-m., nat-s., nit-ac., nux-v., ph-ac., phos.,
plat., pseuts-m., psor., puls., sars., sep., sil., strept., sulph., Syph.,
tarent., ther., thyr., verat., zinc.