Homoeopathic management of fever using Homoeopathic Medical Repertory of Dr Robin Murphy
Dr Amrutha R BHMS MD(Hom)
Fever (also known as pyrexia, from the Greek pyretos meaning fire, or a febrile response, from the Latin word febris, meaning fever, and archaically known as ague) is a frequent sign that describes an increase in internal body temperature to levels above normal. Fever is most accurately characterized as a temporary elevation in the body’s thermoregulatory set-point, usually by about 1–2 °C (1.8-3.6 °F)
Fever is caused by an elevation in the thermoregulatory set-point, causing typical body temperature (generally and problematically considered to be 37 °C ±1 °C, or approximately 99 ±2 °F; see below for specifics) to rise, and effect or mechanisms are enacted as a result. A feverish individual has a general feeling of cold despite an increased body temperature, and increases in heart rate, muscle tone and shivering, all of which are caused by the body’s attempts to counteract the newly-perceived hypothermia and reach the new thermoregulatory set-point.
Fever differs from hyperthermia in that hyperthermia is an increase in body temperature over the body’s thermoregulatory set-point, due to excessive heat production or insufficient thermoregulation, or both.
A fever is considered one of the body’s immune mechanisms to attempt a neutralization of a perceived threat inside the body, be it bacterial or viral. Carl Wunderlich discovered that fever is not a disease, but the body’s response to a disease.
Types – Fever classification
| Grade | °C | °F |
| low grade | 38–39 | 100.4–102.2 |
| Moderate | 39–40 | 102.2–104.0 |
| high-grade | 40–41.1 | 104.0–106.0 |
| Hyperpyrexia | >41.1 | >106.0 |
The last is a medical emergency because it approaches the upper limit compatible with human life. In most of the time, fever types can not be used to find the underlying cause. However, there are specific fever patterns that may occasionally hint the diagnosis:
Pel-Ebstein fever: A specific kind of fever associated with Hodgkin’s lymphoma, being high for one week and low for the next week and so on.
Continuous fever: Temperature remains above normal throughout the day and does not fluctuate more than 1 °C in 24 hours, e.g. lobar pneumonia, typhoid, urinary tract infection, brucellosis, or typhus.
Intermittent fever: Elevated temperature is present only for some hours of the day and becomes normal for remaining hours, e.g. malaria, kala-azar, pyaemia, or septicemia. In malaria, there may be a fever with a periodicity of 24 hours (quotidian), 48 hours (tertian fever), or 72 hours (quartan fever, indicating Plasmodium malariae). These patterns may be less clear in travelers.
Remittent fever: Temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours, e.g. infective endocarditis.
A neutropenic fever, also called febrile neutropenia, is a fever in the absence of normal immune system function. Because of the lack of infection-fighting neutrophils, a bacterial infection can spread rapidly and this fever is therefore usually considered a medical emergency. This kind of fever is more commonly seen in people receiving immune-suppressing chemotherapy than in apparently healthy people.
Fever is a common symptom of many medical conditions:
Causes:
- Infectious disease, e.g. influenza, common cold, HIV, malaria, infectious mononucleosis, or gastroenteritis
- Various skin inflammations, e.g. boils, pimples, acne, or abscess
- Immunological diseases, e.g. lupus erythematosus, sarcoidosis, inflammatory bowel diseases
- Tissue destruction, which can occur in hemolysis, surgery, infarction, crush syndrome, rhabdomyolysis, cerebral hemorrhage, etc.
- Drug fever : Directly caused by the drug, e.g. lamictal, progesterone, or chemotherapeutics causing tumor necrosis
- Reaction to incompatible blood products
- Cancers, most commonly renal cancer and leukemia and lymphomas
- Metabolic disorders, e.g. gout or porphyria
- Thrombo-embolic processes, e.g. pulmonary embolism or deep venous thrombosis
- Persistent fever which cannot be explained after repeated routine clinical inquiries is called fever of unknown origin.
‘Fevers’ is the 25th chapter in homoeopathic medical repertory( third revised edition).
