Haut Anhang 2

[Constantine Hering]

Abscess: Opening the abscess with a lancet is always injurious in the end, even if a temporary relief follows at first. A natural opening keeps the air out, an artificial one induces the air to rush in. Under skillful homoeopathic treatment, it is hardly ever necessary or advisable to open the abscess with the lancet. Hep. or Merc. hastens the suppuration. Hepar, 3rd trit., in water, will hasten the breaking open quite sufficiently.

Im Französischen, Spanischen und anderen romanischen Sprachen wird ein Karbunkel häufig „Anthrax“ genannt, während das französische Wort „charbon“, o. andere, verwandte Begriffe, eine Infektion mit dem Bacillus anthracis bezeichnen.

Als Karbunkel bezeichnet man eine tiefgehende Infektion eines oder mehrerer Furunkel mit S. aureus, + intensiven, entzündlichen Veränderungen im um- und darunterliegendem Gewebe (subkutanem Fettgewebe).

Männer sind in der Regel häufiger betroffen, vor allem im mittleren und hohen Alter. Obwohl Karbunkel auch in gesunden Menschen auftreten können, sind sie häufiger bei Patienten mit Diabetes, Unterernährung, Herzversagen, Drogenabhängigkeit und bei schwerwiegenden, generalisierten Dermatosen wie exfoliativer Dermatitis oder Pemphigus zu beobachten.

Ein weiterer prädisponierender Faktor ist eine langfristige Behandlung mit Kortikosteroiden.

Oberflächliche bakterielle Infektionen der Haut

Der Begriff „Karbunkel“ abgeleitet vom lateinischen Wort für ein Stück kleiner, glühender Kohle, beschreibt die schmerzhafte, harte, rote Eiterbeule im Anfangsstadium der Infektion. Zu diesem Zeitpunkt ist das Karbunkel geschmeidig, kuppelförmig gewölbt und extrem schmerzempfindlich.

Einige Tage lang wird die Eiterbeule größer, bis sie ca 5–10 cm im Durchmesser beträgt. Die Eiterung beginnt nach 5 – 7 Tagen, wobei der Eiter von multiplen follikulären Öffnungen abgesondert wird.

Die Nekrose der dazwischen liegenden Haut hinterlässt einen gelben Pfropfen auf einem kraterförmigen Knoten. Manchmal findet die Entwicklung akut und ohne vorhergehende follikuläre Absonderungen statt, so dass der zentrale Pfropfen der Läsion komplett abgestoßen wird und ein tiefes Geschwür auf eitrigem Untergrund hinterlässt. Befinden sich in der Regel auf dem Nacken, den Schultern o. den Hüften und Oberschenkeln. Sie treten meist vereinzelt auf, können aber auch mit mehreren Furunkeln assoziiert sein.

Konstitutionelle Symptome können begleitend oder prodromal wenige Stunden vor Ausbildung des Karbunkels auftreten. Fieber, Schwäche und Erschöpfung können bei großen Karbunkeln und stark geschwächten Patienten ausgeprägt sein. Im günstigen Fall heilt die Läsion unter Narbenbildung langsam ab. Bei schwachen und älteren Patienten kann die Infektion zur Toxikämie oder metastasierenden Infektionen führen und tödlich verlaufen.

A. Therapie

Die Karbunkulose betrifft in der Regel erschöpfte und schwache Patienten, meist ab der Lebensmitte. Die Läsionen sind selten auf den Extremitäten zu finden o. auf der Vorderseite

des Körpers. Karbunkel sind meist im Nacken zu finden. Befinden sich die Läsionen am oder in der Nähe des Kopfes, oder sind sie ungewöhnlich groß, können sie über septische Komplikationen zum Tode führen.

Die ersten Anzeichen eines Karbunkels sind in der Regel Entzündung, Schwellung und Schmerzen. Die Schwellung ist flach, kreisförmig und dunkelrot gefärbt. Für gewöhnlich hebt sie sich nur leicht von der umliegenden Haut ab. Kurz vor dem Abstoßen des Pfropfens färbt sich die darüberliegende Haut dunkler, wird ausgehöhlt und bricht schließlich an den Rändern auf, durch die entstandenen Risse wird dünner, schlecht aussehender und ungesunder Eiter abgesondert.

