2007 February

Gelsemium; Very high fever in Hospital

by Dr.Manish Panchal +Dr. Phalguni
Case of a very high fever (107 degree Fahrenheit):

In 1992 during my house-post in a government homeopathic hospital in Mumbai ( 30 bed hospital ), I saw a 25 yr old boy suspected of suffering from typhoid ( enteric) fever.

He was admitted to our hospital by his neighbour because he had no one of his own , both of his parents were dead. He was doing jobs here and there to earn his living. At present he was jobless and he has had a fever with chills for the last 10 days. His kind neighbour saw he was sick and brought him to our hospital for treatment. There was no one to take care of him except the resident house-physicians.

The patient spoke little, so we could prescribe for him only by observing him closely and encouraging him as much as possible to communicate with us about his illness.

He had a fever with chills everyday for 10 days. The chill is followed by heat which remains till he eventually falls asleep. Absolutely no sweat . Also he had a severe headache(forehead) during the chill and heat. There were body-aches, languor, feels tired and he wants to lie down. He has pain and tenderness in his chest (right) due to coughing which is worse lying on the painful side.


Appetite: No desire to eat at all. He never ate any food provided in hospital. He would not even get up from his bed even when hospital attendant would remind him to eat.

Thirst :  Increased during fever, he would take half a glass of water every hour due to dryness of his mouth.

Mind :   He was appearing very dull and apathetic. He never liked to be disturbed or spoken to. The whole day he would just lie down in bed and sleep without eating or talking with anyone. He never asked for anything or inquired with the physician about his health and recovery. Both his parents had died and he was living alone now. We could see the sadness and grief in his eyes, but never saw him weeping at anytime.


We suspected enteric fever and advised Widal test, WBC count (for leucopenia) and a liver function test.

Reports: Widal test negative, LFT normal values, WBC 6300 (relatively leucopenia), Hb 11.9gm% and ESR 60 mm.

Remedy: My colleague resident doctor had taken the case and he felt Bryonia and Gelsemium were the two remedies which matched his case.
He selected Bryonia 200, a single dose on the 12th November 1992.



Response (13th November 1992):

There was no change in the paroxysm of chill, it returned again the next day unchanged. His thirst had now decreased, he was almost thirstless now. There was no improvement in his appetite, still no desire to eat anything. He had a severe headache with fever and the pain and tenderness in his chest was still persisting. On examination his spleen was slightly palpable, his liver was not palpable.

Since he was not better I got a call from the nurse at noon to see him immediately. It was during this time I personally spoke with him to inquire if I could get any information to prescribe a better remedy for him. After probing him for 45 minutes I finally got one characteristic symptom, his chills started every day at 11 a.m and the paroxysm with heat lasted till 4 p.m. He was very dull and apathetic, feeling very drowsy and now thirstless.


Rubric: Chill, time 11 a.m to 4 p.m - cactus, gelsemium (kent’s Rep.)

Looking at the other features of the case (low grade fever, dullness, drowsiness, thirstless, grief, aversion to being disturbed, indifference to his illness, weakness with lying in bed. In short, a state of lack of reaction.) Gelsemium seems to be better suited. Phatak materia medica describes gelsemium as :

Generalities: General state of paresis, bodily and mentally. Complete relaxation and prostration, wants to lie down quietly ; half reclined. Dullness ; dizziness, drowsiness.

Mind :   Apathetic. Desire to be quiet or left alone. Indifferent regarding his illness. Answers slowly. Cataleptic immobility with dilated pupils, closed eyes, but conscious. Effects of grief , cannot cry; broods over his loss.

Stomach:  Usually thirstless.

Remedy:  Gelsemium 1m, single dose at 1 p.m on 13th November 1992


Response:
His fever gradually rose from 104 to 106.4 to eventually 107.4 at 3p.m. At this crucial moment I was trying to understand why the fever rose so high and whether I was on the right path. Previously he only had low a grade fever. There was much pressure from my colleague house-physicians and nurse to bring down the fever. It was a blessing in disguise that the patient never had any visiting relatives so it saved me from further pressure of explaining to the relatives. I decided to wait and advised only cold sponging for the fever. I thought it better to wait and understand what is happening rather than desperately trying to bring down the fever and spoil the case.

Gradually the fever came down to 103.4 and then increased to 105 to 105.8 to 106 at 5.30 p.m. Cold sponging was continued so that it decreased to 103.8 at 6.30 p.m. He asked for water and drank one glass. He also ate bread and butter and drank a cup of tea. His headache was only slight where as before it was severe throughout the fever.The dryness of his mouth had decreased.


14th November 1992:
The paroxysm of chill was much less. His maximum temperature was 102 at noon. His appetite improved , he ate the food given to him in the hospital. His thirst improved, he was drinking water. His headache was much less during the fever. He had no pain and tenderness in his chest. His dullness , drowsiness, as well as his weakness was better than before.


15th November 1992:
His chill started at 11.30 a.m, but was very mild with no rise in temperature. His appetite improved and he feels thirsty now. His sleep was disturbed due to lascivious dream. He had a light cough, but the patient was feeling better physically and mentally. He does not remain in bed dozing. He now talks with other neighboring patients and moves about in the hospital room and the garden below. His weakness is less.


16th November 1992:
There is no paroxysm of chill or heat. His appetite returned to normal and also his thirst. His weakness, dullness and drowsiness was absent. He sleeps better and the cough is absent. The WBC count and ESR was normal now. We discharged him after few days.


Subsequent follow up:
My term as house physician had ended, but I met the patient on 3 occasions on my way. I could not recognize him because there was no sadness and grief in his eyes, but he recognized me. He now has a job. There was a smile on his face and a feeling of gratitude. The last time I met him he had started a tea stall next to our hospital, he called me himself with smile and gratitude. I did not see any sadness in his eyes. He appeared full of enthusiasm.


It was a satisfying experience for me to see him full of enthusiasm, a smile on his face with which he was trying to live his life without anyone for support.

Here was a case of lack of reaction with low grade fever, no appetite, no thirst, no sweat, dullness, weakness and drowsiness. When we gave the correct remedy it aroused a curative reaction in the form of very high fever of 107.4, with visible improvement in appetite, thirst as well as other symptoms associated during the fever.

Our duty as a physician is not to disturb this curative reaction of the body. We are to interfere only if this curative reaction comes to standstill, then help the body by another dose of gelsemium.


He needed only a single dose.


Dr. Manish R Panchal
Dr. Phalguni (my wife)

Centre for Classical Homoeopathy,
1, Phalguni Apartment,
39/36 Erandwane, Prabhat road 9B,
Pune-4,
Maharashtra State,
INDIA.
Telephone : 2542 25 91 / mobile: 9922403093
Email : gentlecure07@gmail.com

Categories: Remedies
Keywords: gelsemium, typhoid (enteric) fever, weak, dull, curative reaction
Remedies:

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m.jamshed
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Fever
Reply #1 on : Mon August 12, 2013, 23:56:41
Good and keen observation helps to select single remedy I appreciate doctor who had a keen observation.

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