Dengue
Fever
https://hpathy.com/clinical-cases/the-treatment-and-prevention-of-dengue-fever-in-sri-lanka-the-role-of-echinacea-angustifolia/
Vergleich: Siehe: Krankheiten + Viren
Family Flaviviridae; genus Flavivirus. Other members of the same genus
include yellow fever virus, West Nile virus, St. Louis encephalitis virus,
Japanese encephalitis virus, tickborne encephalitis virus, Kyasanur forest
disease virus, and Omsk hemorrhagic fever virus. Most are transmitted by
arthropods (mosquitoes or ticks), and are therefore
also referred to as arboviruses (arthropodborne viruses).
[Zeit Online]
Dengue
Wo kommt es vor?
Dengue, auch Siebentagefieber genannt, ist eine Infektionskrankheit, verursacht durch ein Virus. Übertragen wird es durch Mücken.
Erkrankte leiden an schweren Fieberschüben und unspezifischen Symptomen, ähnlich einer Grippe. In schweren Fällen kann es zu inneren Blutungen und Organversagen kommen.
Bisher gibt es kein wirksames Medikament gegen Dengue. Wird mit fiebersenkenden Mitteln und Lösungen gegen den Flüssigkeitsverlust behandelt. Forscher arbeiten
an der Entwicklung eines Impfstoffes.
Was ist Dengue?
Übertragen wird das Virus durch die Gelbfiebermücke, die hauptsächlich in tropischen Gebieten vorkommt, sowie die Asiatische Tigermücke, die auch in urbanen Gegenden überlebt. Die Mücke nimmt das Virus auf, wenn sie das Blut eines Infizierten saugt. Das Insekt selbst erkrankt nicht, gibt aber die Viren an den nächsten Menschen weiter,
den es sticht.
Der Übertragungsweg
Dengue kommt im gesamten tropischen Gürtel der Erde vor (Asien, Mittel und Südamerika). Auch im südlichen Teil der USA, in Südeuropa und in Australien
kommt es mittlerweile zu Infektionen.
Jährlich erkranken nach Schätzungen der Weltgesundheitsorganisation WHO 50 bis 100 Millionen Menschen daran. Die Autoren der neuen Studie sprechen sogar von
400 Millionen Erkrankten pro Jahr.
Notes on Dengue from the WHO website:
“Dengue is transmitted by the bite of an Aedes
mosquito infected with any one of the 4 dengue viruses. It occurs in tropical
and subtropical areas of the world.
Symptoms appear 3 14 days after the infective bite. Dengue
fever is a febrile illness that affects all.
Symptoms range from a mild fever, to
incapacitating high fever, with severe headache, pain behind the eyes, muscle
and joint pain, and rash.
No specific antiviral medicines for dengue
available. It is important to maintain hydration. Use of acetylsalicylic acid
(e.g. aspirin) and non steroidal antiinflammatory
drugs (Ibuprofen) is not recommended.
Dengue haemorrhagic fever (fever, abdominal
pain, vomiting, bleeding) is a potentially lethal complication, affecting
mainly children. Early clinical diagnosis and
careful clinical management by experienced
physicians and nurses increase survival of patients.
Eupat-per.
homeopathic medicine Eupatorium for treating Dengue feverit’s the best
suited homeopathic medicine for dengue fever, where platelet count get low and
+ intense pain in joints.
Known as “Boneset”, from the prompt manner in which it relieves pain in
limbs and muscles that accompanies some forms of febrile disease, like dengue,
malaria and influenza.
Head:
– Throbbing pain.
– Pressure as if a cap pressed over the whole skull.
– Vertigo; sensation of falling to left.
– Top and back of head with pain and soreness of eyeballs.
– Periodical headache (every 3rd and 7th day.
– Occipital pain after lying down, with sense of weight.
Fever:
– Perspiration relieves all symptoms except headache.
– Chill between 7 9 h., preceded
by thirst with great soreness and aching of bones.
– Nausea, vomiting of bile, throbbing headache.
– Knows chill is coming on because he cannot drink enough.
Rhus-t.:
wonderful action in dengue fever with chill and red vesicular eruptions,
and also acts very well in joints pain in fever
– Influenza, with aching in all bones. [Eupper.]
Fever:
– Adynamic; restless, trembling.
– Dry cough and restlessness.
– Urticaria fever during
– Chilly, as if cold water were poured over him, followed by heat.
– Muscular pains relived by stretching
Arsa.
acts very nicely in all types of fever with restlessness mentally and physically.
This homeopathy medicine is often used as a preventive drug for Dengue fever.
Mind:
Great anguish and restlessness. Changes place continually. Fears, of
death, of being left alone.
Great fear, with cold sweat.
Thinks it useless to take medicine.
Suicidal.
Hallucinations of smell and sight.
Despair of recovery which drives him from place to place.
Miserly, malicious, selfish, lacks courage.
General sensibility increased [Hep.].
Sensitive to disorder and confusion.
Fever:
High temperature.
Periodicity marked with adynamia.
Septic fevers.
Intermittent. Paroxysms incomplete, with marked exhaustion. Hayfever.
Cold sweats.
Typhoid, not too early; often after Rhust.
Complete exhaustion.
Delirium; < after midnight.
Great restlessness.
Great heat about 3 h.
Chin.:
suitable homeopathic remedy in all fever with debility in body due to
loss of vital fluids.
Debility from exhausting discharges, from loss of vital fluids, calls
for this remedy.
Periodicity most marked.
Extremities:
Pains in limbs and joints, as if sprained; <, slight touch; > hard
pressure
“As of a string around limb”
Joints swollen; very sensitive, with dread for open air.
Great debility, trembling, with numb sensation.
Averse to exercise; sensitive to touch.
Weariness of joints; <: morning/sitting;
Skin:
Extreme sensitiveness to touch, but hard pressure relieves. Coldness;
much sweat.
One hand ice cold, the other warm.
Oedema over whole body
Dermatitis; erysipelas.
Swelling of glands; scrofulous ulcers and caries.
Fever:
Intermittent, paroxysms anticipate; return every week.
All stages well marked.
Chill generally in forenoon,
thirst before chill, and little and often.
Debilitating nightsweats.
Free perspiration caused by every little exertion, especially on single
parts.
Hay fever, watery coryza, pain in temples.
Gels.:
well known homeopathy remedy in fever cases with chill in spine and also
known as 3D medicine for DULLNESS DIZZINESS DROWSINESS.
Fever:
Wants to be held.
Pulse slow, full, soft, compressible.
Chilliness up and down back.
Heat and sweat stages, long and exhausting.
Much muscular soreness, great prostration, and violent headache.
Fever, with stupor, dizziness, faintness; thirstless, prostrated.
Chill, without thirst, along spine; wavelike, extending upward from
sacrum to occiput.
Acon.:
Acute acting homeopathic remedy in sudden fevers.
state of fear, anxiety; anguish of mind and body.
Physical and mental restlessness, fright, is the most characteristic
manifestation of Aconite. Acute, sudden, and violent invasion, with fever, call
for it.