Die Unterscheidungsmerkmale zwischen Eiterbeulen und Karbunkel sind ausgeprägt, so dass eine Verwechslung in der Regel nicht möglich ist. Eiterbeulen haben wenig Verschorfung mit reichlichen Eiterabsonderungen;

Der Pfropfen eines Karbunkels ist im Vergleich enorm ausgebildet, die Eiterbildung jedoch relativ gering oder defizient. Eiterbeulen heben sich beträchtlich von der umliegenden Haut ab

und sind konisch geformt. Karbunkel sind flach und heben sich nur leicht, wenn überhaupt, von den umliegenden Strukturen ab. Die Größe der Läsionen variiert beträchtlich, von 5 - 7 cm im Durchmesser bis zu 13 cm oder mehr.

Junge Personen oder solche mit robustem Naturell werden nur selten befallen.

Beim Karbunkel treffen mehrere Furunkel und gangränöse Veränderungen aufeinander. Prädilektionsstellen sind die Haut entlang der Wirbelsäule, das Genick, inguinal und sternal. Meist verbunden mit SCHMERZ.

Für die Wahl des richtigen Mittels sollte man folgende Punkte beachten:

• Beachten Sie die Lokalisation.

• Dokumentieren Sie das allgemeine Erscheinungsbild: rot, hellgelb, dunkelrot, schwarz oder purpurn etc.

• Beachten Sie dabei auch den Zustand des Karbunkels in Verbindung mit dem Zustand der umliegenden Gewebe.

• Die Schmerzqualität mit den entsprechenden Modalitäten.

• Assoziierende Faktoren oder pathologische Veränderungen

Die Gabe einer niedrigeren Potenz fördert die Eiterbildung. Um die Eiterbildung zu kupieren, sollten hohe Potenzen gegeben werden.

Karbunkel:

W. A. Dewey: Arnica in Boils: produces crops of boils all over the body, beginning with great soreness and going on to suppuration. Boils which have partially matured become sluggish.

Dr. P. Rajagopalarao: Phos.: Ulcers bleed easily at the slightest touch and large ulcers are surrounded by smaller ones.

Tarent-c.: causes a perfect picture of carbuncle even to the sloughing. Effectually used by great prostration and diarrhoea with intermitting fever of evening exacerbation.

Erysipelas:

[T. C. Buskirk]

Canth.: Best remedy. I used to give Bell. Rhus-t., Apis and others, until four years ago. I have never used any other remedy since and have never been disappointed by it.

Eigene Erfahrung: Sec.

[Dr. Subrata K. Banerjea]

Eczema:

Anti.: Erythema, eczema, pemphigus. Intense pruritus, urticaria appearing and disappearing suddenly with internal coldness.

Arund-m.: Eczema behind the ears; itching and crawling (chest/arms).

Cic.: Capitis - long standing in a young woman covered the whole scalp like a cap. Lemon coloured crust. Elevated eruptions as large as peas.

Cist-c.: Itching all over, small painful pimples Mercurio-syphilitic ulcers. Skin of hands hard, thick dry fissured; deep cracks. Hands and arms swollen/itching of swollen, general itching preventing sleep.

Corn-a.: Eczema, cracked skin everywhere, esp. in creases and folds, exuding a sticky watery fluid.

Crot-t.: Intense itching of skin (scrotum), but so sensitive and sore is unable to scratch; > gentle rubbing; < cold washing.

Fago.: Itching; > bathing in cold water; < scratching= soreness/touch. Itching of knee and elbows and hairy portions. Vesicular pustular, phlegmonous dermatitis skin hot swollen.

Fuli,; obstinate ulcers, epidermis, betters eczema, chronic irritations of mucous membranes of mouth.

‡ Folgendes hat anthroposofische Einschlüße ‡

Frei nach: Lueder Jachens, M.D. Acne

Skin delimits the organism from its environment (a complete barrier for form-giving, structuring forces that arise from the nerves inside the organism and reach the skin as sunlight from outside, for instance). on The other side it is permeable to both (im)ponderable principles (in the sphere of the senses).Sense organs that are partly created out of those qualities exist in areas of the body surface where sensory qualities are able to overcome this barrier. These are the only sites where imponderables such as light, sound, odors enter into the organism.

The blood is the main vehicle for the flow of substance reaching the periphery from the microcosm of the internal organs. In the skin, the flow generally changes direction. Having come from the inside it is turned back to move inward again. This happens mainly in the capillary loops of the papillae, the rhythmic up and down of which, in the gearing of dermis and epidermis („As wave forms left in the sand when the sea has receded from a beach“). Part of the flow of matter continues in the original (centrifugal) direction, however, passing through the barrier as sebum, sweat or material desquamating from the highly-differentiated comified layer. R.S. suggested that the basis

for human self-experience lies in the flow of matter coming up against resistance and changing direction in secretory organs. Astral body activity lives in excretions in quite general terms. Secretion to the inside (hormones)

must be distinguished from eliminations to the outside. The astral body is the energy system that maintains a healthy balance between the two.

