By Dana Ullman MPH
(Excepted from Consumer's Guide to Homeopathy, Tarcher/Putnam)
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Surgery represents conventional medicine at its best and its worst. On the one hand, surgery demonstrates incredibly sophisticated informational and technical advancement, yet on the other hand, it often indicates the inability of physicians and patients to prevent this invasive treatment of last resort.
Like other health professionals, homeopaths honor the special role that surgery and surgeons have in health care. Homeopaths are not against surgery, because certain conditions are simply not treatable without it. At the same time, however, surgery is often performed unnecessarily. It is performed when other, safer measures can be effectively used. It is performed too early when the body can sometimes heal itself. And it is performed inappropriately, primarily because surgeons only know surgery and don't know what else to do (the law of hammers pervades many professions: when you are a hammer, everything becomes a nail).
Even when surgery is successful, this does not necessarily mean that the person is "cured." Surgery may, for instance, remove an abscess, a tumor, kidney stones or gallstones, or other diseased parts, but because this removal doesn't change the underlying pathological processes that created them in the first place, it is understandable and even predictable that people tend to reexperience their ailments.
Even if the ailment seems to have disappeared, homeopaths do not believe that a curative process has always taken place. While the initial complaint may have been eradicated, sometimes more serious pathology develops shortly after the surgery. Although doctors tend to believe that this is a "new" disease, homeopaths theorize that the surgery probably suppressed the original ailment.
This critique of surgery is not meant to devalue its appropriate use in treating various congential deformities, structural problems, severe injuries, or life-threatening pathological conditions. As previously stated, homeopaths are not against the judicious use of surgery.
When possible, homeopaths first attempt to to see if treatment with an individualized homeopathic medicine can prevent the need for surgery. Patients and even homeopaths are sometimes surprised and impressed at the significant results that homeopathic medicines can provide--not that they can do the impossible, but they can often elicit a healing response when conventional therapeutics cannot.
The integration of homeopathic medicines with surgical care uses the best of both worlds to create comprehensive and ultimately more effective health care.
Homeopathic Medicines Before and After Surgery
Once it is determined that surgery is medically necessary, homeopathic medicines can reduce complications of surgery and augment healing so that people can recover more quickly afterward.
Surgeons commonly ask patients not to take any food, drink, or drugs prior to surgery. While it makes sense to avoid food, drink, and conventional drugs, there have never been any reported problems from taking homeopathic remedies prior to surgery.
Some homeopaths recommend Ferrum phos 6, four times a day for two days, prior to surgery in order to prevent infection and hemorrhaging.
Homeopathic medicines can also help people deal with the various emotions they are experiencing prior to surgery. Gelsemium 6 or 30 is a common remedy for the person who experiences great anxiety, apprehension, weakness, and trembling prior to surgery. Aconitum 6 or 30 is indicated when the person is terrified about surgery and thinks that he will die from it.
Take either Gelsemium or Aconitum the night before the surgery and another dose upon waking in the morning. If fear and/or anxiety is felt after surgery, take one to three more doses.
One double-blind, randomized trial on 50 children who underwent surgery showed that 95% of those given the homeopathic medicine Aconitum experienced significantly less post-operative pain and agitation.1 Aconitum was chosen because it is a common remedy for ailments in which sudden and violent onset of shock or trauma is a primary indication, as well as symptoms of fear and anxiety, which are especially common emotions experienced by children prior to surgery.
Arnica is another common homeopathic medicine given to people before and after surgery because of its ability to reduce surgical shock and minimize bleeding. Surgical shock is a condition that trauma or surgery can cause in which all the capillaries and small blood vessels are filled with blood at the same time. A randomized, placebo-controlled, crossover study showed that Arnica significantly decreased bleeding time.2
The late British homeopathic physician Donald Foubister recommended Arnica 30 the night before surgery, another dose the morning of the surgery, another dose just prior to the surgery, and different medicines afterward, depending upon the type of surgery and the symptoms the patient feels.
Homeopathic medicines can also be beneficial for patients who undergo long-term intravenous (IV) therapy. Frequent insertion of an IV commonly causes phlebitis (inflammation of the vein) and hematoma (the pooling of blood under the skin); a double-blind study using Arnica 5c found that it can effectively reduce and prevent such problems.3 The study showed significant benefits from Arnica, including reduced pain. Besides subjective improvement, there were also objectively measured increases in blood flow and in blood coagulation factors.
While Arnica is the primary remedy to be taken just prior to the majority of surgeries, there are a certain number of operations for which Dr. Foubister commonly recommended other remedies. For surgery involving cartilage and periosteum, as is often occurs in the knee or elbow, it is recommended to take Ruta 30 the evening before, the morning of the operation, and immediately afterward. For hemorrhoidal surgery, it is recommended to take either Staphysagria 30 or Aesculus 30 in a similar pattern as described for Ruta. And for circumcision, Staphysagria 30 and Arnica 30 should be given similarly as above.