Does not want to be touched.
Sudden and great sinking of strength.
Complaints and tension caused by exposure to dry, cold weather, draught
of cold air, checked perspiration, also complaints from very hot weather
(gastrointestinal disturbances, etc.)
First remedy in inflammations,
inflammatory fevers.
Serous membranes and muscular tissues affected markedly.
Burning in internal parts; tingling, coldness and numbness.
Influenza.
Skin:
Red, hot, swollen, dry, burning in skin
Rash like measles.
Gooseflesh.
Formication and numbness.
Chilliness and formication down back.
Fever:
Cold stage most marked.
Cold sweat and icy coldness of face.
Coldness # heat
Evening chilliness soon after going to bed.
Cold waves pass through him. Thirst and restlessness always present.
Chilly if uncovered or touched.
Dry heat, red face.
Most valuable fever remedy with mental anguish, restlessness, etc.
Sweat drenching, on parts lain on; relieving all symptoms.
Crot-h.:
it’s a suitable homeopathic medicine in dengue fever case having hemorrhagic
tendency. It is often suggested for Dengue hemorrhagic fever, where the
platelet count
goes very low.
Diseases caused by a previous low state of the system; low septic
typhoid or malarial fever; chronic alcoholism; exhausted vital force; genuine
collapse.
Hemorrhagic or broken down constitutions.
Hemorrhagic diathesis; blood flows from eyes, ears, nose, and every
orifice of the body; bloody sweat.
Yellow color of conjunctiva; clears up vision after keratitis, or
keratoiritis.
Tongue fiery red, smooth and polished (Pyr.); intensely swollen.
Blood decomposition, hemorrhages (dark fluid that forms no clots),
tendency to carbuncles, malignant scarlatina, yellow fever, the plague,
cholera, give opportunity to
use this remedy.
Fever:
Malignant fevers of a hemorrhagic or tcharacter.
Low bilious remittents.
Yellow fever.
Bloody sweat.
Cold sweats.
Skin:
Swelling and discoloration, skin tense and shows every tint of color,
with excruciating pain.
Yellow color of the whole body.
Great sensitiveness of skin of right half of body.
Hemorrhage from every part of body.
Bloody sweat.
Chilblains, felons.
Pustular eruptions.
Insect stings.
Bad effects of vaccination.
Lymphangitis and septicemia.
Boils, carbuncles, and eruptions are surrounded by purplish, mottled skin
and edema.
Sore sensation relieved by pressure.
Bry.:
Useful where there is lot of muscle and joint pain, < with every
little motion.
The pains are stitching, tearing, < at night, greatly < motion,
> rest.
The parts which are the seat of subjective pain become subsequently
sensitive to external pressure, and then swollen and red.
Fever:
Pulse full, hard, tense, and quick.
Chill with external coldness, dry cough, stitches.
Internal heat.
Sour sweat after slight exertion.
Easy, profuse perspiration.
Rheumatic and typhoid marked by gastrohepatic complications
Patient <: morning/warmth/any motion/eating/hot
weather/exertion/touch;
Cannot sit up; gets faint and sick.
>: lying on painful side/pressure/rest/cold things;
Arn.:
Favorable homeopathic medicine for dengue fevers with sore, lame and
bruised feeling in all body.
Fever Prodrome
Drawing pains “As if in the periost”
Thirst: For large quantities of cold water, which refreshes him.
Chill With thirst, pain in muscles of back and extremities, as if
bruised; great soreness of whole body.
Less thirst, but increased soreness in muscles; must lie down, yet bed
feels too hard; he cannot find a soft place and keeps constantly changing position
in search of one.
Sweat Generally absent in recent attacks.
In old cases, sour, and offensive
Bruised feeling and soreness continue through every stage, and persist
during apyrexia.
Bell.:
Best homeopathic medicine for high fever, fever is of sudden and violent
nature.
Fever:
Pulse: Ordinarily quick, often full, hard and tense, but sometimes also
it is full.
Throbbing carotid and temporal arteries.
Violent beating of the arteries.
Chill: In evening, especially on extremities, most on arms, with heat.
Evening shaking chill.
Coldness of limbs, with a hot head.
Shivering, running down back.
Heat: Constant dry burning, with sweat on head and neck only Internal,
with anxiety and restlessness of forehead, with cold cheeks.
Internal or external, or both at same time.
Of head, with red face and delirium.
Generally predominating Sweat, Exclusively on the covered parts With, or
immediately after the heat, most on face empyreumatic odour, and stains the
linen.
Sulph.:
Fever:
Pulse Full, hard and accelerated, sometimes intermittent
Chill : And chilliness, principally internal and without thirst, mostly
evenings, but also at other times of day.
External, with concomitant internal heat and redness of face.
Severe, at night in bed.
In forenoon; in afternoon heat with cold feet.
With thirst, after previous heat.
Spreading from toes. Running up
back.
Heat:
Afternoons and evenings, with dry skin and great thirst.
Great, at night, without thirst, often preceding chill with thirst.
Sweat, Nights and mornings, Copious sour smelling , the whole night.
In evening, most on hands.
Copious, from least movement.
Anxious, debilitating, of an empyreumatic, sour, seldom offensive, sometimes
also cold.
Nightsweat, only on nape and occiput.
Phosph.:
Another homeopathy remedy with hemorrhagic diathesis. Is useful for both
simple Dengue fever as well as Dengue hemorrhagic fever.
Fever:
Chilly every evening.
Cold knees at night.
Adynamic with lack of thirst, but unnatural hunger.
Hectic, with small, quick pulse; viscid nightsweats.
Profuse perspiration.
Tub.:
Fever:
Postcritical temperature of a remittent type.
Here repeat dose every two hours. (MacFarlan).
Profuse sweat.
General chilliness.
<: motion/music/before a storm/standing/dampness/from draught/early
morning/after sleep;
>: open air;
Calc.
Fever:
Chill at 14 h. begins internally in stomach region. Fever with sweat.
Pulse full and frequent.
Chilliness and heat.
Partial sweats.
Night sweats (head, neck and chest).
Hectic fever.
Heat at night during menses, with restless sleep.
Sweat over head in children, so that pillow becomes wet.
Skin:
Unhealthy; readily ulcerating; flaccid.
Small wounds do not heal readily.
Warts on face and hands.
Petechial eruptions.
Lyc.:
Fever:
Chill between 15 – 16 h., followed by sweat.
Icy coldness.
Feels as if lying on ice.
One chill is followed by another. [Calc.; Sil.; Hep.]
Sep.:
Extremities:
Lower extremities lame and stiff, tension as if too short.
Heaviness and bruised feeling.
Restlessness in all limbs, twitching and jerking night and day.
Pain in heel.
Coldness of legs and feet.
Fever:
Frequent flushes of heat; sweat from least motion.
General lack of warmth of body.
Feet cold and wet.
Shivering, with thirst; <, towards evening.
Carb-v.:
For the bad effects of exhausting diseases (Chin. Psor.); cachectic
persons whose vitality has become weakened or exhausted.
