Case report with very high fever (41.6° C)
In 1992 I was employed at the state-run homeopathic hospital in Mumbai (capacity: 30 beds) and treated a 25-year-old man who had been admitted on suspicion of typhoid.
He had been brought to the hospital by his neighbour because he had no relatives; both parents were dead. He earned his living with occasional jobs. At that time he was unemployed and had had fever and chills for ten days. His kind neighbour had seen that he was ill and brought him in for treatment. There was no one to look after him. He was dependent on the care of the hospital staff.
The patient spoke little, so for our prescription we had to rely mainly on our observations and encourage him as best we could to communicate.
He had had fever with chills every day for ten days. After each chill there was a hot spell that lasted until the patient finally fell asleep. During the chills and fever he also suffered severe frontal headaches. In addition he had limb pains, was apathetic and had to lie down. His chest ached on the right side and felt sore because of the cough. The cough got worse when he lay on the painful side.
Appetite: No appetite at all, he did not touch the food in the hospital. He did not even get up to eat when a nurse encouraged him.
Thirst: More during the fever; then he drank half a glass of water every hour because his mouth was so dry.
Mental state: He appeared dull and apathetic. He did not want to be disturbed or spoken to. He lay in bed all day and slept, without eating or talking to anyone. He asked for nothing and did not ask the doctors how they assessed his condition. Both parents were dead and the patient lived alone. We could see grief and sorrow in his eyes, but there was no sign that he had cried.
We suspected typhoid and had a Gruber-Widal test done, ordered a liver function test and did a full blood count to check the leukocytes (white blood cells).
Findings: Gruber-Widal test negative, liver function test normal, leukocytes 6300 (relative leukopenia), Hb 11.9 gm and ESR 60 mm.
Prescription: My colleague had admitted the case and thought either Bryonia or Gelsemium would fit. He chose Bryonia C200, a single dose on 12 November 1992.
Reaction on 13 November 1992:
The chills were unchanged and returned the next day in the same way. However, the patient had hardly any thirst left. His appetite had not improved and he still did not want to eat. He had severe headaches with fever, and the chest pain and tenderness were still present. On examination I could feel the spleen, but not the liver.
Because he was not improving, the nurse called me at midday and said it was urgent. At that time I spoke with the patient myself to see if I could find a better remedy for him. After about 45 minutes of persistent questioning he finally gave me a characteristic symptom: his chill began every day at 11 am and the fever with heat lasted until 4 pm. He was very lethargic and apathetic, felt dizzy and now had no thirst.
Rubric: Chill, morning, 11 am, 11–16: cact, gels (in Kent's Repertory)
Considering the other symptoms (low-grade fever, lethargy, dizziness, lack of thirst, sorrow, aversion to being disturbed, indifference to his illness, weakness, must lie in bed – in short: a certain lack of reactive power), Gelsemium seemed the better remedy. Phatak writes about Gelsemium:
General: General state of paresis, both physical and mental. Complete relaxation and prostration. Wishes to lie still or sit in a semi-recumbent position. Stupefaction, vertigo, drowsiness.
Mind and disposition: Apathetic. Wants to lie still, wants to be left alone. Indifferent about his illness. Answers only slowly. Catalepsy-like immobility, with dilated pupils and closed eyes but with clear consciousness. Follows grief, cannot weep, broods dully over their loss.
Stomach: Usually without thirst.
Remedy: Gelsemium 1M, a single dose on 13 November at 1 pm.
Reaction: The fever slowly rose from 40°C to 41.3°C and by 3 pm reached 41.8°C. At this critical moment I tried to understand why the fever had become so high and wondered whether I had done the right thing. Previously the patient had only had mild fever. My doctor colleagues and the nurses were putting a lot of pressure on me and saying that the fever must be lowered. It was a blessing that the patient had no family, otherwise I would have had to justify myself to them as well. I decided to wait a little longer and instructed the nurses to relieve the fever with cool compresses. I felt it was better to observe and really understand the processes than to desperately try to lower the fever and possibly spoil the case.
Gradually the fever fell to 39.6°C and then rose again to 40.5°C. At 5:30 pm it was 41°C. The cold compresses were continued and by 6:30 pm the fever had fallen to 39.8°C. The patient asked for water and drank a glass. He also ate some bread with butter and drank a cup of tea. The headaches, which had been very severe throughout the fever phase, had noticeably subsided. The dry mouth was also lessened.
- n
- November 1992:n
The chills had markedly decreased. His fever now only rose to 38.8°C at midday. His appetite improved, and he ate the meals given to him in the hospital. He had more thirst and drank water. His headaches were not as bad with the fever. He no longer had chest pain. He also did not feel so lethargic, weak and dizzy.
- n
- November 1992:n
The chill began at 11:30 am, but only very mildly and there was no fever. The patient eats and drinks. He had a lascivious dream and did not sleep well. He was still coughing slightly but felt mentally and physically better. He no longer lay in bed dazed all the time. He talks with other patients and even goes into the hospital garden now and then. He does not feel so weak anymore.
- n
- November 1992:n
No chills and no fever. Appetite and thirst are back to normal. Weakness, dizziness and apathy are gone. The patient sleeps better and no longer coughs. All laboratory findings are normal. We were able to discharge him a few days later.
Follow-up:
I no longer work at the hospital, but I saw the patient a total of three more times. I did not recognise him because there was no sorrow or grief in his eyes, but he remembered me. He had found work and was very grateful for the hospital treatment. I last met him at a small tea stall near the hospital. He was beaming and in good spirits. He thanked me again. I saw no sadness.
For me it was a very satisfying experience. It was wonderful to see his enthusiasm, his smile, as he managed his life without support.
His case was one of deficient reactive power: low-grade fever, no appetite, no thirst, no sweating, dizziness, weakness and apathy. We gave him the right remedy and thereby produced a reaction: very high fever (41.8°C), markedly improved appetite, more thirst and other symptoms associated with fever.
As physicians we have the duty not to disturb the body's self-healing powers. We should only intervene if the healing process stalls and then help it along with one dose of Gelsemium.
This patient required only a single dose.
Dr Manish R. Panchal
Dr Phalguni (my wife)
Category: Remedy
Keywords: Gelsemium, typhoid, weak, lethargic, self-healing powers
------------------------------------------------------------------------------------------------------------------------------------
Source: http://www.interhomeopathy.org/gelsemium_very_high_fever_in_hospital
Photo: Shutterstock_1431754331 Copyright: fiz_zero
Photo: Shutterstock_1483258463 Copyright: juliaap
------------------------------------------------------------------------------------------------------------------------------------