These basic features of the skin help us to understand the pathogenesis of acne. Increased sebum production (sebum composition changed) reflects an increase and change in the flow of matter to the periphery. It is not fully "cooked“ with sebaceous follicles densely populated with microorganisms as a result. The I organization which is active in warmth processes has not entirely taken hold of the substance so that foreign bacterial life is able to

thrive on it. The centrifugal process pushing outwards from inside combines with a comification disorder at the sebaceous ducts, which are blocked with plugs of keratinous material. Hardening tendencies of the form principles originating in the nerves are clearly coming into play. Blackheads and follicles filled to bursting develop, with bacterial lipases breaking down the sebum into fatty acids that cause irritation and inflammation - a digestive

process in the wrong site. R.S. refers to this pathological continuation of digestive principles "in the direction of the head" - evident to us in the inflammatory process involving papule and pustule - as one-sided activity of the lower ethers (chemical/life). This causes "softening of the brain/' in this case dissolution of the sebaceous follicle in the skin, an organ that is part of the upper human being.

A characteristic feature of acne vulgaris is that it is located mainly in the face. A shift of digestive activity "in the direction of the head" is apparent in two ways:

1. because the skin, an organ belonging essentially to the human being of nerves and senses, is involved.

2. because the skin of the head is affected. This part of the body surface is most important for social contact, hence the often considerable suffering of young persons. We can understand this if we consider acne vulgaris in the light of the study of man: looking into the mirror, the young person, whose inner life is still maturing, is shown that the metabolic aspect of the process is temporarily not functioning properly.

Looking at the process in relation to the whole human being, it is important to realize that acne generally occurs during puberty. (A third of all young people suffers from some form of acne.) Organic brain development reaches its conclusion towards the end of the first 7-year period. The milk teeth are lost, and powers that previously served the organism become free for thinking as a conscious activity. The child is ready to go to school.

A second level of maturity is reached by the end of the second 7-year period. Organically the young person becomes sexually mature, and in the inner life he or she is now mature for the earth, with a new self-perception. On one hand, the astral body is given new tasks in the organic sphere, e.g. to organize the subtle interplay between developing and breaking down of the uterine mucosa. On the other hand, the whole environment is seen with new eyes; new interest in the world awakens. The process is in stages and will obviously get into "ferment" at times.

Signs of inadequate intervention of astral body and I organization in the metabolism may be menstrual irregularities in young women, constipation, acrocyanosis, and offensive sweats. If one decides to meet the situation with metal therapy, Ferrum offers general assistance with incarnation and helps the organism to be "breathed through“. Mercury may help to stimulate metabolism and especially glandular function. External applications of

Cupr-met. may serve to increase mobility, e.g. letting the blood, the vehicle for warmth, flow right down into the feet.

R.S. and Ita Wegman referred to the way skin inflammations may engage the upper aspects of the human being too much so that they are no longer sufficiently able to perform their functions in the organs of the microcosm.

They gave the example of effects on the liver and digestion. Silica makes internal organs sensitive to one another. Medicinal use of it releases the higher aspects of the human being from their involvement in the skin so that they may be more active in the inner organism. The organ involved in the disorder also needs to be treated, in the present case the liver. Gallbladder, pancreas, spleen and kidneys are other organs where sluggishness may develop so that activity has to be encouraged.

If skin inflammations go hand in hand with daytime tiredness and increased dreams at night, this may be because the higher aspects are not properly "settled" in the physical body. Phosphorus treatment may help in this case. Phosphorus also encourages I organization activity to counteract "excessive etheric and astral activity“.

Sulfur is helpful for disorders of protein metabolism; it makes protein, a physical substance, more inclined to accept intervention from the ether body. Great care is, however, indicated in giving Sulfur to fair-haired people. Fair hair indicates a powerful sulfur process, black hair a powerful iron process. Aggravation from Sulfur is more likely in fair-haired women; blond men tolerate it better (Sulfur selenosum w).

