BHMS 3rd Year Surgery Notes

Complete Notes (Topics 1–65)

 Part A – General Surgery

1. Inflammation
Definition, signs: calor, dolor, rubor, tumor, functio laesa.
Types: Acute, chronic, suppurative, granulomatous.
Remedies: Belladonna – acute inflammation; Hepar sulph – suppuration tendency.

2. Suppuration & Abscess

Acute abscess – localized pus collection.
Features: Pain, swelling, redness, fluctuation.
Remedies: Hepar sulph – ripening abscess; Silicea – chronic abscess with fistula.

3. Ulcers
Types: Traumatic, tubercular, syphilitic, varicose, malignant.
Features: Edge, base, discharge, surrounding skin.
Remedies: Merc sol – offensive ulcers; Nitric acid – painful fissured ulcers.

4. Gangrene
Types: Dry, wet, gas gangrene.
Causes: Diabetes, trauma, atherosclerosis.
Remedies: Secale cor – dry gangrene with coldness; Carbo veg – collapse stage.

5. Wounds
Incised, lacerated, contused, stab, gunshot.
Healing: Primary, secondary, tertiary intention.
Remedies: Calendula – healing of open wounds; Arnica – bruised trauma.

6. Haemorrhage
Types: Arterial, venous, capillary.
Primary, reactionary, secondary haemorrhage.
Remedies: Phosphorus – bright red bleeding; Millefolium – traumatic bleeding.

7. Shock
Definition: Circulatory collapse.
Causes: Trauma, haemorrhage, sepsis.
Remedies: Camphora – cold collapse; Carbo veg – gasping collapse.

8. Burns & Scalds

Degrees: 1st, 2nd, 3rd degree.
Complications: Shock, infection, contractures.
Remedies: Cantharis – burning vesicles; Urtica urens – superficial burns.

9. Tumors
Benign vs Malignant.
Features of malignancy: Infiltration, irregular growth, cachexia.
Remedies: Conium – glandular indurations; Carcinosinum – malignant tendency.

10. Cysts & Sinus

Cysts: Sebaceous, dermoid.
Sinus: Tubercular, osteomyelitis sinus.
Remedies: Silicea – sinus with discharge; Hepar sulph – pus formation.
 Part B – ENT

26. Anatomy & Examination of Ear

External, middle, inner ear.
Examination: Inspection, tuning fork tests, otoscopy.
Remedies: Pulsatilla – ear pain with catarrh; Chamomilla – intolerable pain.

27. Otitis Media

Acute: Ear pain, fever, discharge.
Chronic: Persistent discharge, hearing loss.
Complications: Mastoiditis, meningitis.
Remedies: Hepar sulph – ear abscess; Psorinum – chronic fetid otorrhoea.

28. Tonsillitis & Adenoids

Acute tonsillitis: Pain, fever, dysphagia.
Chronic tonsillitis, adenoid hypertrophy.
Remedies: Belladonna – acute tonsillitis; Baryta carb – enlarged tonsils in children.

29. Epistaxis (Nosebleed)

Causes: Trauma, hypertension, infections.
Treatment: Pinching, cautery, packing.
Remedies: Millefolium – profuse epistaxis; Phosphorus – bright red bleeding.

30. Laryngeal Disorders

Acute laryngitis: Hoarseness, cough.
Chronic laryngitis, laryngeal polyp, carcinoma.
Remedies: Spongia – dry barking cough; Causticum – hoarseness.
 Part C – Ophthalmology

31. Anatomy & Examination of Eye

Parts: Conjunctiva, cornea, lens, retina, optic nerve.
Tests: Vision, fundus exam, slit lamp.
Remedies: Ruta – eye strain; Belladonna – red congested eyes.

32. Conjunctivitis
Acute catarrhal, allergic, purulent.
Symptoms: Redness, discharge, photophobia.
Remedies: Euphrasia – acrid lachrymation; Argentum nit – purulent conjunctivitis.