This chapter begins with the rubric fever remedies in general and ends with the rubric zymotic fever. The total number of rubrics in this chapter is 148. Rubrics on various types of fevers, stages of fever along with modalities and accompaniments can be found in this chapter.
INFECTIOUS DISEASES:
- AFRICAN fever – TER
- AIDS: Is a disease caused by a virus transmitted in body fluids, in which there is severe loss of cellular immunity that leaves the sufferer susceptible to infection and malignancy.
- AIDS acquired, immune deficiency syndrome – ARS, carc, echi, ferr-p, gels, MED, MERC, phos, syph, THUJ, tub
- BACTERIAL, infections – ars, pyrog, thuj
- BUBONIC PLAGUE, infection, (see Clinical,chapter)
- CATARRHAL FEVER: An archaic term for common cold. Catarrhal means increasing flow of mucous.
- CATARRHAL, fever – ACON, apis, ars, asc-c, asc-t, bad, BELL, BRY, cact, con, cupr-m, dros, dulc, eug, gels, ferr-p, HEP, kali-c, kali-i, MERC, nux-v, puls, rhus-t, sabad, spig
- CEREBROSPINAL FEVER(meningococcal meningitis): Is an acute infectious disease affecting children and young adults, caused by neisseria meningitidis; characterised by nasopharyngeal catarrh, headache, vomiting, convulsions, stiffness in the neck (nuchal rigidity), photophobia, constipation, cutaneous hyperesthesia, a purpuric or herpetic eruption, and the presence of Kernig’s sign.
- CEREBRO-spinal, fever – APIS,arg-n, BELL, cic, cimic, GELS, ign, nat-m, NAT-S, nux-v, OP, phos, rhus-t, VERAT-V, zinc
- CHICKENPOX: Is a highly contagious illness caused by primary infection with varicella zoster virus (VZV).Is an acute infectious disease marked by an eruption of non- scarring vesicles. There is usually a slight fever which lasts from a few days to a week.
- CHICKENPOX, infection – ANT-C, ant-t, bell, carb-v, led, merc, PULS, RHUS-T, sep, SULPH, thuj
- CHLAMYDIAL INFECTION: Chlamedia causes wide variety of disease in man and animals.eg: trachoma, proctitis, inclusion conjunctivitis, non-specific urethritis, ornithosis and LGV etc
- CHLAMYDIAL, infection med, sulph, thuj
- CHOLERA, infection, (see Clinical,chapter)
- DENGUE FEVER : Is a acute febrile diseases, found in the tropics, and caused by four closely related virus serotypes of the genus Flavivirus, family Flaviviridae. It is also known as breakbone fever. Dengue is transmitted to humans by the Aedes aegypti or more rarely the Aedes albopictus mosquito, which feed during the day. The disease manifests as a sudden onset of severe headache, muscle and joint pains (myalgias and arthralgias—severe pain that gives it the nick-name break-bone fever or bonecrusher disease, fever and rash.
- DENGUE, fever – acon, bry, EUP-PER, rhus-t,
- DIPHTHERIA, infection, (see Clinical,chapter)
- ENCEPHALITIS: (brain fever, cephalitis): an acute inflammatory disease of the brain due to direct attack by a virus or hypersensitivity initiated by a viral infection. Symptoms include apathy, double vision, extreme muscular weakness, headache, drowsiness or convulsions, and perhaps neck rigidity. ENCEPHALITIS, brain – acon, BELL, bry, camph, con, cupr, cupr-ar, hell, hyos, merc, op, phos, sil, tub
- GONORRHEA: a specific infectious inflammation of the mucous membrane of the urethra and adjacent cavities, due to neisseria gonorhheae. It is characterized by pain, burning urination, a profuse muco-purulent discharge, and may be accompanied by complications such as prostatitis , periurethral abscess, epididymitis, cystitis, purulent conjunctivitis. It may also cause arthritis, endocarditis and salpingitis. GONORRHEA, (see Diseases, chapter)
- HECTIC FEVER: Is a fever of irritation and debility, occurring usually at the advanced stage of exhausting disease, as a in pulmonary consumption.