Useful when there is collapse like state along with Dengue fever.
Fever:
Chilliness in the evening.
Frequent chilliness (at night), chilliness and coldness.
With the irritation to cough, in the evening, chilliness and drawing in
the cheeks. Shivering, frequently
lasting an hour.
Shivering in the evening, with weariness and flushes of heat, before
going to sleep (after ten hours).
Febrile chill in the morning, with thirst, chattering, and blue
fingernails, lasting till afternoon; then in the evening heat and sweat,
without thirst.
Chill with thirst.
Drawing chill, with great thirst.
Feverish coldness in the evening; he does not feel the warmth from the
stove.
Coldness of the left arm and left leg.
Very cold hands and feet in the evening.
She could not get the feet warm, in the evening, in bed, before 1
o’clock.
Chilliness and heat towards evening (after twelve days).
Chill at 11 h. for several days; heat in the evening at 18 h.
Heat at night in bed.
Sensation of heat, with great anxiety, in the evening, although she was
cold to touch all over.
General burning heat in the evening, with great weariness and fantasies
at night.
A little wine heats him very much.
Warmth in the spine rising up to the throat.
Much heat the whole day, though with constantly cold feet.
Much inclined to sweat.
Increased sweat in the morning on waking (after three days).
Profuse sweat of the body, and even of the head, before midnight.
General sweat after a moderate breakfast.
Warm sweat in the morning (after 29 hours).
Sour smelling sweat (after eight days).
Sweat of an offensive odour at night.
He sweat easily on the upper part of the body in a warm room, and then
again became just as easily chilled.
Sweat on the forehead while eating.
Frequent profuse sweat on the face (in a boy two years old).
Heat on the balls of the hands.
Sweat of the feet when walking.
Sil.:
Fever:
Chilliness; very sensitive to cold air.
Creeping, shivering over the whole body.
Cold extremities, even in a warm room.
Sweat at night; < towards morning.
Suffering parts feel cold.
<: new moon/in morning/from washing/during menses/uncovering/lying
down/damp/lying on l. side/cold;
>: warmth/wrapping up head/summer/in wet or humid weather;
Merc.:
Fever:
Generally gastric or bilious, with profuse nightly perspiration;
debility, slow and lingering.
Heat # shuddering
Yellow perspiration.
Profuse perspiration without relief. Creeping chilliness, < in the
evening and into night.
Alternate flashes of heat in single parts.
<: at night/wet, damp weather/lying on right side/perspiring/warm
room/warm bed;
Lach.:
Like all snake poisons, Lachesis decomposes the blood, rendering it more
fluid; hence a hemorrhagic tendency is marked.
Fever:
Chilly in back; feet icy cold; hot flushes and hot perspiration.
Paroxysm returns after acids.
Intermittent fever every spring.
<: after sleep; (Kali bich.) Lach. sleeps into aggravation; ailments
that come on during sleep. [Calc.]
<: left side/in the spring/warm bath/pressure/constriction/hot
drinks/closing eyes;
<: appearance of discharges/warm applications;
Pyrog.:
For septicemia; puerperal or surgical from ptomaine or sewer gas infection;
during course of diphtheria, typhoid or typhus; when the best selected remedy
fails to >> or permanently improve.
The bed feels hard (Arn.); parts lain on feel sore and bruised (Bapt.);
rapid decubitus (Carb-ac.).
Tongue: large, flabby; clean, smooth as if varnished; fiery red; dry,
cracked, articulation difficult (Crot-h., Ter.).
Taste: sweetish; terribly foetid; puslike; as from an abscess.
Vomiting: persistent; brownish, coffeeground; offensive, stercoraceous;
with impacted or obstructed bowels (Op., Plb-met.).
Fever:
Coldness and chilliness.
Septic fevers.
Latent pyogenic condition in Dengue fever.
Chill begins in back.
Temperature rises rapidly.
Great heat with profuse hot sweat, but sweating does not cause a fall in
temperature.
Anthrac.:
In carbuncle, malignant ulcer and complaints with ulceration, sloughing
and intolerable burning.
When Arsenicum or the best selected remedy fails to relieve the burning
pain of carbuncle or malignant ulceration.
Haemorrhages: blood oozes from mouth, nose, anus or sexual organs;
black, thick, tarlike, rapidly decomposing (Crot-h.).
Septic fever, rapid loss of strength, sinking pulse, delirium and
fainting (Pyr.)
Apis.:
Fever:
Chilliness (periodic at 15 h.
Heat predominates, without thirst (usually), with drowsiness.
Heat of head with throbbing, ameliorated by pressure.
Sweat not marked, skin usually dry.
Ferr-p.:
Fever:
Chill daily at 13 h.
All catarrhal and inflammatory fevers; first stage.
<: r./at night and 16 - 18 h./touch/jar/motion;
>: cold applications;
Skin:
Hyperaemia; from mechanical injuries, fresh wounds, not yet suppurating.
Capillary congestion, with burning of the skin, more exercise and warmth.
Abscesses, boils, carbuncles and felons; at the commencement of these
affections this remedy reduces heat, bloodaccumulation, pain and throbbing.
Chickenpox, erysipelas and erysipelatous inflammations of the skin, for
the fever and pain.
Suppurative processes on the skin with febrile symptoms.
Measles, scarlet fever and smallpox.
Pimples, acne, for the pain and heat and congestion.
Ulcers with febrile accompaniments.
Bapt:
The symptoms of this homeopathy drug are of an asthenic type, simulating
low fevers, septic conditions of the blood, malarial poisoning and extreme
prostration.
Dengue fever with marked prostration and muscle pains.
Indescribable sick feeling.
Great muscular soreness and putrid phenomena always are present.
All the secretions are offensive breath, stool, urine, sweat, etc.
Epidemic influenza.
Chronic intestinal toxaemias of children with fetid stools and
eructations.
Fever:
Chill, with rheumatic pains and soreness all over body.
Heat all over, with occasional chills.
Chill about 11 h.
Adynamic fevers.
Typhus fever.
Shipboard fever.
<: Humid heat/fog/indoors;
Ph-ac.:
Extremities:
Weak.
Tearing pains in joints, bones, and periost.
Cramps in upper arms and wrists.
Great debility.
Pains at night, “As if bones were scraped”
Stumbles easily and makes missteps.
Itching, between fingers or in folds of joints.
Skin:
Pimples, acne, bloodboils.
Ulcers, with very offensive pus.
Burning red rash.
Formication in various parts.
Falling out of the hair. [Nat-m. Sel-met.] Tendency to abscess after
fevers.
Fever:
Chilliness.
Profuse sweat during night and morning.
Low types of fever, with dull comprehension and stupor.
>: from keeping warm;
<: exertion/from being talked to/loss of vital fluids/sexual
excesses;
Everything impeding circulation causes aggravation of symptoms.
Mur-ac.:
Extreme prostration.
Cold extremities.
Heat without thirst.
Typhoid types, stupid.
Haemorrhages.
Restlessness.
