Fever
Characteristic – Adapted to the rheumatic, gouty diathesis, persons of a robust vigorous constitution. Old people’s diseases.
External impressions, such as bright light, strong odors, contact, grief, misdeeds of others, make him quite beside himself (Nux vomica, Staphysagria).
Pains are drawing, tearing, pressing, superficial during warm weather, affect the bones and deeper tissues when air is cold. From left to right.
Smell very acute, the odor of cooking food causes nausea (Arsenicum, Sepia).
Aversion to food, loathing even the sight or still more the smell of it.
The abdomen is immensely distended with gas, feeling as if it would burst.
Burning or icy coldness in stomach and abdomen.
Autumnal dysentery, discharges from bowels contain white shreddy particles in large quantities. “Scrapings of intestines” (Cantharis, Carb.ac.).
Affected parts very sensitive to motion and contact.
Aggravation: At night, mental emotion or exertion: Motion: if the patient lie perfectly still the disposition to vomit is less urgent. Every motion renews it (Bryonia).
Type: Not marked. Epidemic or autumnal fevers, intermittent and remittent.
Low fevers following epidemic dysentery.
Time: Hour not marked.
Prodrome: Thirst for cold water, drinking is followed by coldness in stomach and beginning of chill.
Chill: And shivering, running down the back, through the limbs, even in a warm room. Nose, cheeks and extremities cold. Chilly shivering in stomach and abdomen. Coldness in evening ameliorated by warm covering, but returning on going to bed as a chilliness, with chattering of the teeth, disappearing after a short time while lying still, it threatened to return on motion.
Heat: External dry heat the whole night, with violent, unquenchable thirst. Internal with attacks of flushes of heat, or short flushes of heat intermingled with chilliness, even near the warm stove. Great heat of the face, of the hands and feet.
Sweat: Wanting or suppressed, or profuse, easily produced, sour – smelling sweat.
Tongue: Heavy, stiff, insensible, bright red, covered with a downy white fur (milky white coating, Ant.c.). Desire for, or aversion to, food, with loathing when merely looking at it, and still more when smelling it, the smell of broth nauseates, and that of fish, eggs, or fat meat, almost makes him faint.
Nausea with great restlessness, on assuming the upright position, great inclination to vomit.
Apyrexia: Never clear. The gastric symptoms which come to the surface during this stage are usually characteristic.
Analysis – In Colchicum we frequently find the genus epidemicus for the intermittents so often met with late in autumn, when epidemic dysentery prevails. The gastric and abdominal symptoms are guiding, especially sensitive to odor of food.
A Case.
In the autumn of 1866, L.C. aet. 30, was attacked with ague of the quotidian type. The case lasted some eighteen days, a chill every day, and every day alike. It began at 10 A.M. with violent thirst, intense headache, greatly aggravated by the slightest motion, so that the patient lay on his right side with his head almost down to his knees, and moved only when the distress was so intense he could not avoid it. Wanted to be covered, but no relief from the covering. Chill lasted about an hour, and was followed by intense heat lasting about two hours, with continuance of thirst and headache, when the sweat began, with immediate relief of all the symptoms. He received a single dose of Bryonia 200. The next day the chill returned and I got this additional symptom: he could not bear the sight or smell of food. This suggested Colchicum, but, careful not to spoil the case by too hasty prescriptions, I gave Sac. Lac., I took time to study Colchicum. My attention being given almost wholly to the fever symptoms, I concluded Colchicum did not cover the case, and gave Nat. 200, one dose. The chill returned the next day, but Hering says Natrum is a slow acting remedy, and I thought we must give it time. I waited four days with just the same chill every day. Soon it appeared that every day the chill began with desire for cold water, immediately after swallowing which he begins to be cold in the stomach, the coldness at once becoming general. It is not necessary for me to mention the various remedies he received, as I floundered day after day trying to cure intermittent fever, with that symptom of the appetite prominent before me all the time. At length a friend called, and I asked him to go with me to see the case. He did so, and making his examination, took copious notes of the symptoms, till he struck that symptom of the appetite, when he whispered to me “Colchicum,” “Yes,” I said, “but that is the only symptom of it in the case.” He finished his examination, and we gave Sac- lac. The next morning my friend called at my office and said, “That is Colchicum or Cocculus, I am not sure which.” “Well,” I said, “if you say Colchicum, here goes,” and putting a vial of Fincke’s 21 m. in my pocket, I went at once to see my patient. I found him in a chill, as usual. I gave him Sac-lac. in solution, once in two hours, and left a powder of Colchicum 21 m. to be taken as soon as the paroxysm was over. He never had another chill. Moral: Treat the patient, not the disease. – Wm. A. Hawley, M.D.