33. Trachoma
Chronic chlamydial infection.
Features: Follicles, pannus, scarring.
Remedies: Thuja – chronic trachoma; Sulphur – recurrent conjunctivitis.

34. Corneal Ulcer

Causes: Trauma, infection, vitamin A deficiency.
Symptoms: Pain, photophobia, lacrimation.
Complications: Perforation, blindness.
Remedies: Calcarea fluor – corneal opacities; Hepar sulph – suppurative keratitis.

35. Glaucoma
Raised intraocular pressure.
Types: Acute, chronic.
Symptoms: Pain, haloes, loss of vision.
Remedies: Physostigma – glaucoma; Osmium – intraocular pressure.

36. Cataract
Opacity of lens.
Causes: Senile, traumatic, metabolic.
Symptoms: Gradual painless loss of vision.
Remedies: Silicea – cataract tendency; Calcarea carb – senile cataract.

37. Retinal Disorders

Retinitis, detachment, hemorrhage.
Symptoms: Floaters, photopsia, vision loss.
Remedies: Phosphorus – retinal hemorrhage; Aurum met – optic nerve atrophy.
38. Optic Neuritis
Inflammation of optic nerve.
Symptoms: Sudden vision loss, pain.
Causes: MS, infections.
Remedies: Kali phos – optic nerve weakness; Gelsemium – blurred vision.

39. Squint (Strabismus)

Misalignment of eyes.
Causes: Congenital, refractive error, paralysis.
Treatment: Glasses, surgery.
Remedies: Physostigma – muscular weakness; Jaborandi – visual disturbance.

40. Eye Injuries

Foreign body, chemical burns, blunt trauma.
Complications: Corneal ulcer, blindness.
Remedies: Symphytum – eye injury; Calendula – healing.
 Part D – Dentistry

41. Anatomy & Examination of Teeth & Oral Cavity

Teeth: Incisors, canines, premolars, molars.
Oral cavity: Lips, tongue, palate, gums, tonsils.
Examination: Inspection, palpation, percussion, radiographs.
Remedies: Merc sol – offensive mouth, salivation; Borax – aphthous ulcers.

42. Dental Caries

Cause: Bacterial (Streptococcus mutans), poor hygiene, sugar-rich diet.
Stages: Enamel → dentin → pulp involvement.
Symptoms: Toothache, sensitivity, cavities.
Remedies: Plantago – toothache; Staphysagria – caries with nerve weakness.

43. Pulpitis & Periapical Abscess

Pulpitis: Inflammation → severe throbbing pain.
Periapical abscess: Pus at root apex → swelling, tenderness.
Complication: Osteomyelitis.
Remedies: Chamomilla – intolerable pain; Hepar sulph – abscess with pus.

44. Gingivitis & Periodontitis

Gingivitis: Gum inflammation.
Periodontitis: Infection spreads → loosening of teeth.
Causes: Plaque, calculus, poor hygiene.
Remedies: Merc sol – spongy gums; Phosphorus – bleeding gums.

45. Oral Ulcers & Tumors

Ulcers: Aphthous, traumatic, tubercular, malignant.
Tumors: Squamous cell carcinoma most common.
Symptoms: Non-healing ulcer, pain, dysphagia.
Remedies: Borax – aphthous ulcers; Nitric acid – painful ulcers; Carcinosinum – malignant
tendency.
 Part E – Orthopaedics

46. Anatomy & Examination of Bones & Joints

Bone parts: Cortex, medulla, periosteum.
Joint types: Synovial, fibrous, cartilaginous.
Examination: Inspection, palpation, movements, X-ray.
Remedies: Ruta – periosteum injury; Symphytum – fractures healing.

47. Fractures
Break in bone continuity.
Types: Simple, compound, comminuted, pathological.
Symptoms: Pain, swelling, deformity, crepitus.
Remedies: Symphytum – fracture healing; Arnica – trauma with bruising.

48. Dislocations
Displacement of joint surfaces.
Sites: Shoulder, hip, elbow, finger.
Features: Pain, swelling, deformity.
Remedies: Ruta – dislocations; Arnica – soreness after reduction.