Involuntary discharges.
Bedsores.
Pulse rapid and feeble.
Excessive prostration.
<: in damp weather/before midnight;
>: lying on left side;
Homeopathy Prophylaxis for Dengue
Fever
The most commonly suggested homeopathy medicines for prevention or
prophylaxis of Dengue fever are Eupatorium perfoliatum and Arsenic album, but
the remedy can change every year.
[Navin Pawaskar]
Drs. Navin Pawaskar and J. Srikanth present a homoeopathic approach to
dengue fever. Repertory analysis must be combined with material medica in
determining the acute and constitutional remedy.
INTRODUCTION
Dengue is an acute mosquito transmitted viral disease characterized by
fever, headache, muscle and joint pains, rash, nausea and vomiting. Dengue
fever usually selflimited, biphasic febrile illness, its presentation may range
from asymptomatic to Dengue Hemorrhagic Fever (DHF) and fatal shock (Dengue
Shock SyndromeDSS). The illness is more severe and begins more suddenly in
adults, infection is asymptomatic in 80% of infants and children. In 2013
dengue was estimated to be responsible for approximately 3.2 million severe
cases and 9000 deaths worldwide. In India the case fatality rate is about 35%.
Causative organism
It is an arbovirus from Genus –Flavivirus. It is the most common among
all arbovirus infections. There are four 4 serotypes (DENV1, 2, 3 & 4) of
infections identified. Infection with one serotype does not include solid
immunity to the other. Hence, individual may suffer from dengue fever more than
once.
Epidemiology
Large number of cases regularly occurs in urban, suburban and rural
areas, with increasing proportion of Dengue Hemorrhagic Fever and Dengue Shock
Syndrome.
In India during 2013, about 74168 cases were reported with 168 deaths.
Case fatality rate was 0.22%. The highest numbers of cases were reported from
Punjab
followed by Tamilnadu, Gujarat, Kerala and Andhra Pradesh.
Transmission
Dengue is transmitted via Aedes aegypti mosquitoes. It is transmitted by
female mosquitos’, bites during day time only.
Incubation period 2 7 days
CLINICAL PRESENTATION:
Classical Dengue
Dengue Hemorrhagic fever
Dengue Shock Syndrom
CLASSICAL DENGUE
Sudden onset of chills and high
fever with intense headache
Retroorbital pain with
photophobia
Muscle and joints pain which
prevent all movements
Intense myalgia; BREAK BONE
FEVER
Constitutional symptoms like
extreme weakness, anorexia, constipation, altered taste sensation, colicky
abdominal pain, sore throat and general depression.
Typical morbilliform rash
spreading centripetally to face; trunk & limbs, spares palms & soles
with first 2448hrs. Lasting for 15 days, resolves with desquamation.
DENGUE HEMORRHAGIC FEVER (DHF)
Especially children and young
females
Precirculating antidengue
antibody is predominant risk factor. It may be acquired from previous infection
with different serotype or in the form of transplacental transfer.
Leakage in plasma takes place
in DHF & extravasations occur in the endothelial gaps due to increased
capillary permeability.
Onset3rd - 7th
day of illness
Criteria for diagnosis of DHF
Fever or H/O fever lasting 27
days
Hemorrhagic tendencies
indicated by any of the following: Positive tourniquet test, Petechie,
ecchymosis or purpura, bleeding from mucosa, gastrointestinal tract,
injection sites or other locations
Enlargement of liver
Thrombocytopenia : platelet
count < 1,00,000/mm3
Hemoconcentration: hematocrit
increased by > 20%
Plasma leakage evidenced
Rise in haematocrit > 20%
Fall in haematocrit > 20%
after IV fluids
Positive tourniquet test i.e.
appearance of more than 20 petechiae per 2.5 cm2 on inflating sphygmomanometer cuff
for 5 minutes.
DENGUE SHOCK SYNDROME
All the criteria of DHF plus, Shock manifested by rapid and weak pulse
with narrowing of the pulse pressure 20
mmHg or less) or hypotension, tachycardia,
with the presence of cold, clammy skin & restlessness.
Grades of Dengue…
Grade I fever + nonspecific constitutional symptoms. The only
hemorrhagic manifestation is a positive tourniquet test.
Grade II manifestations in grade I plus patient with spontaneous
bleeding (skin hemorrhage).
Grade III circulatory failure by rapid and weak pulse, narrowing of
pulse pressure or hypotension with the presence of cold clammy skin and
restlessness.
Grade IV profound shock with undetectable blood pressure and pulse.
Warning signs for shock…
Intense, sustained abdominal
pain
Persistent vomiting
Restless or lethargy
Sudden change from fever to
hypothermia with sweating and prostration.
INVESTIGATIONS.
Probable diagnosis
Serological tests
NS1 Ag Rapid tests
ELISA for IgM (for recent
infection) Appear within 5 days, persists for months 3.ELISA IgG (for Chronic
infection)
Confirmed diagnosis
Culture is positive within
first 5 days (sensitivity < 50%); can also obtain culture from liver at
autopsy.
Detection of virus in tissue,
serum, or CSF by IHC, IFA or ELISA
Increased specific IgG or IgM
WBC decreased (2,0005,000/uL)
with toxic granulation of leukocytes and neutropenia; may have marked atypical
lymphocytes.
In DHF, decreased platelets
(<1,00,000/uL) with impaired aggregation, prolonged prothrombin time in
severe cases of DHF. DIC may occur.
Increased transaminase
(5,001,000 U/L) and bilirubin indicating decreased hepatic & renal
functions.
RTPCR: Detection of genomic
sequence of virus by RTPCR (sensitivity > 90% early, <10% in 7 days).
Reverse transcriptase polymerase chain reaction
(RTPCR) sensitive and specific for
detection of viral RNA. But this test is still a research tool.
COMPLICATIONS
Bleeding
ARDS (= Acute respiratory
distress syndrome)
Renal failure
Hepatic failure
Encephalopathy
Homoeopathic Approach in Dengue:
CASE 1
DD.:
Nux-v. Puls. and Sep. come close on Repertorization.
Nux-v. marked chilliness along with body ache, cannot bear to uncover.
Patient is thirsty during chills and thirstless during fever. Low back pain is
hall mark
along with aching limbs during fever. Nuxv. loud, painful retching and
water brash along with nausea. Gastric bilious symptoms are present during
apyrexia.
Puls. slow insidious onset with subdued mild symptomatology.
Thirstlessness is a hallmark of Pulsatilla along with loathing for food which
is < on eating.
Taste is bad (morning with white coated tongue).
Sep. irregular fever with changing paroxysm (caused by allopathic or
homoeopathic intervention). Extremely chilly. Nausea not > eating is hallmark concomitant during fevers. Thirst
during chill and though thirsty during heat, less thirst compared to chilliness
stage.
CASE 2
LOCATION SENSATION MODALITY CONCOMITANT
DD.:
Chin.: Prodromal : nervous excitement,
anxiety, headache, nausea, irritability
Chill followed by thirst, wants to
wrap himself warmly, chill begins in the breast.
