Utility of Fever Chapter in Boenninghausen’s Characteristics Repertory by CM Boger

Fever is defined as a temperature 1˚ or more above the normal 98.6˚ Fahrenheit (F) or 37˚ Celsius (C).

Average day time temperature for each location.

Location Average temperature Fever temperature
Anus, vagina, ear 37.6˚  (99.6˚ F) 38 ˚ C (100.4˚ F)
Mouth 36.8˚ C (98.2˚ F) 37.5˚C (99.5˚F)
Armpit 36.4˚ C(97.6˚ F) 37.2˚ C (99˚ F)

Causes

  • Infections and infectious diseases such as influenza, common cold, HIV, malaria, infectious mononucleosis and gastroenteritis. Infections are the most common cause of fever.
  • Medicines like antibiotics , narcotics , barbiturates and antihistamines.
  • Trauma or injury such as heart attack , stroke, heatstroke, heat exhaustion or burns.
  • Damage to tissues from hemolysis, surgery, crush syndrome and haemorrhage.
  • Other medical conditions such as skin inflammation, arthritis , hyperthyroidism, cancers, lupus, inflammatory bowel disease, metabolic disorders, gout and embolisms.
  • Fever that exist for days or weeks with no explanation are called fevers of undetermined origin (FUO)

Treatment
Not all fevers require treatment. Fever indicates that there is something wrong in the body and is used to gauge the success of medical treatments. Fever may also be useful as it increase the amount of antiviral and anticancer interferon in the blood making it difficult for bacteria and viruses to replicate.Fever patients should remain hydrated since fever often increase discomfort and increase heart rate and metabolism.

Fever totality is the unique contribution of Boger. The arrangement of the chapter on fever is self explanatory. For the practical point of view , this chapter is of immense use. It has many subrubrics also. Concomitant in relation to chill, heat, sweat under different headings are really valuable at bedside practice. Each stage of fever is followed by Time, Aggravation, Amelioration and concomitants. Thus they help to repertorize any simple as well as complicated cases of fever. This is one of the best repertories for fever cases. They should be arranged properly in order to get similimum with the help of Bogers repertory.

The arrangement of fever chapter is as follows :

FEVER

  • Pathological types
  • Blood
  • Circulation
  • Congestions
  • Palpitation
  • Time
  • Heart beat
  • Pulse
  • Time
  • Aggravation

CHILL

  • Partial chill
  • Coldness
  • Partial coldness
  • Shivering
  • Time
  • Aggravation
  • Amelioration

Concomitants

  • Mind
  • Head
  • External head
  • Eyes
  • Vision
  • Ears
  • Nose
  • Coryza
  • Face
  • Lips
  • Teeth
  • Mouth & throat
  • Appetite
  • Thirst
  • Taste
  • Erectation,Nausea,Qualmishness and vomiting
  • Stomach Hypochondria, Abdomen
  • Stool
  • Urine
  • Respiration
  • Cough
  • Larynx
  • External throat &neck
  • Chest
  • Back & Lumbar region
  • Upper extremities
  • Lower extremities
  • Skin
  • Sleep

HEAT & FEVER IN GENERAL

  • Partial heat
  • Time
  • Aggravation
  • Amelioration
  • Concomitants
  • Head
  • External head
  • Eyes
  • Ears
  • Nose
  • Coryza
  • Face
  • Lips
  • Lower jaw
  • Teeth &gums
  • Mouth
  • Throat
  • Appetite
  • Thirst
  • Taste
  • Erectations & waterbrash
  • Nausea &vomiting
  • Stomach
  • Hypochondria
  • Abdomen
  • Flatus
  • Stool
  • Urine
  • Respiration
  • Cough
  • Larynx
  • External throat & neck
  • Chest
  • Back
  • Upper extremities
  • Lower extremities
  • Sensations & generalities
  • Glands
  • Bones
  • Skin
  • Sleep