- HECTIC fever – ACET-AC, ARS, ARS-I, CALC, CAPS, IOD, KALI-AR, LYC, PHOS, SANG, SEP, SIL, TUB
- INFLUENZA(epidemic catarrh, epidemic catarrhal fever, grippe, epidemisches scnupfenfiber ): an epidemic, often pandemic disease characterized by inflammation of the mucous membrane of the respiratory tract, runny nose , mucopurulent discharge, fever, pain in the muscles and prostration.
- INFLUENZA, infection – ARS, BAPT, BRY, EUP-PER, GELS, PHOS, RHUS-T
- MARSH FEVER: an intermittent fever of persons residing in marshy areas and attended with alternating cold and hot fits or spells.
- MARSH fever – ARS, CHIN, IP, NAT-M
- MEASLES (morbili, rubeola): a disease which begins with coryza, cough, conjunctivitis and spots in the mouth (Koplik’s spots). A few days later chills , fever and a red maculopapular rash appears first on the face or behind the ears. Three days later eruption fades and is followed by a branny desquamation.
- MEASLES – ACON, APIS, BRY, EUPHR, MORBILL, PULS, SULPH
- MEASLES, ailments after – CAMPH, CARB-V, MORBILL, PULS
- MUMPS (epidemic parotitis, parotiditis): inflammation of the parotid gland. It is charecterised by the swelling of the parotid and salivary glands. MUMPS, infection – BAR-C, BELL, CARB-V, CIST, JAB, MERC, PULS
- PUERPERAL FEVER (childbed fever, puerperal sepsis): septicemia occurring within 3 weeks after abortion or childbirth. Symptoms include chills, abdominal tenderness and pain, rapid pulse and respiration, and fever.
- PUERPERAL, fever – ARS, BELL, BRY, CROT-H, VERAT-V
- PYEMIA: presence of pus in the blood, which is associated with fever and possibly septicemia.
- PYEMIA – ANTHR, ars, calc, crot-h, hippoz, LACH, PYROG
- RABIES, hydrophobia (see Generals)
- RHEUMATIC FEVER: is an inflammatory disease that occurs in children and young adults as a result of infection with group A streptococci.
- RHEUMATIC, fever – AUR, BELL, BRY, CALC-P, CAUST, COLCH, FERR-P, FORM, IOD, KALI-BI, KALM, LYC, RHUS-T, SPIG
- SCARLET FEVER ( scarlatina): an acute contagious disease commencing with vomiting or chill, followed by a high fever, rapid pulse, sore throat, swollen neck glands and the appearace of a red rash. The rash lasts for 5- 6 days. The tongue looks red like a strawberry. The kidneys are often involved. It is caused by hemolytic streptococci.
- SCARLET, fever – AIL, AM-C, APIS, BELL, ECHI, LACH, LYC, MERC, NIT-AC, RHUS-T, TER
- SCARLET, fever, ailments after – AM-C, AM-M, BELL, CHAM
- SEPTIC FEVER: is fever associated with infection either as local abscess or cellulitis or as a septicemia or bacteremia. The infective agent may be a bacteria, virus, fungus, protozoa or even algae.
- SEPTIC, fever – ANTHR, ARN, ARS, BAPT, BRY, CROT-C, CROT-H, ECHI, KALI-P, LACH, LYC, MUR-AC, PHOS, PYROG, SULPH, TARENT-C
- SMALLPOX, infection, (see Clinical,chapter)
- SPOTTED FEVER (cerebrospinal meningitis, tick fever): a malignant epidemic fever , with lesions of the cerebral or spinal membrane.
- SPOTTED, fever – CIMIC, dig, eup-per, sil,
- STAPHYLOCOCCUS, infections – (see Clinical,chapter)
- STREPTOCOCCUS, infections – (see Clinical,chapter)
- TROPICAL, fever – CEDR, chin, gels, PSOR, ter
- TUBERCULOSIS , infection, (see Clinical,chapter)
- TYPHOID FEVER (ship fever, enteric fever, putrid fever): a systemic infectious disease carried by salmonella typhi, which enters the body via food & water and lodges in the spleen and intestine. The principal lesions are enlarged spleen and mesenteric lymph nodes. The intestinal mucous membrane is also affected by a catarrhal inflammation.