49. Sprains & Strains

Sprain: Ligament injury.
Strain: Muscle/tendon injury.
Symptoms: Pain, swelling, restricted movement.
Remedies: Rhus tox – stiffness better by movement; Ruta – ligament injuries.

50. Osteomyelitis
Infection of bone & marrow (Staphylococcus).
Symptoms: Fever, swelling, tenderness.
Complications: Abscess, sinus.
Remedies: Hepar sulph – suppurative; Silicea – chronic infection.

51. Tuberculosis of Bone & Joint

Sites: Spine, hip, knee.
Features: Pain, cold abscess, deformity.
Complication: Paralysis, deformities.
Remedies: Tuberculinum – TB tendency; Silicea – chronic suppuration.

52. Bone Tumors

Benign: Osteoma, chondroma.
Malignant: Osteosarcoma, Ewing’s sarcoma.
Features: Swelling, pain, fracture.
Remedies: Calcarea fluor – bony growths; Symphytum – bone healing.

53. Arthritis
Osteoarthritis – degenerative.
Rheumatoid arthritis – autoimmune.
Gout – uric acid deposition.
Remedies: Rhus tox – stiffness; Colchicum – gout pain.

54. Spinal Disorders

Scoliosis – lateral curvature.
Kyphosis – forward curvature.
Pott’s disease – TB spine.
Remedies: Calcarea phos – weak bones; Silicea – chronic abscess.

55. Amputation
Definition: Surgical removal of limb part.
Indications: Gangrene, trauma, tumors.
Complications: Phantom limb, infection.
Remedies: Calendula – wound healing; Hypericum – nerve pain.
 Part F – Surgical Principles & Minor Surgery

56. Principles of Surgery

Asepsis & Antisepsis – prevent infection.
Haemostasis – control bleeding.
Tissue handling – gentle, minimal damage.
Surgical safety – consent, sterile instruments, monitoring.
Remedies: Calendula – antiseptic wound healer; Arnica – trauma recovery.

57. Pre-operative Care

History, exam, investigations.
Control comorbidities (DM, HTN).
Fasting, consent.
Remedies: Aconite – anxiety; Gelsemium – fear.

58. Anaesthesia
Local: Infiltration, block, spinal, epidural.
General: Inhalational, IV agents.
Complications: Hypotension, shock.
Remedies: Opium – effects of anaesthesia; Nux vomica – gastric issues.

59. Post-operative Care

Monitor vitals, fluids, pain relief.
Mobilization, diet.
Watch complications: haemorrhage, infection.
Remedies: Staphysagria – surgical cuts; Hypericum – nerve pain.

60. Surgical Infections

Types: Pyogenic, anaerobic, specific.
Prevention: Sterility, antibiotics.
Treatment: Drainage, antibiotics.
Remedies: Hepar sulph – pus; Silicea – chronic abscess.

61. Surgical Shock

Causes: Trauma, haemorrhage, burns.
Types: Hypovolemic, septic, neurogenic.
Signs: Cold, clammy, low BP.
Remedies: Camphora – cold collapse; Carbo veg – air hunger.

62. Blood Transfusion

Indications: Anaemia, blood loss.
Complications: Reaction, infection.
Cross-matching essential.
Remedies: China – debility; Ferrum met – anaemia.

63. Minor Surgical Procedures

Incision & drainage.
Excision of cysts/tumors.
Biopsy.
Suturing wounds.
Remedies: Calendula – healing; Ledum – puncture wounds.

64. Surgical Instruments

Cutting: Scalpel, scissors.
Holding: Forceps, clamps.
Retracting: Retractors.
Suturing: Needle, holder.

65. Role of Homoeopathy in Surgery

Pre-op: Anxiety (Aconite, Gelsemium).
Post-op: Pain, healing (Arnica, Hypericum, Calendula).
Limitations: Cannot replace emergency surgery.
Scope: Supportive, palliative.