SWEAT

  • Partial sweat
  • Time
  • Aggravation
  • Amelioration
  • Concomitants
  • Mind
  • Head
  • Eyes
  • Ears
  • Nose
  • Coryza
  • Face
  • Lips
  • Lower jaw
  • Teeth & gums
  • Mouth
  • Throat
  • Appetite
  • Thirst
  • Taste
  • Erectations & waterbrash
  • Nausea & vomiting
  • Stomach
  • Hypochondria
  • Abdomen
  • Stool
  • Urine
  • Respiration
  • Cough
  • Larynx
  • External throat & neck
  • Chest
  • Back
  • Upper extremities
  • Lower extremities
  • Sensations & generalities
  • Glands
  • Skin
  • Bones
  • Sleep

COMPOUND FEVERS

  • Beginning with  chill
  • Beginning with  shivering
  • Beginning with  heat
  • Beginning with sweat

Arrangement of rubric under each subdivisions

FEVER

Pathological types

Adynamic  ( relating to weakness, vital debility, asthenia )  Fer p , Gel

Bilious : ACO, BELL, BRY,CHAM,COLO,NUX,PLAT, STAP

Catarrhal : inflammation of a mucous membrane, especially in the nose and throat, causing an increase in the production of mucus : BRY, CHAM, NUX

Dentition : ACO,CAL-C, CHAM

Gastric: relating to, involving, or near the stomach  :ANT-C, BRY, NUX, PUL

Hectic: symptomatic of or involving a recurrent afternoon fever, especially one accompanying tuberculosis : ARS,CALC C, IOD, KALI C, LYC, PHO,PUL,SUL 

Infectious grippal, exanthematous typhus: disease that is capable of being passed from one person to another : BAP,EUP P

 Intermittent

  • Yearly
  • Hour at same
  • Alternate days : CHIN
  • Quotidian :fever, especially malaria, in which attacks of the illness recur
  • daily –ARAN, ARS,CAPS,NUX V, PUL
  • Tertian: fever, with symptoms that appear every other day –CANTH,
  • NUX V, PUL
  • Quartan: fever that recurs every fourth day-ARS, LYCO, PUL, SABA

Measles: a very contagious acute viral disease with symptoms that include a high temperature, sore throat, and a bright red rash of small spots that spread to cover the whole body -ACO, PUL

Milk fever: (lactation)- CALC C, PUL ,SEP

Puerperal: blood poisoning following childbirth, caused by infection of the placental site-ACO, BELL, BRY, CHAM, NUX V, PUL, RHUS T

Putrid: giving off a foul smell  : BRY, RHUS-T

Quinine (abuse of ): ARN,ARS, CARB V ,FER, NAT M, PUL

Rheumatic : an acute infectious disease that causes a sore throat, fever, pain, swelling in the joints, and often damage to the heart valves. It affects children particularly. ACO, BELL, BRY, CHAM, RHUS –T

Scarlet : a contagious bacterial infection marked by fever, a sore throat, and a red rash, mainly affecting children. Technical name scarlatina  AM-C, BELL

Septic: relating to, involving, or causing sepsis –lach ,pyro

Small-pox

Sudoral fever, febris helodes (relating to sweat)-ARS, SAMB

Thermic : having to do with heat- ACO, ANT C, BRY, KALI C, THU

Traumatic: relating to wounds or injuries -ARN

Typhoid

  • Slow type
  • Pituitous (thick mucous secretion)

Typhus: an infectious disease that causes fever, severe headaches, a rash, and often delirium. It is spread by ticks and fleas carried by rodents.-BRY, RHUS T

Worm fever: ACO, CINA, SABA, SIL, SUL

Yellow fever: an infectious, often fatal viral disease of warm climates, transmitted by mosquitoes and marked by high fever, hemorrhaging, vomiting of blood, liver damage, and jaundice –ARS, BELL, LACH, NUX V

26 types of fevers with medicines & one type with cross reference (periodicity ,see intermittent)

BLOOD
Acrid, black, bright, clotted, slowly, dark, gushing, hot, offensive, septic, stagnated, stringy, thick, thin, thrombi, veins.

