Typhus

 

Vergleich: Paratyphoidinum (B). Siehe: Nosoden + Krankheiten + Eberthinum

Azadirachta indica Staphylococcus aureus und der Typhus-Erreger Salmonella typhosa

 

Krankheit: Typhus aus dem griechischen Wort "typhos" abgeleitet = „Dunst“ oder „Nebel“.

Infektionswege: Nach oraler Aufnahme gelangen die Typhussalmonellen in den Darm, Durchdringen der Darmwand, über die großen Lymphgefäße des Körpers Eindringen in die Blutbahn, Verteilung

mit dem Blutstrom in alle Organe, bevorzugt wird das lymphpatische Gewebe des Darmes befallen.

Inkubationszeit: zwischen 3 - 60 T. Die Inkubationszeit ist von der Infektionsdosis abhängig und umso kürzer, je höher die primäre Keimzahl ist

Symptome: typischer zyklischen Verlauf, wenn nicht gleich Antibiotikagabe erfolgt

1. Krankheitswoche mit allmählich stufenweise zunehmende Temperaturen, Frösteln, Kopfschmerz und Mattigkeit. Zusätzlich ev. Bauchschmerz und Verstopfung.

2. Krankheitswoche Körpertemperatur von 39° bis 41° kontinuierlich so hoch. Der Pulsschlag ist häufig verlangsamt. Fühlt sich schwer krank und sind oft benommen.

Die Zunge ist häufig grau-weiß belegt, wobei die Spitze und die Ränder oft frei bleiben und hochrot erscheinen (Typhuszunge). Leber und Milz vergrößert.

Gegen Ende der 2. Woche zeigt ein Drittel der Erkrankten einen typischen Hautausschlag (Ulcerations)/malignant cancer/der hauptsächlich den Rumpf und seltener die Gliedmaßen befällt (Roseolen: blassrote, ca. 1 mm große Hautveränderungen).

3. Krankheitswoche typische erbsenbreiartigen Durchfälle, eventuelle delirante (= bewusstseinsgetrübte) Zustände

4. Krankheitswoche es kommt zur Entfieberung mit stark schwankenden Temperaturen. Daran schließt sich eine lange Rekonvaleszenz an.

In typhoid the intellect is clouded/face cadaverous. The cold sweat on the forehead is similar to Verat. The tongue is heavy and stiff. There is almost complete loss of speech, and the breath is cold.

The body is hot, the extremities cold. There is restlessness, retching and vomiting. (Colch.)

= known as the subacute miasm. Remedies in this miasm were originally used for typhoid fever (= high, unremitting fever often associated with prostration from violent diarrheas or other infections).

The infections are slightly less rapid in their onset (Bry.) than the remedies in the acute miasm. These remedies useful in a variety of chronic conditions (colitis/Crohn’s disease/collapse states/psychosis). Patients who have acute or recurring psychotic breaks have good prospects from homeopathic treatment/feels himself to be in an urgent, life-threatening situation requiring his full capacity to survive/

willing to use any means to return to a secure position (violence/scheming/flight/lying). Willful children who demand their desires so strongly that parents cave in/conserves every resource to combat

the threat.

Materialism and business struggles are a strong component. The feeling is, “If I can just get through this crisis, I have it made and I can rest.” Seeks rest and a secure position.

Gefühl einer kritischen Situation, die, falls sie in ihrer entscheidenden Phase richtig gehandhabt wird, sich zur völligen Wiederherstellung wenden kann.

Die Reaktion ist ein Dagegen-Ankämpfen.

 

[

Typhus is a disease caused by an infection with the Rickettsia bacteria. Fleas, mites (chiggers), lice, or ticks transmit it when they bite you. Fleas, mites, lice, and ticks are types of invertebrate animals known as arthropods. When infected arthropods bite someone, they may leave the bacteria that cause typhus behind. Scratching the bite opens the skin and allows the bacteria to enter the bloodstream. Once in the bloodstream, the bacteria reproduce and grow.

The type of typhus you are infected with depends on what bit you. Arthropods are typically carriers of one typhus strain unique to their species.

Typhus outbreaks usually only occur in developing countries or in regions of poverty, poor sanitation, and close human contact. Typhus is generally not a problem in the U.S., but you may become infected while travelling abroad.

Untreated typhus can lead to serious complications and it’s potentially fatal. It’s important to see your doctor if you suspect that you may have typhus.

Cause of Typhus

Typhus is not transmitted from person to person like a cold or the flu.

3 different types of typhus and each type is caused by a different type of bacterium and transmitted by a different type of arthropod.