The following are common recommendations for after surgery. Please note that the length of time of treatment can and should be different with each patient, depending upon the intensity of symptoms. Doses should generally be taken as long as pain persists, though they should not be taken for more than a couple of days, unless the person is still in pain and the remedy is providing obvious relief. Arnica 6, 12, or 30 should be given for at least two doses after surgery, approximately one hour apart. In addition to this remedy, the following remedies should be given one hour after the last dose of Arnica:
--Dilation and curettage: Belladonna 30, every 6 hours
--Hysterectomy: Causticum 30, three times a day (some homeopaths recommend Staphysagria 6 or 30, three times a day)
--Caesarean section or episiotomy: Staphysagria 30 or Bellis perennis 30, three times a day
--Abortion or miscarriage: Ignatia 30, every four hours
--Plastic surgery on the breast: Bellis perennis 6 or 30, three times a day
--Amputation of the breast or a lump: Hamamelis 30, every 4 hours
Circumcision: Staphysagria 30 and Arnica 30, every four hours for a day.
Prostate surgery: Staphysagria 30, three times a day
Abdominal surgery: Staphysagria 30 or Bellis perennis 30, three times a day
Appendectomy: Rhus tox 30, three times a day
Gastrectomy: Raphanus 30, three times a day
Gall bladder surgery: Lycopodium 30, three times a day
Eye surgery: Ledum 30, every four hours
Tonsillectomy and adenoidectomy: Rhus tox 30, every four hours
--involving cartilage or periosteum: Ruta 30, every four hours
--involving the spine: Hypericum 30, every four hours
--Surgery for bullet wounds and/or stab wounds: Staphysagria 30, four times a day
Plastic surgery: Arnica 30 (internally) and Calendula, (externally) four times a day
Amputation: Hypericum 30, every four hours
Hemorrhoids: Staphysagria 30 or Aesculus 30, every four hours for two or three days* Varicose veins: Ledum 30, three times a day
Dental surgery: Hypericum 30 and Ruta 30, alternating every two to four hours
Homeopathy for Specific Ailments After Surgery
Readers who experience symptoms or syndromes discussed elsewhere in this book should review those chapters. For instance, if you have urinary symptoms after surgery, which is common when catheterization takes place, consult the section on bladder infection in the section on Women's Conditions (even if you are a man; see: WOMEN). If you are now suffering from acute insomnia, consult the chapter on Insomnia (sorry, not included online).
Some common conditions after surgery for which homeopathic medicines are often effective include the following:
Fear of Death
Aconitum 30 is indicated (every hour for up to four doses).
Arnica 30 helps to slow or stop bleeding after surgery. Phosphorus 30 is the primary remedy for helping to stop bleeding when Arnica does not work adequately. Ipecacuanha 30 is indicated when there is much bleeding of bright red blood, often accompanied by nausea. Secale 30 is effective in treating uterine bleeding that is aggravated by heat and relieved by cold. Cinchona 30 is helpful for people whose bleeding and general loss of fluids lead them to feel weak and faint and have ringing in the ears. This remedy is sometimes indicated several weeks, months, or years after much fluid has been lost, after either an illness or an operation. Arsenicum 30 is useful when profuse bleeding leads to great weakness, burning pains, restlessness, anxiety, and fear, along with a characteristically large thirst for only sips at a time.
Dose: Take the remedy every hour until bleeding stops, not more than four doses. If bleeding has not significantly slowed, consider another remedy. The next day, take one more dose of whichever works to reduce the possible complications of blood loss.
Trauma to Tissue
Arnica topically and Arnica 6 or 30 are useful when the muscle feels bruised or swollen and when there is any pooling of blood under the skin. Hamamelis topically and Hamamelis 6 or 30 are effective when the person has weak veins, passive hemorrhage, bleeding hemorrhoids, or varicose veins. Capillaries are enlarged and congestion is marked. Calendula in external application (gel, ointment, tincture, spray) is indicated to heal wounds or incisions. Bellis perennis 6 or 30 is a remedy for use after abdominal surgery and when deep internal tissue has been traumatized.
Dose: Apply external remedies at least once a day, and apply again if bathing washes them off. Generally, only two to eight doses of the internal remedy over a two day period will be necessary to complete the healing process.
External applications of Calendula and Hypericum, either alone or preferably together, help to both prevent and treat infection of surgical wounds. If pus has developed and caused hypersensitivity of the wound, Hepar sulphur 30 is recommended. Because Hepar sulphur is an effective remedy for helping to push out splinters, pieces of glass, and various foreign objects that get stuck under the skin, it also has a tendency to push out surgical stitches. Thus it is not recommended to use this remedy when there are stitches, except towards the end of the healing process, when their removal is part of the healing. If the wound becomes purplish, Lachesis 30 or Gunpowder 30 is indicated. If there is much burning in the wound or wound area, Sulphur 30 is helpful.
Dose: Apply external remedies at least once a day, and apply again if bathing washes them off. Take internal remedies every two to four hours during the first 24 hours and four times a day for two to five more days.
