Typhoid Fever

Dr. Kent’s advice on the treatment of Typhoid fever. Instead of treating with the group of therapeutically indicated medicine physician must focus on the individual character of the patient in the disease state….

Mr. President, Ladies and Gentlemen:- When I was asked to present the subject of the therapeutics relating to typhoid fever it occurred to me to present the subject in a general way, but as I thought about it and considered the epidemic now in the city, progressing and increasing to intensity, it seemed to me that it would be more profitable to study especially such remedies as relate to the present epidemic. Of course, this consideration cannot be taken up without a general extensive survey of typhoid; but to make the subject comprehensive would require a dozen evenings rather than one, so I will consider tonight only those remedies that belong to our present epidemic in Philadelphia. I shall not have time to go over the subject of diet, hygiene or prophylaxis, nor the numerous things that every well-disposed and intelligent physician should know for himself, but will confine myself to the therapeutics, the homoeopathic remedies that relate to the present form of typhoid.

On the black-board we have a general summary of the pathognomonic symptoms of typhoid fever, those that run through all cases, those that are present more or less all through the fever. You could scarcely have a group of cases of typhoid that did not exhibit these conditions. Then if we go into our Materia Medica we readily group the remedies that correspond. These on the black-board, if considered in a general way, you will find look like the symptoms we have placed opposite them. You see that in this group individualizing and differing symptoms are left out, only those that are common to them all are included. They all have prostration, they all have in degree a continued nature of the febrile condition; they all have, some higher than others, the zymotic tendency; they all have the sordes and the distension known as tympanitic abdomen; they all have more or less a diarrhoea, and most of them have petechiae. In a general way the group on the left equals the group on the right and vice versa, but this is the general and common consideration. But now as that entire group of remedies in complex is equal to that group on the left in complex, so is each one a likeness of the group on the left. Each one has in its nature a species of typhoid or continued fever and yet none of them produces true idiopathic typhoid fever. Only a likeness is found, but we deal only with similars, and while we recognize that the typhoid, the Agaricus and the Zincum are all individuals, yet we recognize that they are all similar. Not all, however, have the symptoms in the same form and hence the necessity of individualization comes up before us. Some have the diarrhoea at one time of the day, some have it at another time of the day; some have continued fever in very high degree and some have continued fever in low degree. Arnica, Bryonia, Lachesis, Stramonium, Sul-ac., have continued fever in very high degree, but China’s most characteristic feature is intermittent fever, and it has continued fever in low degree. China has in a very high degree many of the symptoms and much of the nature of typhoid fever, the prostration, the tympanites, the zymosis, the sordes, the diarrhoea, the delirium,, but as to a continued fever it is in a low degree, and hence China comes in intermittents and remittents which are going towards and becoming continued. Primarily Gelsemium is a remittent remedy, but in a moderate degree it takes on continuance as it progresses, and hence has been found especially suitable for those fevers that are remittent in character in the earlier stages, but, as the disease advances, progresses towards a continued fever, and hence it is suitable for bilious and remittent fevers that take on the continued type, or, strictly speaking symptomatic typhoids.

Some remedies have delirium in the fore part of the night and some in the after part of the night. These questions have to be considered, and the only way to consider them is by a carefully prepared repertory. Even the fever has its time of aggravation. It is important to find the time at which the fever is highest; in some remedies it will be in the afternoon, some from 3 o’clock to midnight; in some the sharpest time is from 9 o’clock to midnight, etc.

Those remedies having highest fever at certain times are as follows:

Afternoon: Agaricus, Apis, Arsenicum, Bryonia, Cantharis, China, Colchicum, Digitalis, Gelsemium, Hyoscyamus, Ip., Lachesis, Lycopodium, nitricum acidum, Nux-v., Ph-ac., Phosphorus, Pulsatilla, Rhus-t., stramonium, sulph., Sul-ac.

Evening: Arsenicum, Bryonia, Carb-v., Chain., China, Helleborus, Ignatia, Ip., Lachesis, Lycopodium, Mur- ac., nitricum acidum, Nux-v., Phosphorus, Phos-ac., Pulsatilla, Rhus-t., Sul-ac., Sulphur

4 to 8 p. m.: Lycopodium

4 p. m. till midnight: Stramonium

5 p. m.: Kali-n., Rhus-t., Sulphur

7 p. m.: Lycopodium, Rhus-t.

8 p. m.: Hepar, Mur-ac., Phosphorus, Sulphur

9 to 12 p. m.: Bryonia

10 p. m.: Lachesis

Night: Am-c., Apis, Arsenicum, Arum-t., Baptisia, Bryonia, Caladium, Carb-v., Chamomilla, China, Chin-a., Cocc., Colchicum, Kali-bi., Lachesis, Lycopodium, Mere., Mur-ac., Nux vomica, Opium, Ph- ac., Phosphorus, Pulsatilla, Rhus-t., Stramonium, Sul-ac. Sulph.

