Clinical Cases

High Fever Without Symptoms

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I shall start with just such a case (which “will need all your awareness”). This is the child of a couple who were both MDs. They knew about homoeopathy and the child was treated homeopathically since birth. This is a good teaching case for many reasons: One is, that unless we have given a constitutional remedy to a person, they are not really healthy. I had been seeing the child all along. He was then four years old. He had developed a fever accompanied by certain pains which radiated in the abdominal region. That was all. The child developed pain and had high fever for a few days before they consulted me. They said, “We cannot get any symptomatology. He complains about pains in the abdomen, with the high fever. What did I prescribe?” You are going to be faced by such cases and I want you to know what I am going to do. I tried, of course, to get some more symptoms. There was heat, perspiration, but nothing special. Don’t be afraid to speak. I prescribed wrongly, so you needn’t be afraid of your ideas.

Response: Sometimes cases that have nothing to offer in symptoms can be given Sulph.

George: This is an idea. Are there any other ideas?

Response: Constitutional remedy repeated.

George: That is another idea, if we had found a constitutional remedy. I said that I had been prescribing all along, but I did not tell you that I had found a constitutional remedy. You will see here, as this develops, how important it really is, to have given the deeper remedy. I have been giving remedies and the child was okay. He had tonsillitis, diarrhoea, and that all along until he was four years old. I had not found a constitutional remedy. It appeared later.

Question: Had you been treating the parents ?

George: Yes, I had been treating the parents and they did not have anything special in their history. There was high fever without symptoms.

Question: What about the examination of the child’s background?

George: The parents were both MDs. They had auscultated. They had seen no rales, rhonchi, and they could not locate anything special in the abdomen.

Question: Was there a sore throat?

George: A little bit. The tonsils were not swollen and no glands were enlarged.

Question: What was the character of the pain? Did he bend double or was the abdomen irritable?

George: There were no modalities. What I ask you for, is a remedy. We suppose that you have examined the patient and have not found any’ more symptoms. So you have a high fever, without symptoms. Which is the remedy? It is the remedy which is mentioned in Kent’s Materia Medica? It starts with F.

George: Ferr-p. is the remedy which is usually prescribed when there is a fever without any attendant symptoms. Sulph. is correct also. When you don ‘t have any symptomatology, there is a paucity of symptoms as we call it, and we give Sulph. But why didn’t we give Sulph. in this case? There is always a reason for giving a remedy- at least you have certain reasons. Sulph. is given when there is a paucity of symptoms. Which means that you have been treating someone constitutionally or for a chronic ailment for the second time. And you have taken away his symptoms, but the person does not feel at all well. Symptoms which are not prominent and do not give you the idea of a remedy, may make you think of Sulph. But this is not so in an acute case. You will not prescribe Sulph. in an acute case because there are no symptoms. Sulph. is a good remedy which you may need to use appropriately later. I prescribed Ferr-p. in this case and, as you can understand, nothing happened. On the third day the parents decided to give antibiotics. They did not wait long.

I think it was one day he had the fever, the second day we gave the Ferr-p. and another two days when the parents gave the antibiotics, so this was the fourth day. We found a definite diagnosis. They gave antibiotics for four days and then discontinued it. The child remained better for a week. Then the fever and the pains returned. With a relapse there was a swelling of the cervical and sub-maxillary regions.

There was not much prominence to these glands, however. There was a shortness of the pulse, together with redness which was prominent, and inflammation. There was now thirst present. I did not find any other symptoms, and I could not elicit any from the parents. Doctors are very bad at giving symptoms for themselves or their family. Nothing! I then prescribed another remedy, which, of course, was wrong again. Could I give something? There was stiffening in the abdomen. The cervical and sub-maxillary glands were swollen, and there was thirst; the thirst was not marked, but it was definitely increased. I prescribed Bryonia We have tonsillitis and thirst: Bryonia! But this does not always work. (Laughter)

This did not work. The child’s fever was constantly high without remission. After Bry, I prescribed Sulph. and then Puls because they told me that the child had developed some fear of the dark. The child was red with fright. The thirst had gone away by giving Bryonia and Sulph. Now the child was warm and crying, and I prescribed Pulsatilla A few more days passed and the child was worse. The fever continued and all of the symptoms became worse. The pediatrician was consulted and said that this was mononucleosis. I do not know the logic. Penicillin was prescribed to protect. Usually in mononucleosis they don’t give anything, but this was given to prevent a possible streptococcal pneumonia or something like that.