Heat without thirst, fiery red face with
congestion of head, other parts chilly
Sweat with thirst, drenching
profuse, debilitating
Apyrexia: debility, restlessness,
anemia, edema
Headache and weakness as
concomitants.
Fever patterns clear
and well defined
Nux-v. Fever with prominent gastrobilious
symptoms
Chill: preceded or accompanied by
blueness of fingernails
Chill with yawning & aching in
limbs and back
Chill not > covering or external heat
Thirst less during fever
Low backache during heat
< Pressure
Weakness is not a
prominent concomitant.
Nat-m.: Useful in inveterate and badly
treated cases of fever
Chill: 10 11 am, begins in small of
back or feet
Chill with thirst and generalized
aches and pains
Heat: high fever with throbbing
headache, increased thirst,
Fever blisters around lips
Sweat: debilitating , relieves
headache
Marked periodicity
Sep.: Irregular Fevers
Marked Chilliness
< Jarring
> Pressure
Profound Prostration
Nausea at smell and sight of food
Nausea not better by eating
Thirst less during fever
DISCUSSION:
Repertory is a tool of great help but, has its limitation. Quantitative aggregation
presented by repertory software needs qualitative analysis. In this case Sepia
does not come
up in first five remedies, yet on qualitative studies in Materia Medica
stands up prominently. Meticulous differentiation of remedies based on Materia
Medica brings down errors in prescribing.
OBSERVATIONS MADE OF PATIENT’S BEHAVIOUR
Patient was a quiet lady who
spoke little and appeared to be mild
Patient was always accompanied
by someone for the follow up.
She was afraid when spoken to
about admission and the diagnosis
She timidly followed
everything told to her by the team of physicians and her husband.
PROBABLE CLINICAL DIAGNOSIS Dengue fever
REASONS:
Sudden onset of fever with
severe intense headache and myalgia.
The appearance of rash at the
deeffervescence of fever with its characteristic pattern of initial macular to
later purpuric type are characteristic of dengue fever.
A low leucocyte count.
Falling platelets with
appearance of bleeding is also more suggestive of a dengue infection.
ON EXAMINATION
Rash same, Purpuric spots on the lower extremities and very few over the
abdomen.
Case taking of the chronic totality done to know the deep acting
CONSTITUTIONAL REMEDY as well as the probable ACUTE REMEDY in relationship with
the constitutional remedy.
Acute Totality:
1. Dullness fever during
2. Weeping pain due to
3. Thirstlessness
4. Nausea < eating
5. Head pain > binding
the head
6. Bitter taste
7. Nausea < drinking
8. Head pain < noise
9. Menses profuse
10. Menses dark red
CHRONIC TOTALITY
1. Sensitive to reprimands
2. Weeping tendency
3. Mildness
4. Timidity
5. Aversion milk
6. Aversion sour
7. Aversion sweet
8. Hunger agg
9. Thermals HOT
10. Menses dark
11. Menses offensive
12. Menses staining
13. Head pain do to exposure to
sun
FOLLOW UPS:
DATE GENERALS PLATELET COUNT ACTION
18/9/09 App and thirst
improved, No fever, body ache Rash reduced, Headache mild, PV bleeding reduced 58,000 Placebo
19/9/09 App and thirst
further improved, energy levels better Rash improved, purpuric spots SQ,
erythema reducing, bleeding reduced 62,000 Placebo
20/9/09 Better Purpuric spots
also fading, no erythema, bleeding stopped 1,68,000 Placebo
22/9/09 Improved Only
mild headache Rash only 12 purpurae seen 1,68,000 Placebo
29/9/09 No symptoms 2,35,000 Placebo
DISCUSSION:
Case presented during de effervescence of the episode. Onset duration
and progress clearly showed a slow mild, and insidious pace of illness. Thou
patient did not have high grade fever lady was weeping due to headaches and
also had other concomitants like drowsiness. Complete history was sought to
obtain constitutional data. Constitutional data helps plan the treatment based
on remedy relationships.
In this case constitutional remedy Pulsatilla itself covered the fever
totality. Susceptibility assessment did not show any gross deviations from
state of health as illness was in declining phase. Hence single stimulation was
adequate for the case to sail through.
Key decision making points were stage of disease, pace and progress of
symptoms, state of susceptibility and confirmation of acute and chronic
totality coverage by Pulsatilla.
CASE 4
PRELIMINARY INFORMATION
Name: R.C.N. Age: 25 yrs, Sex:
Male, Religion: Hindu Education: student D.O.A: 8092004
Patient presented with high grade fever sever chilliness and body pains
since 2 days. He had travelled to an endemic area a few days ago, also had ice
cream on the journey. Since the fever he had low appetite, bitter taste,
thirstless and headache. Body ache was extremely severe associated with
restlessness. Whole body was sore, patient was unable to lie down in one
position for more than a minute.
Totality of symptoms: 1.Ailment from ice cream.
Restlessness due to intense
soreness and aching of body parts lied upon
Feel too weak to move in bed.
Fever with rapid prostration.
Thirst decreased during fever.
Highgrade fever with toxic
state.
Painless inflammation of
tonsils.
DD.:
Allopatic diagnosis was inconclusive for first 3 days, though had
suspicion of Dengue and Malaria, but because prescribing characteristics were
present in the case homoeopathic treatment could be started even before
conclusive diagnosis was arrived at. This is one advantage of using homoeopathy
in early stage of diseases, even
before classical pathological symptoms develops, because homoeopathic
treatment is patient specific and not disease specific. However this doesn’t
undermine importance
of diagnosis for the homoeopathic physician. Diagnosis helped to do
follow up investigations, to anticipate complications, to understand natural
course of disease visa vis course of disease in this specific case after
homoeopathic treatment.
CONCLUSIONS:
Homoeopathic treatment helps
in cutting short the clinical course of disease, reduction of distress of
patient, prevention of complications & cutting short the convalescence in
Dengue.
Meticulous homoeopathic case
taking during Dengue fever focusing on; onset, duration and progress of each
symptom, fever pattern & concomitants during different stages is essential.
Carefully elicited symptoms
and systematic recording in LSMC format as suggested by Boenninghausen helps in
analysis, of common symptoms from individualizing characteristics.
Assessment of individuals
susceptibility based on pace of disease, stage of illness, presence of
homeopathic characteristics help in deciding the potency and repetition
schedule. In Dengue, rarely is multiple dose repetition essential unless
clearly indicated by severely deviated state of susceptibility like in DHF or
DHS.
Close follow up of dengue
patient is essential. Mere sense of well being, absence or reduction of fever
should not be relied upon. Dengue is known for relapses and
kickback fevers. Objective signs like platelet count, purpuric rash and
active bleeding should be observed closely.
After patient is a febrile for
48 hours or during convalescence, the deep acting constitutional remedy should
be prescribed to prevent relapse.