- TYPHOID, fever- AGAR, APIS, ARN, ARS, ARUM-T, BAPT, BELL, BRY, CALC, CARB-V, CHIN, CHLOR, COLCH, CROT-H, ECHI, FERR, GELS, HYOS, LACH, LYC, MERC-CY, MUR-AC, NIT-AC, OP, PHOS, PH-AC, RHUS-T, STRAM, SULPH, TER, VALER, VERAT, ZINC,
- VIRAL, infections – carc, GELS
- WORMS, from – CINA, indg, ip, merc, sabad, spig, sulph
- YELLOW FEVER: is a tropical viral disease transmitted by mosquitoes, which affect the liver and kidneys causing fever and jaundice, and is often fatal.
- YELLOW, fever – ARS, CADM-S, CANTH, CARB-V, CROT-H, LACH, MERC
- ZYMOTIC FEVER: zymotic relating to fermentation. Is an obsolete term in medicine, formerly applied to the class of acute infectious maladies, presumed to be due to some virus or organism which acts in the system like a ferment.
- ZYMOTIC, fever – ARN, ARS, BAPT, BRY, CARBN-S, CROT-H, ECHI, KALI-P, LACH, LYC, , MUR-AC, PYROG, RHUS-T,SULPH,
DIFFERENT TYPES OF FEVER
CONTINOUS FEVER: Temperature remains above normal throughout the day and does not fluctuate more than 1 °C in 24 hours, e.g. lobar pneumonia, typhoid, urinary tract infection, brucellosis, or typhus.
CONTINUED fever (see Typhoid)
HIGH, fever – ACON, ARN, ARS, BAPT, BELL, CARC, CON, GELS,MEZ, NAT-M, , PULS, PYROG, RHUS-T, SEC
Intermittent fever: Elevated temperature is present only for some hours of the day and becomes normal for remaining hours, e.g. malaria, kala-azar, pyaemia, or septicemia. In malaria, there may be a fever with a periodicity of 24 hours (quotidian), 48 hours (tertian fever), or 72 hours (quartan fever, indicating Plasmodium malariae). These patterns may be less clear in travelers.
INTERMITTENT fever , ague,malaria – ARS, CALC, CHIN, FERR, KALI-S, LYC, NAT-M, NAT-S, NIT-AC, PSOR, PYROG, SULPH, TARENT, TUB
- apoplectic – NUX-V
- back, pain in small of – LACH
- cachectic persons – CALC, hydr
- dropsy, with – AUR-M
INTERMITTENT fever , ague,malaria –
- after suppressed – CALC
- liver, complaints, after – LACH
- liver, complaints, after enlarged, with – NIT-AC
- malarial – ARN, CHIN
- marsh fever – ARS, CHIN, IP, NAT-M
- marshy regions in warm seasons and tropical countries – CEDR
- menses, after – NUX-V
- monthly attacks – NUX-V
- paralysis follows – RHUS-T
- prosopalgia, suppressed by quinine – STANN
- quinine, after abuse of – CALC, CHIN, CHIN-S, IP, PULS
- quartan, fever – BUFO, CIMX, NUX-V,
- quotidian, fever – ARS
- spleen, enlargement of – CEAN
- tertian, fever – ANT-C, EUP-PER, NUX-V
- quotidian 11 a.m. – CACT
- quotidian hour, at same – cact, CEDR, aran
- quotidian scrofula, profuse saliva with, chronic – CALC
- fever relapsing, fever quinine, after – ARS
- fever spoiled – calc, ferr, ip, SEP, tarent
- stages distinct – CHIN, CHIN-S, petros
- stomach, derangement of – CACT
- water, working in cold – CALC
- IRREGULAR , stages, fever – ARS., BRY., NUX-V
LOW, fever – ARS, BAPT
RELAPSING FEVER : Any of a group of infectious diseases due to various species of Borrelia, marked by alternating periods of fever and apyrexia, each lasting from five to seven days.