Temperature running very high: Bryonia, Hyoscyamus, Rhus-t., Stramonium

Midnight: Arsenicum, Lycopodium, Rhus-t., Stramonium, Sulphur, Veratrum

Midnight, before: Arsenicum, Baptisia, Bryonia, Caladium, Carbo-v., Lachesis, Lycopodium, Nux-v., Stramonium

After: Arsenicum, Bryonia, China, Chin-a., Lycopodium, Nux-v Phosphorus, Rhus-t., Sulphur

These points as to the highest temperature are important. Remedies select a particular time. You may ask, “Why?” I am not here to answer that, but we observe the fact, and by observing we act accordingly. Find out from the nurse, or by your thermometer, at what particular time the temperature is the highest, and then examine such medicines as have this increase of temperature.

But these are only most common and general considerations. The most important symptoms to consider for the selection of a remedy are such as are not necessarily found in most cases of typhoid, such as belong to the patient himself, such things as stamp upon the sickness the nature and state of the patient. According to Hahnemann the sole duty of the physician is to pay attention to the patient, not to treat his disease, but the sick man. Everyone suffering from this fever has only what might be called a species of typhoid.

When the physician enters the room he should begin to observe and gaze at everything for symptoms; for the symptoms are to the intelligent physician the index of the disease.

What this patient is doing is certainly an important thing for the physician to observe. Does he desire to move or remain quiet? If he is worse during rest he will move, and if he moves continuously we at once examine a certain class of remedies, that may be called the moving remedies, or restless remedies, such as Arnica, Arsenicum, Baptisia, Hyoscyamus, Lachesis, Lycopodium, Rhus-t., Stramonium It is important to examine into the cause of his restlessness, and by observing him a little, or, if he be able to talk, by questioning him we will find that one (the Arnica) patient moves because he is sore and bruised and wants to get off the sore spots; he often says that the bed is hard, but if he describes his sufferings concretely he will say he is sore and bruised and moves to find relief, only to become sore and bruised again, and so he keeps on moving. Arsenicum is continuously moving. It is said in the text he moves from the bed to the chair; and from the chair to the bed, but you see by his face, that it is an anxious restlessness that possesses him. His mental state is one of anxiety, and is depicted upon his countenance; and you will see that this mental state drives him to move and he cannot keep still. We sometimes see the Baptisia patient restless and moving, although many times curled up in a bunch and doing nothing, but when he moves it is like Arnica, to get off the sore place. Hyoscyamus moves from restlessness. Rhus tox. moves because he aches; he is sore and bruised and the longer he keeps still the more violent is that aching, and so he moves and tosses and lies but a moment; after moving he thinks now he is going to be comfortable, but the soreness soon returns and causes him to move. How does that differ from Arsenicum? Arsenicum has the mental anxiety and it is depicted upon the face. Rhus tox has that also in a less degree, but the anxious restlessness in Rhus, is not so severe as are his pains. Arsenicum is mental, Rhus tox is physical. Stramonium moves and moves, with the delirium and wildness of his mental state; his anxiety and awful state of frenzy keep him in continuous motion. This then expresses a difference, no two are alike.

But if after long watching the physician sees that the patient lies in one position and desires to be quiet, does not want to move, is not restless, he must study Bryonia, Cocc., Colchicum, Helleborus, Phosphorus These all lie perfectly still as if dead. Bryonia in a high degree wants to be let alone, does not want to talk, is worse from motion, has a scowl if asked to move, lies there as if tired and dreads to move. Cocculus does the same lying on the back, eyes partly open, knows a good deal that is going on, but does not want to be spoken to, with a great state of paralytic prostration. There is a strong key to it, viz., if you talk in his presence about his food, and how we will go about it to feed him, he is nauseated at once; Colchicum has the same state, and it is only by further consideration that we will be able to distinguish between these two remedies. Cocculus has more of the paralytic weakness. Colchicum has a characteristic diarrhoea. In Cocculus it is the brain that is troubled; we will look in the abdomen for the symptoms of Colchicum. Hellebore also lies still with the head thrown back, the limbs drawn up upon the abdomen, rolling the head in delirium, but otherwise wants to keep perfectly still, and the physician has only to observe a few days to see that there are wrinkles coming in the face and brow showing cerebral disturbance of the gravest character. Or the mental weakness and increasing prostration, with thirst for ice cold water which gurgles through the bowels, will enable you to distinguish that he is needing Phosphorus.

James Tyler Kent
James Tyler Kent (1849–1916) was an American physician. Prior to his involvement with homeopathy, Kent had practiced conventional medicine in St. Louis, Missouri. He discovered and "converted" to homeopathy as a result of his wife's recovery from a serious ailment using homeopathic methods.
In 1881, Kent accepted a position as professor of anatomy at the Homeopathic College of Missouri, an institution with which he remained affiliated until 1888. In 1890, Kent moved to Pennsylvania to take a position as Dean of Professors at the Post-Graduate Homeopathic Medical School of Philadelphia. In 1897 Kent published his magnum opus, Repertory of the Homœopathic Materia Medica. Kent moved to Chicago in 1903, where he taught at Hahnemann Medical College.