[Julia Groß]
Dengue ist eine höchst unangenehme Krankheit, die auch Knochenbrecherfieber genannt wird. Zwar können Infektionen auch so mild wie eine schwere Erkältung verlaufen. Doch meist zwingen sie Patienten mit extremen Kopf und Gliederschmerzen, hohem Fieber und Schwäche tagelang ins Bett. Tückisch sind Komplikationen, die auftreten können, wenn das Fieber gesunken ist und die Erkrankten sich schon auf dem Weg der Besserung wähnen. Dann kommt es zu inneren Blutungen, der Blutkreislauf kann zusammenbrechen und die Patienten geraten in einen Schockzustand. Schätzungen zufolge verläuft Dengue bei etwa einem Prozent der Erkrankten tödlich, Kinder sind überproportional häufig betroffen.
[Dr. Anshu Nema]
Dengue Fever and its homeopathy treatment explained in great detail with
effective homeopathic remedies like Eupatper. Ars. Croth. etc.
Dengue fever (Bone Breaking Fever) is a vector borne fever, caused by a
virus known as arbovirus which is spread by the bite of mosquitoes (Aedesaegypti,
main vector
of the disease).
This is also known as Break bone fever, because this fever produces very
much pain in bones and joints.
Dengue fever is a selflimiting disease. When there is a prevalence of
Aedes aegypti and Aedes albopictus together, with circulation of more than one
type of dengue virus
in a particular area, it gives birth to either Dengue Haemorrhagic Fever
(DHF) or Dengue Shock Syndrome (DSS).
[Joe de Livera]
Virus infection and highly contagious/transmitted by the Aedes Egyptii
mosquito which can be identified by the zebra like black and white markings on
its thorax and abdomen. Onset usually starts when the patient feels unwell and
runs a low temperature with acute body pains and splitting headache which
usually follow within 24 hours after the onset of the disease.
Used Eupat-per.
C 200 as Wet. dose (every 2 hours for the first
day and every 3 hours thereafter till the patient is cured) treated many
patients presenting Dengue and the majority have confirmed that they
experienced perceptible relief in about an hour after their first dose, when
their throbbing headache left them. They also reported that
their excruciating body and joint pains left them within 2 3 hours.
Some have reported that they suffered from a low temperature on the 2nd
day. Rest and drinking plenty of fluids is needed till the temperature drops
and if it continues,
it is best to enter hospital as it is possible that the Blood Platelet
count may have dropped in the case of the Hemorrhagic type of the Dengue Flu
when more invasive
methods of treating the disease with a blood transfusion may be called
for.
There are 4 virus serotypes –
DENV1
DENV2
DENV3
DENV4
Virology
Dengue fever virus (DENV) is an RNA virus of the family Flaviviridae;
genus Flavivirus. Most are transmitted by arthropods (mosquitoes or ticks), and
are therefore
also referred to as arboviruses (arthropodborne viruses).
Mechanism
When an infective mosquito carrying dengue virus bites a person, the
virus enters the skin together with the mosquito’s saliva. It enters white
blood cells, and multiplies
inside the cells and they move throughout the body. The white blood
cells respond by producing a number of signalling proteins, such as cytokines
and interferons,
which produces many of the symptoms, such as the fever, the flulike
symptoms, and the severe pains. In severe infection, the virus production
inside the body is greatly increased, and many more organs (such as the liver
and the bone marrow) can be affected. Fluid from the bloodstream leaks through
the wall of small blood vessels into
body cavities due to capillary permeability. As a result, less blood
circulates in the blood vessels, and the blood pressure becomes so low that it
cannot supply sufficient blood to vital organs. Furthermore, dysfunction of the
bone marrow due to infection of the stromal cells leads to reduced numbers of
platelets, which are necessary for effective blood clotting; this increases the
risk of bleeding, the other major complication of dengue fever.
The secondary infection by dengue serotype2 or multiple infections with
different serotypes leads to form either DHF OR DSS.
Vector of Demgue Fever
Aedes aegypti and Aedes albopictus are 2 causative vectors of dengue.
They both have high susceptibility towards infective virus as carrier of this
infection.
Aedes aegypti bytes more than one host to complete 1 blood meal and it’s
a discordant species i.e. it bites more than 1 host to complete the gonotropic
cycle.
Aedes albopictus is that species which complete its blood meal by biting
only 1 person at a time and does not require a second blood meal for completion
of the
gonotropic cycle.
DISEASE TRANSMISSION.
The Aedes mosquito becomes infective by feeding on the patient from the
day before the onset to the 5th day (viremia stage) of illness.
After incubation period
of 8th to 10th day, mosquito becomes infective,
and becomes capable to transmit the infection.
Once the mosquito becomes infective, it remains so for life. The virus
attacks the genital tract of mosquito and start transmitting in the fully
developed eggs at
the time of oviposition.
BREEDING SEASON OF AEDES AEGYPTI WITH ENVIRONMENTAL FACTORS
The Aedes aegypti mosquito breeds during rainfall and in humidity. Its
favourable temperature and weather for the influence of life span is humid wet
weather,
it best survives in the temperature between 30° C and relative humidity of 60% 80%.
It breeds in a hollow vessels and containers where rain water is
accumulated.
It is of 3 types
Classical dengue fever
Dengue haemorrhagic fever
(DHF)
Dengue shock syndrome (DSS)
INCUBATION PERIOD: 3 10 DAYS
SIGN AND SYMPTOMS OF DENGUE
Dengue patients repeated attacks of chills, facial flushing, with
nonspecific febrile syndrome which may accompanied by maculopapular rashes.
Other symptoms:
Headache
Nausea and vomiting
Severe myalgia
Retro orbital pain
Skin Rashes
Constipation
Colicky pain
Abdominal tenderness
Arthralgia of knee and
shoulder
Anorexia
Weakness
Sore throat
Mild haemorrhagic
manifestations (epistaxis, haematuria)
Fever is usually between 39.0C40.0C.skin eruptions appear in majority of
the cases. The rashes may be reddish, pointed, maculopapular mainly at face,
neck and chest.
These rashes last up to 2 hours to several days.
Fever ends for about 57days. Infection with 1 serotype gives immunity against
that particular serotype and partial protection against others.
DENGUE HEMORRHAGIC FEVER
It’s the infection caused by more than one dengue virus (double dengue
serotypes). Initially the dengue hemorrhagic fever is also very similar to
classical dengue fever
but shortly after the fever, symptoms of leakage of plasma appears with
hemorrhagic symptoms, which also appears such as gum bleeding, epistaxis,
haematuria.
Dengue hemorrhagic fever turns to dengue shock syndrome if left
untreated, including persistent headache with nausea and vomiting,
restlessness.
There is a persistent decrease in platelet count which causes
hemorrhage.
DENGUE SHOCK SYNDROME (DSS)
Shock syndrome is a dangerous complication of dengue infection and is
associated with high mortality. Severe dengue occurs as a result of secondary
infection with a different virus serotype. Increased vascular permeability,
together with myocardial dysfunction and dehydration, contribute to the
development of shock, with resultant multi organ failure. The onset of shock in
dengue can be dramatic, and its progression relentless. The pathogenesis of
shock in dengue is complex. It is known that endothelial dysfunction induced by
cytokines and chemical mediators occurs.