1. Epidemic/Louse-Borne Typhus

Caused by Rickettsia prowazekii and carried by the body louse. It can be found around the world(U.S.), but is typically found in areas of high population and poor sanitation, where conditions promote lice infestation.

2. Endemic Typhus

Formerly known as murine typhus, this type is caused by Rickettsia typhi and is carried by the rat or cat flea. Endemic typhus can be found worldwide. It may be found among people in

close contact with rats or areas where rats live. It isn’t commonly found in the U.S. but cases have been reported in some areas, primarily Texas and southern California.

3. Scrub Typhus

Caused by Orientia tsutsugamushi and carried by mites. More commonly found in Asia, Australia, Papua New Guinea and the Pacific Islands. It is also called tsutsugamushi disease.

The louse, flea, tick, or mite becomes infected with the bacteria when they feed on the blood of an infected person or an infected rodent (in the case of endemic typhus). If you come in contact with these infected arthropods (for example, by sleeping on bed sheets infested with lice), their faeces may be deposited on your skin when the louse, flea, tick, or mite feeds on your blood. If you scratch the bite, the bacteria can enter your bloodstream through the tiny wound on your skin.

 

Symptoms of Typhus

Symptoms vary slightly by the type of typhus, but there are symptoms that are associated with all three types of typhus, such as:

    headache

    fever

    chills

    rash

Symptoms of epidemic typhus usually appear suddenly and include:

    severe headache

    high fever (above 104 degrees Fahrenheit)

    rash that begins on the back or chest and spreads

    confusion

    stupor and seeming out of touch with reality

    low blood pressure (hypotension)

    eye sensitivity to bright lights

    severe muscle pain

The symptoms of endemic typhus last for 10 to 12 days and are very similar to the symptoms of epidemic typhus but are usually less severe.

They include:

    dry cough

    nausea and vomiting

    diarrhea

Symptoms seen in people with scrub typhus include:

    swollen lymph nodes

    tiredness

    red lesion or sore on the skin at the site of the bite

    cough

    rash

The incubation period for the disease is 10 to 14 days, on average. This means that symptoms won’t usually appear for 10 to 14 days after you are bitten. Travellers who get typhus while travelling abroad may not experience symptoms until they are back home. This is why it is important to tell your doctor about any recent trips if you have any of the above symptoms.

Diagnosis

If you suspect that you have typhus, your doctor will ask about your symptoms and your medical history. To help with the diagnosis, tell your doctor if you:

    are living in a crowded environment

    know of a typhus outbreak in your community

    have travelled abroad recently

Diagnosis is difficult because symptoms are common to other diseases, including:

    dengue (breakbone fever)

    malaria (infectious disease spread by mosquitos)

    brucellosis (infectious disease caused by the brucella bacteria)

Diagnostic tests for the presence of typhus include:

    skin biopsy (sample of the skin from your rash will be tested in a lab)

    Western blot (test to identify presence of typhus bacteria)

    immunofluorescence test (using fluorescent dyes to detect typhus in samples of sputum, which is the thick fluid or mucus found in the lungs and the breathing passages)

    blood test (results can indicate the presence of infection)

Treatment

Antibiotics most commonly used to treat typhus include:

    doxycycline (preferred treatment)

    cholramphenicol (option for those not pregnant or breast-feeding)

    ciprofloxacin (used for those who are unable to take doxycycline)

Complications of Typhus

Some complications of typhus include:

    hepatitis (infection of the liver)

    gastrointestinal hemorrhage (bleeding inside the intestines)

    hypovolaemia (decrease in blood volume)

Outlook for Typhus

Early treatment with antibiotics is very effective and relapses aren’t common if you take the full course of antibiotics. Delayed treatment and misdiagnosis can lead to a more severe case of typhus.

Epidemics of typhus are more common in poor, unsanitary, and crowded areas. People who are most at risk of dying are generally those who are unable to afford quick treatments. The overall mortality rate for untreated typhus ranges from 10 – 40% (Ohio Department of Health). The highest rates are seen in the older adults and those who are malnourished. Children usually recover from typhus. People with underlying diseases (diabetes mellitus, alcoholism, or chronic renal disorders) also have a higher risk of mortality.

Endemic typhus is rarely deadly, even without treatment (less than 4% of cases), according to an article in Clinical Infectious Diseases.

Preventing Typhus

During World War II, a vaccine was created to prevent epidemic typhus. However, the shrinking number of cases has stopped the manufacture of the vaccine. The easiest way to prevent typhus is by avoiding the insects that spread it.