Scarring and Adhesions:
Apply Thiosinaminum tincture externally or use an external combination formula that also contains Calendula (some injury gels include these ingredients). Take Graphites 12 internally.
Dose: Apply external remedies at least once a day, and apply them again if bathing washes them off. You may need to do this for several weeks or months. Internal remedies should be taken three times a day for two days, and if necessary, repeated one month later.
Raphanus 6 or 30 is indicated when there is constipation with no urgings for a stool and/or when there is painful gas; see also the chapter on Digestive Disorders for other potential medicines for constipation.
Dose: Take this remedy three times a day for up to four days.
Nausea and Vomiting
Nux vomica 6 or 30 is good for violent retching, especially when there is generally ineffectual retching that does not lead to vomiting. Phosphorus 6 or 30 helps to prevent or treat nausea after surgery; it is indicated when the patient has a strong thirst for ice drinks; he or she may also have a concurrent headache. Ipecac 6 or 30 is effective for persistent nausea with vomiting, when vomiting does not provide relief. Arsenicum 6 or 30 treats violent and incessant vomiting which is made worse by drinking water, especially cold water, or eating. There may also be burning pain in the stomach. See also chapter on Digestive Disorders.
Dose: Take a remedy every two hours during intense symptoms and every four hours during less intense discomfort. If improvement is not obvious after 24 hours, consider another remedy.
Carbo veg 6 or 30 helps people who suffer from great distension and offensive gas, who get some relief from release of gas, and who desire carbonated drinks because they seem to help them release gas. Cinchona 6 or 30 is useful when there is more pain than distension, frequent rumbling in the abdomen, and no relief from releasing gas. Raphanus 6 or 30 is a common remedy for people who have a distended abdomen but are unable to expel gas. Because this condition is extremely common after surgery, especially abdominal surgery, this remedy is often indicated. Colocynthis 6 or 30 is effective when there is more pain than distension, and also cramps that are relieved by bending over.
Dose: Take a remedy every two hours during intense pain and every four hours during mild discomfort. If improvement is not obvious after 24 hours, consider another remedy.
(see the chapter on Conditions of the Elderly for details)
1J.P. Alibeau and J. Jobert, "Aconit en Dilution Homeopathique et Agitation Post-Operatoire de l'enfant," Pediatrie, 1990, 45 (7-8): 465-66.
2J. Baillargeon, et.al., "The Effects of Arnica Montana on Blood Coagulation: A Randomized Controlled Trial," Canadian Family Physician, November 1993, 39:2362-67.
3C. Amodeo, et.al., "The Role of Arnica in the Prevention of Venous Pathology from Long-term Intravenous Therapy: Evaluation of Platelet Aggregation," Ninth National Conference of the Italian Society for Vascular Pathology, Capanello, June 6-9, 1987. The study included 39 patients, including 21 undergoing intravenous feeding, nine in infusion protracted beyond 72 hours, and nine in chemotherapeutic treatment.
SOME ADDITIONAL REFERENCES TO THE PEER-REVIEW LITERATURE:
Barnes, J, Resch, KL, Ernst, E, "Homeopathy for Post-Operative Ileus: A Meta-Analysis," Journal of Clinical Gastroenterology, 1997, 25: 628-633.
Karow, Jens-Hagen, Abt, Hans-Peter, Froling, Markus, Ackermann, Hanns. Efficacy of Arnica
Kotlus BS, Heringer DM, Dryden RM. Evaluation of homeopathic Arnica
Kulick, M, Clinical Research Study of SinEcch (Alpine Pharmaceuticals brand and dosage regimen of Homeopathic Arnica
Macedo, SB, Feerreira, LR, Perazzo, FF, and Tavares Carvalho, JC, Anti-inflammatory Activity of Arnica
Paris A, Gonnet N, Chaussard C, Belon P, Rocourt F, Saragaglia D, Cracowski JL. Effect of homeopathy on analgesic intake following knee ligament reconstruction: a phase
Porozov S, Cahalon L, Weiser M, Branski D, Lider O, Oberbaum M: Inhibition of IL-1beta and TNF-alpha secretion from resting and activated human immunocytes by the homeopathic medication Traumeel S®. Clin Dev Immunol. 2004;11:143-9
Ramelet, AA, Buchheim, G, Lorenz, A, et al., Homeopathic Arnica in Postoperative Hematomas: A Double-blind Study, Dermatology, 2000;201(4):347-8.
Sakakura CE, Neto RS, Bellucci M, Wenzel A, Scaf G, Marcantonio E Jr. Influence of homeopathic treatment with comfrey on bone density around titanium implants. A digital subtraction radiography study in rats. Clin. Oral Impl. Res. 2008,19,6:624-628. doi: 10.1111/j.1600-0501.2007.01514.x
Singer SR, Michal Amit-Kohn M, Weiss S et al, Traumeel S for pain relief following Hallux Valgus surgery: a randomized controlled trial.
Totonchi A, Guyuron B. A randomized controlled comparison between arnica and steroids in the management of postrhinoplasty ecchymosis and edema. Plast Reconstr Surg 2007;120:271-4.
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