Diagnosis is largely clinical and is supported by serology and
identification of viral material in blood. No specific methods are available to
predict outcome and progression. Careful fluid management and supportive
therapy is the mainstay of management. Corticosteroids and intravenous immunoglobulins
are of no proven benefit. No specific therapy has been shown to be effective in
improving survival.
CLINICAL FEATURES OF DENGUE ILLNESS PROGRESSING TO SHOCK
Dengue infection should be considered when patients who live in areas
where dengue is prevalent present with a febrile illness together with
hemorrhagic manifestations
or features of shock.
Dengue infection begins as a febrile illness; the fever is accompanied
by constitutional symptoms and a characteristic flushing of the skin. Intermittent
highgrade fever accompanied by chills and rigors is a feature. Vomiting,
headache, myalgia, epigastric discomfort, and abdominal pain are common, and
patients often feel quite ill.
The fever lasts 2–7 days and
is followed by a fall in temperature; complications of dengue often take place
at this point. Patients who remain ill, despite their temperature returning to
normal, are more likely to
develop shock. Shock generally occurs on day 3–4 of the illness.
Thrombocytopenia is a
characteristic finding. Platelet counts below 1, 00,000/mm3 together with a
rise in the haematocrit define DHF. In the classical shock syndrome, increased
vascular permeability results in third space fluid loss, leading to pleural
effusions, pericardial effusions, ascites, noncardiogenic pulmonary oedema and,
subsequently, hypotension. Right hypochondriac pain occurs similar to that seen
in cholecystitis; without calculous, cholecystitis is a characteristic feature
of DHF.
Myocarditis is a wellknown
complication
Although often mild it can
result in heart block and can be severe enough to result in progressive acute
heart failure with acute cardiac dilatation.
Lactic acidosis, which occurs
as a result of the sluggish circulation, possibly contributes to myocardial
depression in severe cases. Acute hepatic derangement can occur though
fulminant liver failure is rare.
Acute renal failure is usually
secondary to hypotension in shock syndrome and is associated with increased
mortality.
Death is usually due to severe
haemorrhage or intractable shock with multi organ failure.
DIAGNOSIS WITH INVESTIGATIONS
The WHO guidelines on dengue have clearly defined criteria for the
diagnosis of dengue shock.
Confirmation of dengue
infection is by serology or detection of dengue viral material in blood by
RTPCR. Denguespecific IgG and IgM ELISA is widely used.
The test is relatively
inexpensive, and becomes positive for IgM antibodies on or after day 5 of the
fever. IgM ELISA has a sensitivity of 83.9–98.4% and a specificity
of 100%.
The presence of IgG antibodies
indicates previous infection; hence, the presence of both IgG and IgM
antibodies suggest the possibility of a secondary infection, although this has
not been validated in clinical studies.
RTPCR for dengue viral
material can help to diagnose the illness early, before antibodies become
positive; the method, although relatively expensive, is very sensitive and
allows for serotyping.
While these tests are used for
diagnosis of dengue infection, they do not accurately predict which patients
are likely to develop dengue shock. The association between
high antibody titers or high viral load and the clinical manifestations
of dengue has not been studied. No other biochemical investigations are available
to predict which patients will develop shock, which is largely a clinical
diagnosis. Haem concentration and dropping platelet counts herald the onset of
shock. Extravasation of fluid due
to vascular leakage can be detected radiologically (chest radiography
for pleural effusions, echocardiography for pericardial effusions, and
ultrasonography for ascites).
The presence of fluid around the gall bladder, together with thickening
of the gallbladder wall, has been shown to be associated with shock.
None of these features, however, predict the development of severe shock
syndrome or mortality. Patients with shock do, however, show a variety of
metabolic derangement, including lactic acidosis, elevated transaminases, and
rising serum creatinine and blood urea. Pulse oximetry and arterial blood gas
analysis showing hypoxia
may indicate the development of pulmonary oedema, which may be
cardiogenic or noncardiogenic. Electrocardiography is useful in identifying
early myocarditis
(T wave and ST segment changes are seen).
Echocardiography is the main
investigation used to diagnose myocardial dysfunction and should be done early
when impending shock is suspected. The place of cardiac troponins in diagnosing
myocarditis has not been evaluated.
NS1 ELISA
The nonstructural protein 1 (NS1) of the dengue viral genome has been
shown to be useful as a tool for the diagnosis of acute dengue infections.
Dengue NS1 antigen has been detected in the serum of DENV infected patients as
early as 1 day post onset of symptoms (DPO), and up to 18 DPO. The NS1 ELISA
based antigen assay is commercially available for DENV and many investigators
have evaluated this assay for sensitivity and specificity. The NS1 assay may
also be useful for differential diagnostics between flaviviruses because of the
specificity of the assay.
[Gitesh Kalyankar]
January 11, 2013
The
author along with other homoeopathic doctors, discovers and uses the genus epidemicus
for Dengue Fever during an epidemic.
Dengue fever is due to a viral infection from a flavivirus.
It generally lasts for 10-12 days, and the day on which the patient is being
offered treatment is very important.
For
the first 3-4 days, counting from the first day of fever, the patient is
expected to be symptomatic. After this, the symptoms reduce and an asymptomatic
phase of complications starts. The most well-known complication in this phase
is the drop in the platelet count.
In
Pune, in a well-known hospital -KEM hospital, a physician- Dr Rajesh Gadia, was
fighting it out. Out of sheer sympathy with the patients who kept suffering in
spite of
the
symptomatic treatment that could be offered, he called upon the team of PRANA –
The Homoeopathy Yoga center. Three members from the team were delegated the
task Dr. Manisha Kamble, Dr. Gitesh Kalyankar, and Dr. Shrikant Talari. They
went to the said hospital, and collected data of as many as 25 patients.
Homoeo-prophylaxis
or the role and approach to the Genus Epidemicus:
Individualization
is the core of homoeopathy. However, it is not so in the acute epidemics– rapid
morbid processes, which finish their course more or less quickly and attack
many persons with similar sufferings from the same cause.
From
the above definition itself (§ 72 -73)
it is clear, that an epidemic is a collective disease, occurring due to the
presence of a common contagious principle – “infectious organism”. This means
that such an occurrence should have a common “picture”, and therefore a common
remedy could be found out for it. This is the well-known concept
of
“Genus
Epidemicus”. (§100- 102)
Usually
we say that a person won’t manifest the symptoms of a disease unless internally
susceptible to it. But sometimes when the disease cause is very strong it will
overwhelm the individual’s vitality & affect him. This leads to an epidemic
where large numbers of people develop the same symptoms simultaneously. In such
a case many people who get the disease don’t even realize it and don’t get
treated for it. That’s because due to their inherent vitality, the symptoms
developed are very mild and are resolved by their own life-force i.e. immune
system without needing medication, especially if they aren’t otherwise weak or
stressed.
