Chickenpox

Chickenpox or Varicella is an acute infectious disease characterised by a rash which appears in crops and disappears in a few days by desiccation and scab formation. It is an extremely common infection affecting infants and children practically during all seasons of the year. It is uncommon in children above 10 years of age and probably significant percentage of children in the urban cities are effected.
Causes.
The exciting cause of the disease is a volatile filtrable virus which is found in a patient's blood and in the contents of the vesicles during the outbreak of the eruption. Infection in most cases is by direct droplet spray,  but articles of clothing may remain infectious for a long time and the disease is sometimes carried by a healthy intermediary. In fact,  the infection is contagious from the very first hour of the eruption, as such it is difficult to control its spread. The occasional development of chickenpox in children exposed to herpes zoster suggests that the two diseases are different manifestations of the same viral infection. The details of incubation period are as follow,,,
Incubation period (period between exposure to disease and appearance of Symptoms) 
14-16 days, occasionally 3 weeks.
Period of communicability (period when child could have infected others)
One day before appearance of rash and no longer than 6 days after appearance of the first vesicle.
When child can mix with other children and return to school.
7 days after onset of rash. Crust is not infectious like in small pox.
One attack of chickenpox usually confers life long immunity, second attack being extremely rare.
Symptoms
The onset of the disease is sudden with slight fever and simultaneous appearance of eruption which is maculo popular from a pin head to a lentil size. In exceptional cases in children, vomiting and convulsions may occur. The maculae are scattered and very transparent content. The eruptions first appear on the trunk and then on the limbs and face and the distribution of the lesions is chiefly centripetal and not centrifugal as in case of small pox. The lesions tend to be more abundant on covered parts than on the exposed parts of the body. The common occurrence of the eruption is a successful crop of 4 to 5 days and each may be associated with a slight rise in temperature. The characteristic lesion is first a mucule, then a papule, then a vesicle and finally a pustle, with a subsequent scab formation. The eruptions also appear on the face, the palms and soles, mucous membranes like conjunctiva, fauces, cheeks etc. They soon burst and Ulcerate causing difficulty in eating and swallowing. Generally, there is no confluence of adjacent vesicles. However, due to the itch, the rash is often infected by scratching or rubbing and then the lesions become larger and more inflamed. The vesiculation is generally complete in 24 hours or little more. The vesicles look translucent droplets lying on the skin. The areola may or may not be present.
The severity of the infection may be judged from the numbers of pocks, which in severe cases may become confluent. The scabs are shaped in about 10 days though in severe cases these may be delayed for 2-3 weeks.
As chickenpox closely resembles small pox, the differential diagnosis of the two diseases is here below,  
  
Chickenpox
A,  The onset is rapid and the first crop of maculae appears on first day.
Small pox
A The crop may appear on the second day, deep maculae and papulae appear on the third day.
B  Vesicles are oval, superficial and generally appear on third day.
B  Vesicles are round and appears on sixth day.
C Pustulation and scab formation takes place on the 4-5 day respectively.
C  Pustulation occurs on the 9th day and scab formation followed by scar formation may take place after 15th day.
D  Onset is mild and is attended with slight rise in temperature.
D  The onset is like influenza with fever, headache, vomiting and backache.
E  The vesicles appear all over the body, most frequently on the hairy part of the head and face. The vesicles are not putted.
E  The eruptions breaks out first on the face, mainly on the forehead, the hairy part of the head and simultaneously on the back and nose, and these appear on the trunk and more densely on face, and on the third day on the limbs. The vesicles appear against a pinkish background and are pitted.
F  There is polymorphism of the eruption which is centripetal in nature.
F  There is no polymorphism of the eruption which is centrifugal nature.
Types.
In addition to the ordinary form of chicken pox three types of chicken pox, namely
Bullous, in which large blebs containing turbid fluid and about 25 mm in diameter appear.
Gangrenous,  in which large dark crusts form revealing rapid and deep ulcers and
Haemorrhagic,  in which haemorrhage is found around the base of the pock and external haemorrhage from the nose and mouth. The second and third varieties of chicken pox are often fatal.
Constitutional causes
In the homoeopathic parlance it is the susceptibility of an individual child to a particular infection that is important, so to say, the soil must be receptive to the infection. The Miasmatic background and the Constitution of the child are basic considerations which differ in approach from that of the modern medicine.
Generally, those children who are psoric or of tubercular constitution are prone to the eruptive fevers. While the Constitutional make up of children has been dealt with elsewhere, it is evident from the overall picture of the eruptive fevers that these arise from a definite Miasmatic flow. Hence, till a child is studied in regard to the different constitutional traits and treated, it will continue to be susceptible and be vulnerable to such fevers.