 

Suggestions for prevention include:

    maintaining personal hygiene (helps guard against lice carrying the disease)

    controlling the rodent population (rodents are known to carry arthropods)

    avoiding travel to regions where typhus exposure has occurred, or to countries that are high risk due to lack of sanitation

    chemoprophylaxis with doxycycline (used as a preventive only in those at high risk, such as those on humanitarian campaigns in areas with extreme poverty and little or no sanitation)

Use tick and insect repellant. Perform routine examinations for ticks, and wear protective clothing if you’re travelling near an area where there have been typhus outbreaks.

 

Typhoid Fever

Cause: salmonella typhi-gram positive bacteria. It is endemic in areas where sanitation is poor.

Spread and incubation period

It is transmitted by faecal or oral route, through water or food contaminated by human faeces. It can be spread also by vomitus and oral secretion during the acute stage. The bacteria live only in humans.

A small percentage of humans become carrier of this disease after recovery from infection. Incubation period of bacteria is 10-14 days.

Cause of typhoid fever

Firstly the bacteria S.typhi enters the gastro intestinal tract then it infects the biliary tract, it invades the lymphoid tissues and walls of the ileum and colon, seeding of intestinal tract with millions of bacilli resulting in the typical lesions in the peyer’s patches and follicles and then gain access to the blood stream. The bacilli may live in gall bladder for months or years.

Clinical features of typhoid fever

Onset of disease is insidious, gastro intestinal symptoms may develop with in one hour of s.typhi ingestion but usually subside prior to the onset of the typhoid fever.

 

1st week symptoms-

    Fever- temperature rises in step ladder fashion for 4-5 days, temperature shoots up to 104° F (= 40° C) mostly in evening,

    Temperature associated with:

    Anorexia

    Malaise

    Headache

    Myalgia

    Relative bradycardia

These all symptoms followed by remittent fever up to 7 days with constipation in elders and diarrhoea and vomiting in children.

 

End of 1st week

    Rash - at the end of the week a rash may appear at back and upper abdomen, slightly raised, rose-red spots (fade on applying pressure)

    Gastro-intestinal symptoms in early illness diarrhoea in children with vomiting and constipation then succeeded by diarrhoea and with distended abdomen

    Tenderness

    Enlarged spleen

    Respiratory symptoms

    Cough

    Epistaxis

    Lymphnodes- generalised lymphadenopathy.

 

End of 2nd week

 

After 14 days if infection begins to continue:

                Persistent fever with delirium

                Increased weakness and fatigue

 

After 3 weeks:

    Internal bleeding as the result of gastro intestinal ulcers, abscesses and intestinal perforation results into hypovolaemic shock.

    Damage to the liver and spleen in 10% of cases.

 

Complications of typhoid fever

    Pneumonia

    Thrombophlebitis

    Osteomyelitis

    Septic arthritis

    Cerebral thrombosis

    Meningitis

    Myocarditis

    Acute circulatory failure

    Death

 

Diagnosis of typhoid fever

    Presence of rose spots, splenomegaly with leukopenia.

    Widal test

    Blood culture

    Examination of faeces for presence of causative organism

 

Homeopathic treatment of typhoid fever

Apis.: muttering delirium; trembling of tongue; tongue dry, cracked, ulcerated. Great relaxation of muscles; restlessness and fidgety; great soreness and bloatedness of abdomen; skin burning hot

in some places and unnaturally cool in others; pricking sensation in tongue and fauces and very tenacious.

Arn.: at an early stage diarrhea of offensive gushing stools and apathy and stupefaction, with foul smelling breath and ecchymotic black or yellowish-green spots on skin. Forgets the words while speaking and goes to sleep while answering; weakness, bruised sensation; general sinking of vitality; fear of being touched; brown streak through midline of tongue; involuntary stool and urine; breathing short and anxious; erethistic typhoid fever.

Bell.:  in the beginning, during the stage of irritation by the typhoid poison; furious delirium with scream out and violent efforts to escape from the bed and house; intense headache, with lancinations in back part or top head; twitching of limbs.

Bapt.: specific for typhoid fevers; septic conditions of blood; great muscular soreness, offensive breath, stool, urine, sweat.

Bry.: Great soreness over the body. Tired feeling. Every exertion fatigues; dread from all the motions; a splitting, agonizing frontal headache, < motion.

[Dr. W.H. Dickinson]

In 7 out of 10 cases of typhoid for which Bryonia was indicated, it would be the only remedy, because the symptoms of the drug correspond to those of every stage of typhoid.

Hyos.: this remedy is quite likely to be required sooner or later in typhoid fever for some symptoms at least; that is, there are times when it will accord with the totality.