This
happened with swine flu for a couple of years and eventually a herd immunity
developed owing to which most people are now resistant to swine flu. A genus is
not
the
person’s individualized constitutional remedy. It’s a general one, the greatest
common denominator that best fits the symptoms of the large group of people
affected.
Such
a non -individualized approach is used in homoeopathy in an epidemic situation.
However this generalization does not imply an allopathic approach; the
direction of cure is still inside- out (i.e. to address cause), rather than
outside – in (i.e. to suppress symptoms). In short, the genus epidemicus is the
remedy found out from the collective totality of many patients suffering from
the same disease in an epidemic.
This
concept was ably understood and effectively used in this current epidemic of
dengue, both for the treatment and prevention of it.
The
team at PRANA studied the data. This was what came out.
Most
of the patients had the following symptoms
· Nausea
· Palpitation
· Vertigo
· Tachycardia
· Coldness of the body
· Sub conjunctival hemorrhage
· Crampy pain in the abdomen
· Cramps in the legs
·
What
was peculiar amongst all this was the deathly nausea, coldness of the body;
anxiety as if he was responsible for this condition and the family would suffer
because of the same
·
Vertigo,
which was aggravated on opening the eyes.
· Desire for fanning.
The
typical symptoms of dengue fever being:
1. fever with chills
2. body ache,
3. Headache
4. Eye pain
5. Muscular and joint pain
6. Nausea and vomiting
7. Rash on the body
8. Muddy sclera and sub-conjunctival
hemorrhage
9. Tourniquet test/ Blanching on
pressure.
10. Mobile, matted and soft
lymphadenitis.
11. Puffiness of face.
The
atypical symptoms that were chosen were:
· Vertigo opening eyes agg
·
Nausea
incessant (characteristic on the basis of its intensity)
·
Anxiety
of conscience as if guilty of a crime
· Fanning desire for
The
above rubrics were chosen as PQRS, keeping in view the patho-physiology of
dengue.
The
Remedy Tabacum came up as the most prominent remedy and the proposed
genus epidemicus.
NOTE:
Clinical pathogenesis of tympanitis is well covered by Tabacum.
Following
are the toxic effects of tobacco
·
Marked
irritation of functions of vagii. Emaciation of cheeks and back. Complete
prostration of entire muscular system. Icy coldness of surface: covered with
cold sweat.
·
Paroxysms
of – asthma, sick headache, vertigo, sneezing.
· Great despondency with Indigestion.
· Palpitation, intermittent pulse.
·
Vertigo:
death- like pallor, increasing to loss of consciousness;
·
Dim-
sighted: sees as through a veil; strabismus, depending upon brain troubles.
Amaurosis, from atrophy of retina or optic nerve. sub conjunctival hemorrhage
·
Face
pale, blue, pinched, sunken, collapsed; cowered with cold sweat
·
Nausea:
incessant, as if seasick; vomiting, on least motion; with faintness;
In
this current remedy there is sub-cutaneous and sub-conjunctival hemorrhage with
other very characteristic symptoms documented in over 10 affected patients from
K.E.M. Hospital Pune, that indicate the remedy Tabaccum prepared from tobacco
leaves, which is from the Solanaceae or nightshade plant family (potato and
tomato family).
We
also advised juice of papaya leaves along with the above protocol. While being
advised to avoid eating vegetable from the Solanaceae family until they recovered
completely.
POSOLOGY
We
gave the Dose- in 200 c potency in water dose 3x daily as a protocol. This was
kept flexible as per the needs of the case. This was given to 30 patients and
data was collected to check the remedy response. Out of 30, 3 needed 30 potency
and three others needed LM 4. We even gave it to a pregnant lady in her second
trimester and
she
recovered swiftly, with no problem to her pregnancy or to her fetus.
Indications
for 30C:
30C
was given to asymptomatic patients, with need for the remedy in order to
prevent the complications.
Indications
for LM4:
LM
4 was given to patients who had a more virulent strain of the disease. These
patients had subcutaneous or even frank bleeding, also to patients who were
unfortunate
to
get their menses during the tenure of the disease. In such cases, the bleeding
not only remained under control, but the subcutaneous ones stopped within a
day.
Role
of inter-current remedies in few cases:
Some
cases were seen when they already had complications like pleural effusion. In
these, the remedy helped them with other symptoms like fever etc., but they needed
a few doses of Bacillinum 200 as inter-current so as to clear the effusion.
This reduced the breathlessness, after which Tabacum cleared the symptoms
instantly.
POSOLOGY
FOR HOMOEO-PROPHYLAXIS:
Tabacum
was given to the family members and attendants of the patients so as to protect
them from getting the disease. We found that none of them finally got the
disease.
It
was given in the 200th potency, twice daily. Along with this, we advised them
to stop the repetition as soon as they got any symptom.
FOLLOW-UP:
All
of them improved not only on symptomatic / clinical parameters, but also on the
pathological ground – i.e. in those patients who came in the symptomatic phase,
not only were they relieved of their symptoms, but we were able to prevent any
complication, and the fall of platelet count. Also for those who came with
already low platelet counts, their counts shot up more than anybody could
believe.
REACH OF GENUS:
As
was observed, the patients in this study, although collected in one hospital,
came from varied regions of Maharashtra – from Kashti, Bhigwan, Baramati,
Talegaon Dabhade, Jalgaon, Shrigonda and Mahad other than those from Pune
itself. This gave us a fair idea that the perimeter of the genus was
widespread.
This
was also confirmed by the fact that, Dr. Abhay Talwalkar, a team member of
PRANA, confirmed similar symptoms in cases seen in his nursing home at Nira 80
kilometers from Pune. His patients also showed speedy recovery and rise
of platelet count, with the same remedy.
Apart
from giving important insights on the genus, Dr Sunil Anand our team leader and
President of Prana, helped derive the genus and supervised the cases, while
offering timely intervention for a few select cases, where some fine tuning in
the form of posology or an inter-current remedy, where remedy action faced a
block, after acting well initially. It was a huge learning and satisfying
experience for us all. This involved about 300 hours of extensive research and
follow up visits to the wards by our team members. The results at the end were
very much valued and covered by the media. You may visit Dr Anand’s site at
www.drsunilanand.com and read about the same if interested, under cases and
articles and titled- Homeopathic treatment for Dengue.
Note:
The above initiative was taken up by Team Prana as a social cause and
consultation of patients and dispensing of medicine was done free of charge. We
intentionally did not patent the remedy and we wished that all be able to avail
of the same. It was made available at the Prana pharmacy and at VV and Co under
the name Tab Dengue. This was done to keep some control on the dosing to
ensure proper use and avoid over dosing from the side of a patient.
At
our Centre, nine of us including our Dean – Dr Sunil Anand, worked to help Dengue
patients in the epidemic. Three of us – Dr. Manisha Kamble, myself and Dr.
Shrikant Talari regularly visited the wards of a renowned hospital, collected
data, dispensed medicines and took follow-ups and were backed wonderfully by
the others.
Vorwort/Suchen. Zeichen/Abkürzungen. Impressum