Dietary advice in acne cases bases on the role sugar plays as vehicle for the I organization in the blood. If I-activity in the metabolism is weakened, refined sugars and fine flour make this weakness evident by causing an aggravation of the skin condition. Proteins are most open to ether forces. Their degradation and synthesis are ultimately determined by the I organization, and we relieve the latter by reducing the intake of meat, cold meats and cheese. Whole milk is best avoided, with soured milk products taken instead. Lactic acid-forming bacteria predigest cow's milk, as it were, and this relieves the strain on weakened digestive powers. Fat is mainly the vehicle for heat; excessive fat intake causes "parasitic heat foci" in the organism and a tendency to inflammation. A low-fat diet is therefore recommended for acne.

Raw food may also prove therapeutic (beginning medical treatment of severe acne). It supports the structuring activity of silica at the periphery, healing the deformation caused by inflammation.

An interesting observation that has been frequently made is that young people of asthenic habit tend to develop acne on the chest and back. This may be due to the enhanced nerve impulse of asthenic subjects not being exhausted in pathologic skin changes in the facial region but extending to the upper trunk. < stress also points to a one-sided nerve process. The forehead is often affected in grammar school pupils who have to do much intellectual work, whereas perioral efflorescences may suggest that the causes are predominantly metabolic.

If acne persists beyond the early twenties, this may be a sign of constitutional weaknesses persisting from puberty. This shows the potential offered by acne treatment taking account of the whole constitution and providing genuine prevention of more serious conditions. Oral contraceptives, often taken even in puberty, impose foreign functional principles on the pelvic processes in young women. The astral body cannot come fully into its own in establishing an individual menstrual cycle. Acne will, of course, often improve because the peripheral hormonal situation in the sebaceous gland changes, with sebum production reduced. The acne will, however, return when the hormones are discontinued. Several years of oral contraception may cause a type of acne to develop which is partly due to hormonal effects on liver metabolism.

Acne patients have different constitutions, with a marked polarity that points to different requirements: hysteria / neurasthenia.

[Vithoulkas]

DISEASES OF skin

Ferr-p.: Inflammation of the skin when there exists either fever, heat, pain, throbbing or redness; pimples, heat and congestion of the skin.

Kali-m.: ACNE. Pimples on the face with thick white contents, caused by a disturbed action of the follicular glands. They remain indolent, and they are apparently connected with gastric or

genital derangement. Often will prevent suppuration.

ECZEMA. Crusta lactea, scrufy eruptions on the head and face of little children. Dandruff. This is the principal remedy in alternation with Ferrum phos., from vaccination with impure lymph. Eczema resulting from deranged uterine functions, characteristic tongue, dry, flourlike scales on the skin. Albuminoid discharge from the skin with white tongue. Vesicular eczema, albuminoid secretions or contents. It will often act magically in very obstinate forms of chronic eczema.

ERUPTIONS. Acne, pustules, pimples, etc., connected with stomach derangements, white tongue accompanied with deranged menstrual periods, sero-fibrinous secretions.

ERYTHEMA. After Ferr-p. if swelling be present and vesicles or bullae form.

HERPES ZONA. Shingles, vesicles encircling half of the body like a belt, white tongue.

LUPUS. Useful in stubborn cases with gastro-intestinal symptoms.

WARTS. On the hands, also externally.

SYCOSIS. Primary remedy. Early stage pustules, later dry flour-like scales persistent with glandular involvement.

BUNIONS. Chilblains and lupus, principal remedy.

Kali-p.: ECZEMA. If nervous irritation and oversensitiveness accompany it. Greasy scabs with offensive smell; secretions of the skin, irritating, causing soreness of the parts, itching, with a crawling sensation, gentle friction agreeable, excess causes sore, chafed skin, bloody, watery secretions, excessive, offensive perspirations. Itching of scalp; back of head sore as if hair was pulled. Alopecia areata. Carbuncles.

CHILBLAINS. On toes, hands and ears, tingling and itching pain. Recent, not suppurating. Neurotic subjects.

MALIGNANT PUSTULE. Blisters and blebs all over the body, watery contents, skin withered and wrinkled. Neurotic symptoms and pain exaggerated.

Kali-s.: Dryness of the skin from suppressed skin diseases. Dread of hot drinks.

ECZEMA. Discharge of yellow, effete matter, eczema suddenly suppressed with other symptoms of this drug.

ERUPTIONS. Suddenly receding through a chill or from other causes. Diseased condition of the nails, interrupted growth, skin scales freely on a sticky base. Sores on the skin, with yellow, watery secretion on limited portion, with peeling off of skin.

PSORIASIS. Several cases of this affection are reported as having been cured with this remedy. Great desquamation of the epidermis is a keynote indication.

DANDRUFF. Yellowish or white scales on the scalp (also as a wash), falling off of hair, lower lip dry and scaly.