Response: Was there a monospot test done?

George: Yes, the test did not show very clearly that it was streptococcus. The child was given Penicillin for a week. See how we mess up cases? We need the help of allopathic medicine. This is a fact attributed to two factors: first because of my inability to prescribe correctly; secondly because of the anxiety of the parents to have the child treated and become well immediately.

When you see a case like that where the fever is high and steady for many days, you have to have great psychological endurance and tell the parents, “No, do not give anything”. If that child had been left without antibiotics, eventually he would have developed a clear picture. Then the remedy could have been found, no matter what stage might have been reached. During the stage just before death there will be a come-back


So then there were seven days of Penicillin. The fever went down. The child remained without high fever for six days after the Penicillin was finished. Then again the whole picture of symptomatology came up. Fever, enlarged glands, pains in the abdomen as soon as any food or drink was taken. Antipyretics, anti-fever medications, did not affect the high fever at all. This was given after the Penicillin when the fever started again. I did not prescribe, but waited. The symptomatology was consistent and the fever was high. The abdominal pain occurred immediately after eating or drinking. The child had no appetite and had lost weight. There was thinness and exhaustion in the appearance. I had tried to take symptomatology on the make-up of the child from the mother. She said that the child was “quite brave” and according to her understanding the child would express less than what she felt. Stoic.

In a few days they gave antipyretics and the child developed measles. Now I don’t think that this was measles from the beginning. It was perhaps mononucleosis. I do not know. The tests showed some white blood cells you know, the mononucleosis cells-in greater number. Then the child developed the measles, which is a continuation of the whole story in another version. I do not think it was measles from the beginning. So the measles was allowed to run its course. I tried to prescribe during the measles because it was a very severe case. The child was covered with eruptions. There was exhaustion and suffering. We tried to relieve this by giving a remedy. At that moment, according to the symptomatology which I thought she had, I prescribed Sulph. again. Then the measles improved -the next day, as regards the eruptions. She was more quiet then, but it took another three days, which is the natural course. This showed me that I had not done anything so far. Because the parents are MDs..voom! …what is going on? There were consultations with pediatricians. What is going to happen to the child? What are we going to do? Take Sulph. Take this. Take that. Nothing! Then we come to the last stage and now we know that it is measles. Whether we give a remedy or not, the measles will go away. You see the situation. Then the fever went down. The rash and eruptions slowly disappeared. This was on the fifth day. The abdominal pains came back as the child would eat – this was around the umbilical region. The child was exhausted. They again called the pediatrician and I went again to see the child. So I went and now the story starts! (Laughter)

The child was dehydrated to the extent that the lips were cracked with even small evidence of blood coming from the lips. The child was lying down and looking at the father in a fairly “mellow” way, as if to say, “What is wrong with me? Save me!” There was a melodramatic attitude to the child. She would not talk. She would not complain. When I pressed the head forward, the Budzinsky sign was positive. They called the pediatrician again. There was stiffness of the cervical region and the child had started to complain of headache. The fever was not high. It was 38.3°C. The highest fever one can reach is 41 degrees Celsius. It was elevated but not high. The child no longer had the strength or vitality to produce a high fever.

I did not like the situation and the pediatrician asked that the child be prepared to go to hospital. The father cried and there were all sorts of reactions. There can be an encephalitis or meningitis after measles, which is very precarious. I could see no remedies. However, the child needed intravenous saline -some fluids. This occurred at night. The next morning the child was taken to the Children’s Hospital. They did a cervical spinal puncture in the hospital and said that it was meningoencephalitis (virus) and there was nothing to give at the moment. They were advised to wait before giving Hydrocortisone. The damage is perhaps more in such cases

The parents phoned me from the hospital in the morning and I told them I was coming. I went to the hospital. As you can understand, the mother and father knew the diagnosis and what it meant, being MDs. The fever is not very high but the child appeared a bit stupefied and complained, when she could speak, about pain in the head.