Effects
Some of the effects of the chicken pox are laryngitis or slight bronchitis, pox on conjunctiva, acute nephritis, arthritis etc, though the complications are generally rare in children.
Homoeopathic therapeutics.
Aconite
This remedy is required in the initial febrile stage,  when the skin is hot and child is restless, anxious and thirsty. High fever with rapid hard and full pulse. The hands are hot and feet cold.
Ant crud
Fever with nausea, vomiting and a thickly coated white tongue. The child is extremely irriatable and fretful and cannot bear to be touched or looked at. This remedy is also useful in case of cough and bronchitis remaining after the chicken pox. When eruptions attack the fauces, the palate and the corner of mouth, this remedy will be helpful.
Ant tart
This is one of the chief remedies for chickenpox when the fever is attended with convulsions or the eruptions are delayed or receding and are blue in colour. The child is drowsy, weak and sweaty and has a coated, pasty and thick white tongue. The face is pale and covered with cold sweat. One of the important symptoms of this remedy is that there is incessant quivering of chin lower jaw. This remedy is especially indicated when the chickenpox is associated with bronchitis and other chest troubles,. The child has thirst for cold water, little and often and desire for apples, fruits and acids.
Apis Mel
This remedy is indicated when there is an excessive itching of the skin or puffy swelling of the eyelids which is aggravated by slightest heat or warmth. There is thorstlessness along with scanty high colored urine.
Belladonna
This remedy is indicated when the febrile conditions are accompanied by severe headache and cerebral symptoms. The child has flushed face,  red eyes and hot skin usually without any thirst. There is great drowsiness with inability to sleep. This remedy is also useful in the initial febrile stage of the chickenpox.
Merc sol.
This remedy is indicated when the vesicles suppurate  or the disease taken a turn towards Gangrenous type. There is great itching especially from warmth of bed. This remedy is also indicated when the disease is complicated by bloody and slimy stools when the painful ulcers form in the mouth is fetid odour from the mouth. The tongue is thick, moist, yellow and shows the imprints of teeth.
Gelsemium
This remedy should be thought of when the onset of the fever is slight and the child is very weak. The child is dull,  delirious and dizzy with pain in the occipital region. Complete thirstlessness is one of the important symptoms of this remedy.
Rhux tox
This is of the chief remedies for chickenpox when there is intense itch and burning. This remedy if given in the ist stage often arrests the progress, shortens the period of suffering and effects perfect cure. Unless any other medicine is strongly indicated, this remedy may be given with advantage. Some of the important symptoms of this remedy calling for its use in chickenpox are extreme restlessness with continued change of position, great apprehension at sight so that the child cannot remain in bed, bitter taste in the mouth, coated tongue except red triangular spaces at the tip, pain and stiffness in the limbs and great inclination to stretch the limbs and yawn. This remedy is also helpful when the complications like pustular inflammation of the eyes take place.
Sulphur
This is indicated when there is intense itching and burning in the eruptions and the child has great tendency to scratch. Least washing aggravates the itching and burning. There are frequent flashes of heat of and this remedy will generally show great redness of lip and around the anus. This being a strong anti psoric will benefit a child who is either of psoric or tubercular constitution. This remedy is also useful when the carefully selected remedies fail to act.
Each individual case should be considered the totality of the symptoms and not on the symptoms of fever and eruption alone. The prescription must be such as not to suppress the signs and symptoms or the course of the disease. Various symptoms like fever, types of eruptions at different stages, concomitant symptoms like convulsions, vomiting, etc, as well as any other peculiar symptoms should be taken into account of repertorization. It is not considered necessary to give a detailed repertorial Analysis for chickenpox. However following three rubrics concerning chickenpox are given in Dr. Kent's repertory which may be found to be of some use.,
Chickenpox,,
Aconite,  ant crud,  ant t,  ars,  asaf,  bell,  canth,  carb v,  caust,  coff,  cycl,  hyos,  op,  led,  merc,  nat c,  Puls,  rhus t,  sep,  sil,  Sulph, thuj.
Cough after chickenpox Ant c.
A case treated
A 9 years old boy contracted chickenpox from a class mate in the school and developed fever and typical rash of chickenpox about 15 days after exposure. The temperature was 38 °c and the eruptions appeared all over the body the only cause of worry for the parents was that there was an intolerable itching and burning sensation in the eruptions which was aggravated during night and by slightest warmth. Close observation also revealed the swelling of the eyelids. The throat was intensely red with tonslis swollen. The child was thirstless. With a view to give minimum necessary medication based on the above symptoms,  Apis Mel 30,  five doses were given which greatly relived the child of the intense itching and burning as well as the great sensitiveness to the warmth. The disease ran its nor course and the case was dismissed with usual advice on diet, quarantine etc.