In the early stage of the disease the delirium and later the symptoms of cerebral paralysis.

If the delirium be furious or low and muttering, with picking at the bed clothes, and especially if subsalts tendinum be present, then hyoscyamus is the remedy.

Kali-p.: typhoid fever, a dry, brown tongue, foul and putrid diarrhea, great debility, low pulse, offensive breath, sordes on teeth, with great mental depression.

Ars.: terrible prostration so characteristic of the drug is accompanied by an irritability and anxiety. Faint and weak, exhausted, perhaps with cold sweat and delirium; the mouth and teeth are covered with sordes; soreness of mouth; dark offensive diarrhoea; intense fever and the characteristic thirst

[Dr. Gawlik]

Während der Gefangenschaft war ich Lagerarzt für etwa 1.800 Leute und 40 Mann russische Besatzung. Plötzlich, es war kurz vor Weihnachten, erkrankte das ganze Lager an Fleckfieber.

Nur 10 Mann blieben übrig, der Rest ging zu den Englein (...). Wir 10, die wir überlebt hatten, lagen im „Nebel“ (typhusähnlich). Als wir aufwachten, wir waren die einzigen, die aufwachten,

da hatten wir alle dieselbe Symptomatik: wir hatten eine absolute retrograde Amnesie, d.h. keiner von uns wusste, wie er heißt, keiner wusste, wo er herkommt, keiner wusste, was er gelernt hatte, nichts mehr von der Familie, gar nichts. Wir lagen auf Matratzen ohne Stroh, auf dem kalten Fußboden, draußen waren minus 20° (...), aber wir haben nicht gefroren. Wir haben auch keinen Hunger

gehabt, obschon wir ja sowieso kaum was zu Essen bekamen. Es waren noch andere Symptome dabei, aber das war das Eindrucksvollste. Geheilt mit Opium in Potenz.

[E.A. Farrington]

Selenium after Typhoid Fever

Selenium. for the sequelae of typhoid fever. When the patient begins to walk about, there is such great debility of the spine that he fears that he will be paralyzed.

[Eugene Beauharnais Nash]

This is one place where the homœopathic treatment is superior to the old methods, for we may treat the patient before the disease may be certainly pronounced a confirmed case of typhoid or some such unwelcome diagnosis.

I know we are sometimes charged with treating such cases and claiming to have "broken up" a fever, and it is not impossible that mistakes along that line have been made but I submit that an old practitioner of abundant experience treating cases during a prevailing epidemic of the disease, would have to be given credit for knowing something of the case he was treating before it had reached the point where all the most serious diagnostic indications were developed, and be reasonably sure he had "aborted" a case, which some, claim to be impossible. Those who claim to treat disease by name, with diagnosis fully established, must,

to be consistent, wait until the time for preventing the disease is past. No wonder they claim that typhoid cannot be aborted. Such proceeding would be criminal with the homœopathist.

In our indications for remedies we will follow out our own experience in the treatment of the disease, prodroma and all. Forty years ago if asked from our knowledge of remedies what were the remedies most likely

to be needed in this (the prodromic) stage, we would have answered

Bry. Nux-v. Rhus-t. Puls. and Bell. It is different now, for there are two remedies that are oftener indicated than any of those named and which must be added, viz. Gels. and Bapt.

 

Bry.: Great lassitude or weakness. Pains in head, back and limbs, < on moving white-coated tongue, dry parched lips and mouth, without or with thirst for water in large quantities at a time loss of appetite, empty eructations and constipation with restless sleep, which is accompanied by dreams of business, tiring him out, and particularly when the patient does not want to move, as all his bad feelings are greatly aggravated by it. One very characteristic symptom often but no always present is that the patient gets sick and faint when rising up from lying down.

Gels.: Extreme muscular and nervous prostration, with general trembling as a consequence. Wants to lie down, feels so weak. If he attempts to walk the legs tremble, or the hands tremble if he attempts to lift them the tongue trembles when he attempts to protrude it the pulse becomes weak and slow, but is accelerated on the least motion there is some chilliness, hands and feet cool, while there is crimson flushing of the face inclination to drowsiness, or sleeps frequently, with incoherent muttering head feels "big as a bushel," with vertigo and dimness of vision tongue slightly coated, or not at all speech thick, because the tongue, like all the rest of the muscles, "refuses to obey the will" from sheer inability, or from weakness, to do so. There is generally little or no thirst, no constipation or diarrhœa, and at this early stage, no stomach or bowel symptoms, unless it be, in some cases, the same sense of weakness (sometimes expressed as goneness) which is felt in general. Drooping of the eyelids is very characteristic and in keeping with the general prostration.