RELAPSING, fever – CALC, FERR, PSOR, SULPH
Remittent fever: Temperature remains above normal throughout the day and fluctuates more than 1 °C in 24 hours, e.g. infective endocarditis.
REMITTENT, fever – ACON, ARS, BELL, BRY, CHAM, MERC
STAGES OF FEVER
STAGES, chill followed by heat – ACON, CAPS, CYCL, HYOS, IOD, IGN, IP, LYC, NAT-M, NUX-V, PULS, RHUS-T, SANG, SULPH
- then sweat – ARS, CHIN, IP, NUX-V, PULS
- chill, then sweat, without intervening heat – CAPS, CAUST, LYC, MEZ, PETR, THUJ
- heat, followed by chill – CALC, NUX-V, PULS, SEP, STANN
COMPARISON OF THE RUBRICS:
| MURPHY’S REPERTORY | BOGER’S REPERTORY | KENT’S REPERTORY |
| Bilious fever | Fever – Pathological types- BILIOUS fever | – |
| Bubonic plague | Inguinal & pubic region- Buboes | Abdomen- Bubo |
| Candida albicans | Sensation and complaints in general – fungoid growth | |
| Catarrhal fever | Fever – Pathological types- Catarrhal fever | Fever- Catarrhal fever |
| Cerebrospinal fever | Fever- Cerebrospinal fever | |
| Chickenpox, infection | Skin & exterior body- Chickenpox | Skin – eruption- Chickenpox |
| Cholera infection | Stool – Rice water like | Rectum – cholera |
| Cow pox vaccinia | Back – eruption – cervical region – cowpox like | |
| Diphtheria | Throat & gullet – DiphtheriaLarynx & trachea – Diphtheria | Throat – membrane – exudation, diphtheria |
| Encephalitis | Head- inflammation – Encephalitis | Head- inflammation of brain |
| Erysipelas with | Head – erysipelasSkin & exterior body- erysipelas | Head – erysipelasFace – erysipelas
Skin- erysipelas |
| Exanthematic ,fevers(see measles, scarlet fever ) | Fever – Pathological types- infectious ,grippal, exanthematous | Fever – exanthematic fevers ,measles |
| Gastric fever | Fever – Pathological types-Gastric fever | Fever- Gastric fever |
| Gonorrhea | Genitalia- male organs – gonorrhea | Urethra – discharge gonorrheal |
| Hectic fever | Fever – Pathological types-Hectic fever | Fever – Hectic fever |
| Influenza | Sensation and complaints in general – influenza | |
| Intermittent fever | Fever – Pathological types- Intermittent fever | Fever – Intermittent fever |
| Malaria | Fever – chill – shaking (ague) | Fever- chill – exposure after – malarial |
| Measles | Skin & exterior body- measles | Fever – exanthematic fevers, measles |
| Meningitis | Head – inflammation – meningitis | Head – inflammation – meninges |
| Plague | Sensation and complaints in general –plague | Abdomen – bubo |
| Puerperal fever | Fever – Pathological types- Puerperal fever | Fever- Puerperal fever |
| Rabies | Sensation and complaints in general- hydrophobia | Mind – hydrophobia |
| Rheumatic fever | Fever – Pathological types- Rheumatic fever | |
| Scarlet fever | Fever – Pathological types-Scarlet fever | |
| Septic fever | Fever – Pathological types-Septic fever | Fever – Septic |
| Small pox infection | Fever – Pathological types- small pox | Skin – eruptions – small pox |
| Typhoid fever | Fever – Pathological types- Typhoid fever | Fever – continued fever |
| Worm fever | Fever – Pathological types- worm fever | |
| Yellow fever | Fever – Pathological types- Yellow fever | Fever – Yellow fever |
| Zymotic fever | Fever – Zymotic fever |
Guide lines for taking a case of fever is equally important