Therapeutics of fever by H C Allen – A Book Review

Dr P K  Satheesh Kumar BHMS,MD(Hom)
Medical Officer,Dept. of  Homoeopathy, Govt. of Kerala

Name of book: Therapeutics of fever
Author : H.C Allen, MD.Author of Keynotes and characteristic of  materia medica, materia medica of nosodes and therapeutics of intermittent fever.
Classification: Coming under the category clinical repertory on a clinical condition fever.
Publishers : B. Jain Publishers Pvt .Ltd, New Delhi (India)
Edition : Current edition is reprint edition 1990.No information about the previous edition.
Year of publication: No information about the year of publication.
Total number on pages: 571 (including Materia medica part)
179 pages repertory alone.
Grading : Bold, italics, and ordinary letters.

Mode of construction of book:
This work can be divided into six parts

Preface
Begins with the author’s expression of his gratitude to his professional colleagues of India for their commendations of the monograph on intermittent fever, which was published in 1879.
The treatment of intermittent fever prevalent during that time was mainly by the administration of massive doses of quinine. This type of suppressive treatment practiced by the dominant school of medicine is not only positively injurious but also often fatal. Massive doses of Peruvian bark or any of its alkaloids can only suppress the symptoms and there by increase the suffering of the patient.
Hahnemann’s lesson in the “ chronic diseases” on the treatment of acute syphilis must be applied to fevers of all types and acute diseases of every name and every kind irrespective of habitat.
“Therapeutics of fever ” deals with therapeutics of typhoid, typhus and fevers of every grade and name, from acute sporadic and epidemic intermittent to the malignant type of the malarial fevers of the tropics.
At the end of the end of the preface author express his obligations to Drs. Geo. H. Clark, C.B. Gilbert, Wm.Guernsey, St. Clair Smith, E.V.Rose and P.C.Mujumdar for valuable suggestions; and to Drs. C.E.Fisher and C.B. Hall for suggestions and proof reading.

Introduction –
Begins with a coating from Hahnemann’s ‘medicine of experience’. “After he has found all the existing and appreciable symptoms of the disease, the physician has found the disease itself. He has a complete idea of it and knows all the need know to cure it.”
Introduction consists of few important essays. These essays include “ the cause”, “Malarial theory”, “ Psoric diathesis”, “Genus epidemicus”, Examination of the patient” etc.

Materia medica-
Begins with Aconite and ends with Zincum met. Total number of medicine—
General representation of a medicines is as follows-
Name of medicine
General characteristics of medicine (both mental and physical)
Relation – Complimentary, acute, chronic, inimical etc
Aggravation
Modality
Amelioration

Followed by nature of fever described under the following heading
1. Type (of fever)—Quotidian, tertian, yellow fever, typhoid etc.
2. Time –12 – 2 am, 2 – 4 am etc.
3. Prodrome
4. Chill
5. Heat
6. Sweat
7. Tongue
8. Pulse
9. Apyrexia

Comparison –under certain drug like Ars alb, Capsicum etc a comparative study of most similar drug is given.
E.g.: – In drug Capsicum, Eup. purp. Compared with capsicum.
In drug Ars alb, Cinchona compared with Ars alb.

Analysis – under analysis he mentioned most important characteristic symptoms of the drug in fever. [Causation / important features of chill, heat and sweat etc]
Repertory—
Begins with – chill type and ends with the chapter general accompaniment –constitutional and general.
Plan of construction of repertory:
It contain 133 medicines and have 47 chapter starts with “ chill-type” and ends with the general accompaniment of fever –constitutional and general.

The repertory part can be divided in to 7 sections
1. Chill
2. Heat
3. Sweat
4. Appetite, taste, tongue etc. Symptoms of:
5. Apyrexia and
6. Typhoid and typhus and
7. General accompaniment of fever  (Beginning with symptoms of the mind and ending with constitutional and general)
A) Chill consists of 12 chapters.  They are as follows
1. Type
2. Time
3. Cause (attack brought on by)
4. Prodrome (conditions occurring during)
5. Commencement of chill (chill beginning in)
6. Chill location of (chill part affected or location of)
7. Chill aggravated
8. Chill ameliorated
9. Symptoms during the chill
10. Chill character of
11. Chill symptoms during
12. Chill followed by
B) Heat consists of 7 chapters.
Heat aggravated by
Heat ameliorated by
Heat absent
Heat in general
Heat symptoms during
Heat followed by
Heat character of
C) Sweat –16 chapters.
Sweat aggravated
Sweat ameliorated
Sweat followed by
Aggravation while sweating
Amelioration while sweating
Sweat absent
Sweat in general
Sweat predominate
Sweat produced by
10. Sweat character of
11. Sweat time
12. Sweat location of
13. Sweat symptoms during
14. Sweat suppressed
15. Aggravation after sweat
16. Amelioration after sweat
D) Appetite, taste, tongue etc. Symptoms of:
E) Apyrexia symptoms during
F) Typhoid, typhus, prodromic stage
G) General accompaniment of fever   –9 Chapters are given separately starting from symptoms of mind and ends with gastric. 13 chapters from “diarrhea and constipation” to “constitutional and general” are given under “gastric”.