CIRCULATION

Blood vessels, aneurisms

  • Bluish
  • Bubbling
  • Burning
  • Bursting as if
  • Cold feeling
  • Like ice water
  • Inflamed, phlebitis
  • Reticulated, netted (mottled skin )
  • Varicose

   CONGESTIONS

  • Single parts
  • To head
  • Eyes
  • Anaemia
  • Ebullitions, surging or rush of blood, flashing, orgasms
  • Plethora
  • Stagnated feeling

  PALPITATION

  • Anaemia
  • Anxiety without
  • Ascending : Thu
  • Audible: Thu
  • Breathing short with: AUR,PUL,SPI
  • Climacteric during
  • Coition from
  • Cough with
  • Emotion from: PUL
  • Excitement from
  • Faintness with
  • Goitre with

Lying

  • Back on
  • Side on
  • Down on
  • Left <
  • Right <
    • >

Menses before

  • During
  • After
  • Music hearing
  • Painful
  • Rheumatic metastasis from
  • Shaking whole body
  • Siesta after
  • Sitting <

                                                        Time

Morning, Forenoon, Evening, Night

Heart beat

  • Audible: ANG,IOD,SABA,SUL
  • Ceasing: Dig
  • Fluttering: Nat m
  • Heavy:Lycps
  • Imperceptable: Ver a
  • Shaking: whole body: nat m
  • Tremulous: ANT T, ARS, CALC C, PLAT, SPI
  • Tumultuous:agar,calc c,kalm,plb
  • Twitching: nux v
  • Vigorous:Aur,dig,iod, nux v, spi
  • Visible: PUL, SPI

PULSE

  • Abnormal
  • Audible: Dig , Thu
  • Double:
  • Full:ACO,ALU,ANT T,BELL
  • Imperceptable: ARS, CAM, CAN, CARB V, CUP,RHUS T,VER A
  • Intermittent
  • 3rd beat :mur acid
  • 4th beat : NIT-AC
  • 4th -5th beat : Nux –v
  • Irregular
  • Jerky: Arn
  • Quick
  • Slow:AG C, CAM,CON, CUP,
  • Alternating with quick pulse: Bell,rhus t
  • Suppressed on
  • One side: Led,op
  • Thready: VER A
  • Unequal: AGAR, ASAF, CANTH, CARB V, CHAM, KALI C, LACH, LAU
  • Vibrating: Sang
  • Weak: AG C, ARS, BARY C, CAM, CAN

TIME

Morning, Forenoon, afternoon, Evening, Night, Midnight

AGGRVATION

CHILL

  • Anticipating : Nux
  • Ascending
  • With gooseskin
  • Nervous
  • Repeated
  • Shaking
  • With shivering
  • Single parts
  • Unilateral
  • As if dashed with cold water
  • As if standing in cold water: Gel
  • Chilliness in general lack of vital heat
  • Cold sensitiveness to (Chilled easily, lack of vital heat)

 PARTIAL CHILL

  • Upper parts of the body
  • On abdomen
  • Proceeding from

COLDNESS

Single parts

PARTIAL COLDNESS

  • Tip of fingers: Men
  • Spots: ars
  • Head: CALC C , RHUS T
  • Tongue: VER A
  • Lower extremities
  • One with heat of other: carb v, rhus t

  SHIVERING

  • Gooseflesh with: cam, caus
  • Partial: BELL, STAP, VER A

TIME

  • Returning at same hour: BOV, CED, SABA, SPI
  • 2 AM :    KALI- C
  • 3AM :   Thuj
  • 11 AM: Gel
  • Every 14 days: ars , chin
  • Every year : ars, lach
  • 4 PM : pul
  • 7PM : Rhus t

AGGREVATION

  • Epileptic attack after : CUP
  • Fright, fear after: GEL
  • Pains during: BOV, COLO,DUL, KALI BI, MEZ, PUL,
  • Sleep during : BOR
  • Speaking of unpleasant subjects : calc c, mar
  • Toothache during: pul
  • Uncovering: AGAR, CHAM, CLEM, NUX M, NUX V, SCIL
  • Vertigo with: Chel
  • Warmth of stove : COCL, IP, MEZ,PUL

Pathological types of fever mentioned in the repertory can be used for reference and final selection of the drug,   but more importance should be given to the reportorial result which is obtained by following the above order.  Section blood circulation   should be used if symptoms are prominent during any of the stages of fever. Thus it is the unique chapter in Boger repertory . No other repertory can replace it.

REFERENCE :
Boenninghausen’s characteristics and repertory by Boger
Essentials of repertorization : Dr Tiwari

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