Management of acute fever by repertory of therapeutics of intermittent fever by HC Allen

Dr Uttara Agale¹ Dr DG Bagal²
Y.M.T.H.M.C Navi Mumbai 

Abstract
Acute fevers  of less than 7 days in duration are characteristics of infectious diseases such as malaria and viral-related upper respiratory tract infection while sub-acute fevers (usually not more than 2 weeks in duration) may be seen in cases of typhoid fever and intra-abdominal abscess, among others. Such cases are managed with homoeopathic medicines more appropriately as there are less chances of relapse. In this article a case is treated with homoeopathic medicines and the similimum is selected by using Repertory of Dr. H.C Allen’s Therapeutics of Intermittent Fever. The case  is effectively managed with the medicine and thus explains scope of the clinical repertory in these cases.

Preliminary data:

• Date: 10/08/ 2019
• Sex: Male
• Age: 16 years
• Occupation: Student
• Religion: Hindu
• Marital status: Unmarried

Chief complaints: Fever with chill since one day.

Patient started with fever with Body ache, Headache since one day. Fever is viral and aggravated evening ++ Fever has all three stages chills followed by Heat and sweat.  Chills. Along with fever there is irritability++ anxiety about disease++. Patient has weakness++ and malaise during fever.

History of chief complaint:

• Time : – Evening
• Prodrome : – Burning Heat, Sleepiness 
• Chill : – Without thirst, alternating with heat, ameliorated by external warmth
• Heat : – Heat over whole body, Thirst during heat
• Sweat : – Sweat all over body
• Concomitant :- Body ache, Headache, Generalised weakness

Past History: Eczema 7 years back.

Family History:Mother-DM

Personal History:

• Diet – Mixed
• Habit- Nothing Specific no change during complaints
• Addiction– Nothing Specific no change during complaints

Physical Generals:

• Appetite : Decreased due to chief complaints.
• Desires : Cold things
• Aversions : Nothing Specific no change during complaints
• Thirst : Thirsty ++
• Sleep : disturbed
• Dreams : Nothing Specific no change during complaints
• Stools : Once in a day
• Urine : 5 to 6 times / day
• Perspiration : Profuse all over body after heat stage. 

Thermal and general reaction: Chilly. Patient wants covering while sleeping.

Like summer. Do not want fan during fever.

Present Mental Characteristics: Patient comes with mother, Patient is irritable during complaints, Anxious. Yet Patient is neat and clean on appearance, no taking much.    

Vital Data
Temperature:   101⁰ F                                                   Pulse:      98/Min.
Respiratory rate:  12/Min.                                           Blood pressure: 110/80 mm of Hg

General Physical Examination:

• Pallor : Absent
• Clubbing: Absent
• Icterus :   Absent 
• Oedema :  Absent
• Cyanosis:  Absent
• Tongue: White Coated
• Lymph Nodes: Not Palpable

Systemic Examination:

• Respiratory system: Clear, AEBE
• Cardio vascular system: S₁ S₂ Heard
• P/A: Soft, No Scar, No Rash
• GUS: Nothing Specific
• C.N.S.: Conscious, Oriented 

Investigations: Advised Routine blood examination

Since in investigation nothing significant was detected as WBC count and Platelet count are normal.

Diagnosis: Pyrexia of Unkown origin

CASE PROCESSING

Phase of disease: Acute Phase

Diagnosis of the Miasm: Psora

Fundamental:   Psora

Dominant: Psora

Susceptibility: Moderate

Analysis of the case:

TIME	PRODROME	CHILL	HEAT	SWEAT	CONCOMITANTS
Evening	Thirst, Body ache	Chill Ameliorated by warmth	All over body	All over body	Irritability, Anxiety, Headache, Weakness

Evaluation:

1. Irritability with fever
2. Anxiety during heat stage of fever
3. Chills ameliorated  by covering
4. Body ache during fever
5. Weakness during  fever
6. Viral fever
7. Headache
8. Compound fever chills followed by heat followed by sweat
9. Thermally chilly

Repertory Selected:  As a febrile illness, a characteristic time modality and more concomitants associated with fever, The Therapeutics of Fever Repertory by H.C. Allen is selected for repertorisation.

Process of Repertorization: Total Addition Method

Repertorial Totality:

1. Time : Evening 
2. Chill Ameliorated By Warmth, External
3. Heat In  General
4. Sweat Location Of :  Body All Over
5. Symptoms Of The Mind : Anxiety
6. Symptoms Of The Mind : Irritable

Non Repertorial Totality

1. Thermallychilly
2. Tongue white coated
3. Thirsty

Probable remedies: Arsenic Album, Aconite, Bryonia, Gelsemium   

Reportorial Result:

• Aconite 10/5,
• Arsenicum Album15/6,
• Belladonna- 8/4,
• Bryonia-7/4,
• Rhus Tox-8/4,
• Silicea-8/4

Prescription: Arsenicum Album 200 (1 powder) stat.

Auxiliary mode of treatment:

1. 1. 1. 1. 1. Bed Rest
            2. Drink Plenty of liquids 
            3. Soft Diet

Follow-ups:

Date and time	Complaints	Remedy
12/08/2019	Chills with high grade fever+++ , Anxiety with ++ Irritability ++, Weakness++ , Body Ache, Headache , Weakness	Rx ARSENICUM ALBUM 200 (1 P) Stat COSMOS 4 Pills TDS
14/8/2019	Weakness++ , Headache, Fever ++, Anxiety + Mild Body ache, Irritability+	Rx ARSENICUM ALBUM 200 (1P) COSMOS 4 Pills TDS
16/8/2019	Weakness +, Chills  not present, Temp-990F Anxiety +, Mild headache, No body ache	Rx ARSENICUM ALBUM 200 (1P) STAT COSMOS 4 Pills TDS
18/8/2019	Afebrile, No weakness,No Anxiety, No irritability Appetite normal, No Headache	Rx COSMOS 4 pills TDS