Symptoms of the mind
Sensorium
Head internal
Head external
Eyes and sight
Hearing and ears
Smell and nose
Face

Gastric (Following chapters are given under the heading gastric)
10. Diarrhea and constipation
11. Urine
12. Voice
13. Breathing
14. Cough
15. Heart
16. Back
17. Extremities
18. Sleep
19. Skin
20. Sweat
21. Tissues and
22. Constitutional and general
5.Index –general— and
6. Index to repertory.

Misplaced rubrics:
Chill:
Type –
1. Day

  • Every at precisely same hour
  • At different times of
  • Every other
  • Every other in evening
  • Every seven (weekly)
  • Every fourteen
  • Every twenty one

(Time regular intervals/ time paroxysm returning at)
2. Menses after the (Nux vom, Pso, Sep)
3. Monthly
4. Perspiration when checked by the draft of air.
5. Summer
Excessive heat of
6. Suppressed by quinine or anti periodics
7. Weather change of
8. Winter
9. Yearly
Time –
10. Bed in
Chill location of –
11. Ascends
12. Descends
Symptoms   during the chill–
13. Chill absent
14. Chill in general
Chill character of–
15. Fright, from, during menses
Heat:
Heat character of
16. Abdomen of
17. Afternoon without chill
18. Back over the
19. Body left side
Right side of
Left side of
Whole of
Left side of coldness of right
20. Chest in or on
21. Day, during the periodically
22. Evening
23. Face
24. Forenoon
25. Head mostly in
26. Hip burning in the
27. Hands palms of
28. Limbs of
29. Night at
30. Morning
31. Mid night at
32. Noon
33. Parts affected of
34. Soles
35. Spine along the
Sweat:
Sweat, time of
36. Long lasting

Repetition of same rubrics with different medicines:
Chill – 1) Type
Yearly –Ars alb, Carb veg, Lachesis, Natr, Psor, Sulph, Thuja, Tub.
Time
Paroxysm returning at –yearly– Ars alb, Carb veg, Lachesis, Sulph
2) Type
Perspiration, when checked by draft of air – Cad sul.
Cause
Perspiration suppressed from a draught –Acon
3) Type
Suppressed by quinine or anti- periodics– Stan.
Cause
Quinine, abuse of – Alst, Arn, Carb veg, Ipec, Lach, Natr, Puls, Stan.
4) Type
Day – every seven — Amm. M, Cinch, Lyc, Canth, Meny, Plant, Rhus, Sul, Tub.
Time
Regular intervals— interval of seven days – Amm.m
5) Type
Day – every fourteen — Amm, Ars, Calc, Chin .s, Cinch, Lach, Plant, Psor, Puls.
Time
Regular intervals—interval of fourteen days—Ars alb, Calc, Cinch, Puls

Merits:
Less importance is given for pathological rubrics. (Or limited number of pathological rubrics are given Eg: – Typhoid, yellow fever, Zymotic etc) which shows that the author has given more importance to symptomatology.
It contains many additional rubrics when compared to other repertories.
E.g.: – Chill location of

  • Abdomen
  • Arms
  • Arm left
  • Back, in, or on the etc

Cause

  • Mechanical injuries from
  • Organic lesion

Whole febrile condition is divided in to four stages i.e. chill, heat, sweat and apyrexia. Each of these stages further subdivided into type, time, location of, cause etc. There by the selection of the rubrics become more accurate and easier.
General accompaniment of the fever are given separately- begins from symptoms of the mind and ends with constitutional and general. But in other repertories these symptoms has to be looked in regional chapters.
The book has got both materia medica part and repertory part so one can use it for easy reference.

Demerits:

  • Misplaced rubrics are many.
  • Repetition of same rubrics in different chapter with different medicines.
  • No definite pattern or order for the arrangement different chapters.
  • Limited number of medicines when compared to Murphy or other modern repertory.
  • Even though grading is given as bold, Italics and ordinary letters, there is no information about it s mark.
  • Rubrics are given in alphabetical order but in some places this order is not
  • Followed. Eg: – under the chapter “Chill- type” the rubric- “Fever, without chill, returning at” is given in wrong alphabetical order.
  • Under the section chill, there were two chapters with the same heading with entirely different rubrics. i.e. “symptoms during the chill” and “chill, symptoms during”
  • Under the section general accompaniment of the fever; symptoms of diarrhea, constipation, urine, voice, breathing, cough, heart, back, extremities, sleep, skin, sweat, tissues and constitutional and general are given under the heading “gastric” instead of given as separate chapters.
  • Abbreviations are given for the name of medicines. But no information about this abbreviations.
  • No introduction for repertory part

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