Typhoid Fever is caused by 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 secretionduring the acute stage. The bacteria lives only in humans.
A small percentage of humans become carrier of t6his 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.
Homeopathic treatment of typhoid fever
Homeopathy is one of the most popular holistic systems of medicine. The selection of remedy is based upon the theory of individualization and symptoms similarity by using holistic approach. This is the only way through which a state of complete health can be regained by removing all the sign and symptoms from which the patient is suffering. The aim of homeopathy is not only to treat typhoid fever but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several remedies are available to treat typhoid fever that can be selected on the basis of cause, sensations and modalities of the complaints. For individualized remedy selection and treatment, the patient should consult a qualified homeopathic doctor in person. There are following remedies which are helpful in the treatment of typhoid fever:
Apis Mel – good remedy for typhoid fever; 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.
Arnica Montana –
Arnica frequently fits in this disease most usefully. As above stated, it has many symptoms common to Baptisia and Rhus, yet its individual symptoms are marked. It is a remedy that is not so likely to be indicated early as Baptisia. There is a stupor, and indifference to everything, patients do not know that they are sick, and care less; they go to sleep while answering questions; the head is hot the body cool, and all over there is a bruised feeling; the patient tosses about the bed to find a soft spot; the stools and urine are in involuntary; there are ecchymoses and bed sores, petechiae appear all over the body; finally a condition of stupor arrives characterized by dropping of lower jaw. The three-legged stool of Arnica in this disease is:
1. The bruised, sore feeling all over the body.
2. The ecchymoses.
3. The involuntary stools and urine.
No other drug has this trio of characteristic.
Belladonna – 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.
Baptesia– specific for typhoid fevers; septic conditions of blood; great muscular soreness, offensive breath, stool, urine, sweat.
Hyoscyamus –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 totality. In the early stage of the disease the delirium and the later the symptoms of cerebral paralysis may call for Hyoscyamus. It the delirium be furious or low and muttering, with picking at the bed clothes, and especially if subsultus tendinum be present, then Hyoscyamus is the remedy. Still later there may be dropping of the lower jaw, the patient being exceedingly weak and tremulous, with muscular twitchings as a prominent symptoms. With Hyoscyamus,too, we have involuntary stools. In the delirium there is much similarity between evidences of blood poisoning than Belladonna. This fact should be borne in mind in the treatment of typhoid fever, and drugs selected according to the totality of the symptoms; but the pathological condition should be taken into consideration in making up that totality.
Kali Phos – great remedy for typhoid fever, a dry, brown tongue, foul and putrid diarrhea, great debility, low pulse, offensive breath, sordes on teeth, with great mental depression.
Bryonia – this is one of the great typhoid fever remedies, and is, soeener or later, indicated in a majority of cases of the disease. The characteristic symptoms are these: great soreness over the body. Tired feeling. Every exertion fatigues; dread from all the motions; a splitting, agonizing frontal headache, worse from motion.
Arsenic Album – this is one of the best remedies for typhoid fever; the terrible prostration so characteristic of the drug is accompanied by an irritability and anxiety. The patient is 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.
Acid Phos – Under this remedy we have characteristically sensorial depression, indifference and perfect apathy, but out of this condition he is easily aroused and is perfectly rational. There is apt to be nose bleed, and abdominal symptoms are plentiful. The abdomen is distended and bloated; there is much rumbling and gurgling and painless diarrhea, stools often containing undigested matter. There may also be present intestinal haemorrhage. Like Arsenic, Baptisia and Colchicum, the tongue is dry and the teeth covered with sordes. With this remedy there is a characteristic aversion to conversation and patient is apt to lie with a stupid, fixed, glassy stare. Stramonium has the opposite of this-desire to talk and wild look. Phosphorous has more sensorial excitement and more dryness of the tongue than Phosphoric acid. It is to Phosphoric acid that Arsenic is to Rhus. It is also the main remedy when pneumonia complicates.
Gelsemium – This is a remedy often indicated in the first stage, and especially in comparatively mild cases. The patient feels sore and bruised all over, as if pounded, there being also a dread of motion, headache, drowsiness, red face; the nervous symptoms are predominant. Patient is characteristically dull and apathetic, and looks and feels as if he were going to have a fit of sickness; but he does not care much, he never worries over his condition. Drooping eyelids in characteristic, it shows general languor and malaise. Trembling is scarcely less prominent. There is chilliness, full and flowing pulse, not resisting as in Aconite. Gelsemium usually precedes Baptisia, its symptoms being similar but milder. Nash says Baptisia leads when soreness is most prominent, and Gelsemium when prostration is most marked. The mind is clouded with Baptisia, not so much so with Gelsemium. Dr. G. J. Jones preferred Gelsemium to Baptisia, and he used the second dilution.
Muriatic acid – Great weakness characterizes this remedy, great foetor of the breath, and ulceration of the mucous membrane. Salivary glands tender and swollen, mouth very sore. It corresponds th later stages, where putridity is prominent and the weakness is expressed as being so marked that he slips down to the foot of the bed. The tongue is so dry that it rattles in the moth. The diarrhea is watery and often escapes while urinating; the heart is feeble, irregular and intermits every third beat. Bed sores are prone to form; petechiae and oedema of ankles.
Lachesis – This is a remedy also indicated in the later stages of typhoid, where the patient is in a stuporous condition; lower haw dropped, perhaps a low muttering or loquacious delirium; all showing a tendency to cerebral paralysis; diarrhea is present, and, like the preceding remedy, is offensive. The tongue is dry and catches on the teeth when it protrudes, also it trembles, here being similar to Apis; and in the dropping of the lower jaw and symptoms of paralysis of brain it should be distinguished from Opium, which has in addition a dark red face and stertorous breathing, and from Hyoscyamus, which is especially characterized by muscular twitchings.
Cinchona – Has some similarity to Arsenicum in its debility, and it has also a tympanitic condition of the abdomen; and Colchicum should not be overlooked, as it sometimes stand midway between Arsenicum and Cinchona, having the great debility and restlessness of the former remedy and the tympany of the latter. Preponderance of abdominal symptoms should suggest Cinchona. It is also the remedy during convalescence.
Carbo vegetabilis – This is another low down remedy; suitable when there is a giving out of vital forces and the patient seems on the brink of dissolution and lies pulseless and cold; feet and legs, especially below the knees, are cold. The discharges are horribly offensive and colliquative. The characteristics are the great prostration, the desire for air patient wants to be fanned all the time -and the cold extremities, which are frequently covered with cold perspiration; the sunken hippocratic face, cyanosis, ecchymoses and bed sores.
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 degree F (40 degree C) mostly in evening, temperature associated with-
- Relative bradycardia
These all symptoms followed by remittent fever up to 7days 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 (rashes fade on applying pressure)
- Gastro-intestinal symptoms- in early illness diarrhoea in children with vomiting and constipation then succeeded by diarrhoea and with-
- Abdomen distension
- Enlarged spleen
- Respiratory symptoms
- Lymphnodes- generalised lymphadenopathy.
End of 2nd week
After 14 days if infection begins to continue-
- Persistent fever with delirium
- Increased weakness and fatigue
At 21 days
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
- Septic arthritis
- Cerebral thrombosis
- Acute circulatory failure
Diagnosis of typhoid fever
- Presence of rose spots, splenomegaly with leukopenia.
- Widal test
- Blood culture
- Examination of faeces for presence of causative organism