Bapt.: Great prostration and soreness as if bruised in whatever position the patient lies the parts rested upon feel sore and bruised. (Arn.) Stupor falls asleep while being spoken to, or in the midst of his answer face flushed, dusky, dark red, with a stupid, besotted, drunken expression. Tongue coated with a well-defined streak down the middle, at first white, but very soon turns brown, with red edges. Sometimes the tongue is large and flabby, with a red dry tip, but not distinctly triangular like Rhus-t. Exhalations and discharges early become fetid, and offensive breath, stool, urine and perspiration. Nervous, cannot get to sleep because she cannot get herself together feels scattered about, tosses around to get herself together.

A picture of a rapidly advancing case of abdominal typhoid. The diarrhœa and decomposition of fluids set in early and progress rapidly, if not speedily checked by Bapt. will come to the stage of Ars. Carb-v. Mur-ac.

DD.: Psor.: profuse perspirations remain after typhus fever.

Then it is necessary that we understand them thoroughly, so as to apply them correctly, for a mistake at this stage is not easily corrected later, and may prove fatal. Let us compare a little. All 3 remedies have muscular soreness and prostration but if the soreness most prominent Bapt.

Gels. drowsy with red face + mind less clouded/want to lie still, and dread motion, because he is so weak

Bapt. drowsy with red face + mind very clouded/want to lie still, and dread motion because of pain (head) greatly aggravated.

Bry.. constipated, Bapt. diarrhœic, Gels. neither. With all three the face is red. Bapt. most so "besotted," Gels. next. Bryonia least, and turns pale on rising or sitting up.

Bapt. tendency to decomposition comes early, not so with the others.

Bry. delirium is about business of the day, Bapt. cannot get himself together. Gels. not characteristic.

Bry. tongue white, with parched lips and thirst. Gels. tongue thinly coated or not at all, no thirst, tongue trembles when attempting to protrude it; Bapt. only one that turns dark in a well defined streak through the middle in this stage.

Bapt, urine scanty, dark and offensive, Bry. urine scanty and high colored, if changed at all, Gels. urine may be profuse.

Other diagnostic differences between these remedies might be added, but enough is done to show that there is no reason for confusing them or difficulty in choosing between them.

 

Now let one, because I have taken pains to set forth the indications of these three remedies, so as to make them easily and quickly available, accuse me of a spirit of routinism and let it not for a moment be supposed that I mean to convey that any other remedy indicated by the symptoms must be ignored, because there are other remedies that may in some individual case rule all these three out. For instance, if I should find a case in which the excessive soreness and bruised feeling, complaining of hardness of bed and prostration, and even coupled with a dark streak through the middle of the tongue, so strongly indicating Bapt. as above described, and the history of the case should show that the patient had come to this state through the strain of overwork and fatigue, I should consider and compare Arnica, notwithstanding this remedy is not generally useful until later in the course of ordinary fevers. Rhus-t. also will come strongly to mind in cases arising from similar causes.

 

In other cases who, during an epidemic of fevers, have come down after a long strain of night watching and broken rest in taking care of the sick, no remedy so helps them as Cocc-i. Cupr-met. stands next.   

 

Puls.: Much chilliness yet the patient cannot bear to be in a close room, it oppresses her white tongue without thirst bad taste in the mouth sour eructation, and especially if the menses retard, or are suppressed very greatly discouraged, or gloomy and lachrymose. Predominantly found among women.

Nux-v.: Sedentary men who come down with severe headache and constipation, with frequent desire for stools, which do not satisfy, or ineffectual efforts at stool, and especially if with very high fever and bright red face there is constant desire to be covered, for he is chilly if he moves or is uncovered in the least. NERvous, sensitive and easily affected by external impressions. Predominantly found among men.

I put these two remedies here together because I think they belong here. If some should object that these are not typhoid fever remedies, because they do not create or cause the pathological changes that characterise a fully developed case of this disease, I answer that any remedy having the symptoms of the patient, even though they be only subjective symptoms, is homœopathic to the case, and that if applied when and where it belongs the pathological changes so characteristic may be averted. To meet and defeat in this way disease at the very outset is one of the chief excellencies of our art as compared with the old school of medicine. The "practice of medicine made easy" by prescribing the one remedy for all cases of one (nominal) disease, without regard to the individual, or peculiar, symptoms in the case, is simply in the line of the old mistake of Quinine for malarious affections, Mercury for syphilis, etc., etc.

 

Antidotiert von: Bry. Rhus-t.

 

 

Vorwort/Suchen     Zeichen/Abkürzungen                                   Impressum