"The internal use of Kali-s., a dose every four hours, has invariably cured every case of tinea capitis. I rely upon this remedy exclusively, using no wash or greasy ointments whatever."

(A. P. Davis.) Effects of ivy poisoning, fuming, itching papular eruptions. Nettlerash.

Mag-p.: Barber's itch; herpetic eruptions with white scales.

Dandruff, pustules and pimples on scalp. Rash like insect bites, worse about knees, ankle and elbows.

Nat-m.: ERUPTIONS. With clear, watery contents, small vesicles or blisters with colorless, watery contents, forming into thin scabs or crusts which fall off and readily form again. Pustular

eruptions on forehead. Skin of hands, (about nails, dry and cracked).

ECZEMA. White scales, eruptions with watery contents from eating too much salt.

INTERTRIGO. Soreness of the skin in children with watery symptoms, white scales on the scalp. Intertrigo between thighs and scrotum with acrid discharge and excoriation.

PEMPHIGUS. Fluid from blisters and blebs like water.

RUPIA. Blisters, not pustular eruptions.

SYCOSIS. If watery symptoms correspond.

DANDRUFF. White scales on scalp. Falling of hair from lack of nutrition.

WARTS. In palms of hands or scales, large and sensitive.

URTICARIA. About the joints especially.

HERPES ZOSTER. Second remedy, herpetic eruptions occurring through the course of any disease.

Effects of bites of insects (externally), warts in the palms of the hands. Urticaria and miliary eruptions.

Nat-p.: Soreness, chafing of the skin in children. Swelling of

the sebaceous glands; eruptions from vaccination. Goitre.

ECZEMA. With symptoms of acidity, secretions creamy, honey-colored, golden-yellow scabs. Crusta lactea about ears of little children.

LUPUS both internally and externally.

ERYTHEMA. Roserash (with Ferrum phos.), sore patches on the skin, yellow, creamy discharge, hives, itching all over the body, like insect bites.

Nat-s.: Chafing of the skin in children with bilious symptoms. Chilblains.

ECZEMA. Vesicles, eruptions containing yellowish, watery secretions. Yellow scales.

PEMPHIGUS. Watery vesicles or blebs all over the body. Debilitated subjects.

WHEALS. Containing a yellow watery secretion. Oedema of the skin.

WARTS. It abstracts water from the base of the warts and causes a shrinking of the same. Warts caused by long exposure to dampness.

Sil.: Itching exanthema, small pustules filled with lymph,

dying quickly (around joints). Small wounds suppurate

profusely. Phagedaenic ulcers, carbuncles. Suppurative process in the skin. Acne, burns by day. Pemphigus, zona, rhagades, rose-colored blotches. Erysipelas with suppuration. Boils come in crops. Malignant pustules. Diseases of the finger nails, brittleness, etc.

Calc-p.: Chafed skin, excoriation, itching of the skin.

ECZEMA. Eruption of the skin, with yellow-white scabs and vesicles (albuminous, white of egg contents), anaemia, bloodlessness of the skin. A cachectic eczema < from changes of weather.

FRECKLES. Lessened by this remedy.

HERPES. Itchings acute or chronic, intercurrently.

LUPUS. If partial manifestations of scrofulosis.

PRURIGO. Pruritus, troublesome itching of the skin, often in old people (4x tr.), alternately with Kali-p.

ACNE. In young people during puberty who suffer from headaches after mental application.

PERSPIRATION. TOO frequent or excessive, especially if about the head, vesicular blisters with albuminous contents, tubercles on the skin.

Calc-s.: Scald-head of children, if there be purulent discharges

or yellow purulent crusts, festers, etc. Pimples, if matter

forms on their heads, pustules, nodules, suppurating purulent scabs, suppuration of the skin, sores discharging pus or sanious matter. Herpetic eruptions, all over itching of soles.

CHILBLAINS. Discharging pus.

Calc-f.: Chaps, cracks of the skin, also use externally with

vaseline, fissures in the palms of the hands, fissures of the anus, horny skin, suppurations with callous, hard edges. Carbuncles. Brittleness of finger nails. Teeth likely to be brittle.

ECZEMA. Due to venous hyperaemia, < damp weather; > at night. Squamous eczema with thickening and cracking of the skin. Eczema of anus consequent to haemorrhoids.

PSORIASIS of extremities, which is uncommonly hyperaemic, deep reddish in tint.

< wool: Psor. Sulph. Hep. Phos. Puls. Bacillus morgan.

Vorwort/Suchen Zeichen/Abkürzungen Impressum