• EPIDEMIC DROPSY- Causes, Clinical Features, Treatment

    DEFINITION

    Epidemic dropsy is caused by consumption of adulterated mustard oil with argemone and characterized by GIT disturbances, oedema especially of lower limbs, blotchy erythema of skin, and features of cardiac failure.

    ETIOLOGY OF EPIDEMIC DROPSY

    Caution:
    – Contamination of mustard oil with seeds of argemone mexicana (prickly poppy) which contains toxic alkaloid: Sanguinarine.
    – Several groups of people are simultaneously affected who consume mustard oil from same common source.
    Age: All ages breast fed infants. Maximum ins cidence in age of 20 — 40 years.
    Sex: Both sexes are equally affected.
    Socio economic status: Lower and middle class suffers most G1T

    CLINICAL FEATURES
    Onset: Usually insidious may be sudden at times.
    Premonitory Symptoms:
    Vague abdominal pain, flatulence and diarrhoea. Heaviness of lower extremities, with tingling and numbness. Breathlessness on exertion. Mild to moderate fever.
    GIT
    Anorexia, nausea, vomiting, abdominal pain and borborygmi. Diarrhoea (due to congestion of intestinal mucosa). Bleeding from gums, haematemesis, and melena and bleeding from piles.
    Skin
    Oedema (solid) of legs associated with erythma (due to subcutaneous vascular dilatation). Ecchymotic patches (due to dilatation of telang iectatic dilatation of blood vessels) common to be seen over lower part of chest, abdomen, buttocks and thighs. Gradually oedema spreads to thighs, sacral region, trunk, hands and ultimately face is also involved. Tingling numbness is common. Patchy pigmentation is seen over forehead and malar bone.
    Cardiovascular system:
    Dyspnoea and palpitation on exertion. Precor dial pain with or without effort. On examination heart is enlarged. Heart sounds are feeble. May show gallop rhythm. Systolic murmur is audible over apex (due to dilatation of mitral ring). Pulse is soft and rapid (90 —140 min.). In late phase; features of CCF are present. B.P. is low.
    Respiratory system:
    In severe cases where CCF is present; cough and dyspnoea are present. Haemoptysis may occur (due to pulmonary congestion).
    Nervous system:
    Heaviness of limbs with tingling numbness. On examination there is no wasting or loss of re flexes.
    Urinary system:
    Total daily output is decreased (due to CCF).
    Eye:
    Rainbow hallows around light are seen. On examination intra-ocular tension is raised. Cornea is normal. Headache is frequently present.

    Clinical Features in Brief
    Symptoms:

    • Fever.
    • Anorexia.
    • Nausea.
    • Vomiting.
    • Diarrhea.
    • Swelling of feet.
    • Dyspnoea.
    • Redness of skin.
    • Burning of feet.

    Signs:

    • Temperature: raised.
    • Respiration: fast.
    • Pulse: Rapid.
    • Weak.
    • Blood pressure: low.
    • Anemia: mild to moderáte.
    • Pedal oedema: Bilateral, Pitting.
    • Marked tenderness over edematous parts.
    • Skin: diffuse blotchy erythema.
    • Liver: enlarged.

    COMPLICATIONS

    • Cardiac failure.
    • Glaucoma.

    PROGNOSIS

    • Good, with treatment.

    MIASMATIC CLEAVAGE

    • A non-miasmatic disorder.

    THERAPEUTIC AIM

    • To cure.
    • To prevent complications.

    GENERAL MANAGEMENT

    • Use of contaminated mustard oil to be stopped.
    • Bed rest.
    • Oxygen inhalation.
    • Salt restricted diet.
    • Nutritious, easily digestible diet.

    PRO PHYLACTI C MEASURES

    • Frequent sample analysis to identify contamination.
    • Prompt destruction of contaminated oil.

    HOMOEOPATHIC TREATMENT OF EPIDEMIC DROPSY

    • Apis Mel.
    • Apocynum Can.
    • Argemone Mexicana.
    • Arsenicum Album.
    • Phosphorus.

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    Categories: General Problems, Skins

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    8 thoughts on “EPIDEMIC DROPSY- Causes, Clinical Features, Treatment

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