The assistant professor, who had examined the child, said that he had never seen a child with meningoencephalitis, dehydrated to such a great degree. (The child had already been dehydrated since the previous day.) According to him, this was very serious. The child was to stay in the hospital ten days for observation.

Examination at this time revealed the following symptoms: dryness and peeling of the lips, tremendous dryness of the tongue; tongue felt as if it was sandpaper. This is after the child has taken saline intravenously all night. This is very important. I came there about 11 o’clock in the morning. Still the dehydration was tremendous. Dehydration was especially noted in the center of the tongue. The base of the tongue was discolored deep brownish. The child was almost comatose, but was aware. The child was very quiet. The mother told me that the child was ‘really brave’ because during the venous or spinal punctures, she had not complained. There was discoloration of the face. This was the symptomatology. See what you can find. The child did not complain of thirst either because she was not in a state to ask for water or because she was taking saline intravenously. This is information which comes only from observation. I left this until the end in order to show you that if you are not observant enough you will not be able to find the remedy. And that is where the “art” comes and blends with science. We have this symptomatology which is doubtful and it will not give us the remedy. Any suggestions?

Response: Natrum mur.

George: Natrum mur., very good. China? Yes, there is logic in that Opium, yes. Stramonium? The picture would have to be much more violent in such a case. The pain. The child would cry.

Response: But is the painlessness of complaints usually painful?

George: The child is not completely painless. She complained about the abdomen and head. I shall give you the key now. I noticed that the mother was sitting next to the child. The child was here in bed and the child was holding the mother’s hand.

Audience Member: Phosphorus

George: Wait! Don’t jump to conclusions. So I told the mother to take away the hand. She slowly did so and the child started crying. She again held the child and the child stopped. I said for her to pull it out again. She pulled it out and the child cried again. This was repeated. Then I was sure about the remedy, but why? What was the remedy? I went to the repertory. I looked and saw: “Dryness of the tongue in the center”.

Responses: Aconite, Ant-c., Amm-c., Mang., Arum-t. (in the two), Arg-m., Lap-a.

Another Response (from several): Phosphorus

George: Capital there?

Response: Yes. Others?

Responses: Silicea, Stramonium, Sul-ac.

George: So, this is the rubric. Definitely, because the dryness is so much that we can rely on that rubric. And then again, on the tongue there is a discoloration, brownish and the center. The tongue is like that and the discoloration is here which is very very prominent. It is not exactly on the base, you see? Neither is it on the tip.

Response: Arnica (2) Arsenicum (I)Bryonia (2), Cantharis (1), Colchicum (2), crot. (2), Eurp-pur. (2) Hyoscyamus (I),Iodium (1), Lac-c. (2),Nat-p. (1), Phosphorus (2),Plb. (2), Pyrogen (1) Vib-o (1).

George: Now out of these two rubrics, what do we have? We have Colchicum, crot-h. Phosphorus These are reliable symptoms, very strong and very reliable. Now, which of the ones are the remedies for the child? One. The child is very afraid to stay by himself. He wants someone to comfort him. But the mother says the child is very brave. The child did not speak. This child was punctured several times and did not speak. It was fear! It was tremendous fear that made the child speechless -literally. The mother was interpreting this and giving me all this time a symptom which was exactly the opposite of what was happening. There is one more point that makes it absolutely Phosphorus Who will be able to tell me from what I have said? The homoeopath must take into consideration anything, anything! When you enter the room, whatever they tell you, is important. So who can tell me ?

Response: Fear of the dark and the fact that she was so quickly dehydrated.

George: Yes? Why?

Response: Phosphorus is so thirsty.

George: Exactly! This was the fIrst time in my life I had seen a child become so quickly dehydrated. When Phosphorus wants to take water all the time, what is that ? It is a predisposition to dehydration. So this predisposition of the child with Phosphorus was confirmed by the fear of being alone. Now we are absolutely sure. But the parents had given me only two or three symptoms. What I observed, was that she was SO MUCH dehydrated. And the child did not want the hand to be taken away. There was a fear to stay alone. Of course, I did not speak. I didn’t explain anything. I turned to the mother and said: “When do you want your child to be well?” The afternoon or tomorrow morning?” Now we are so sure that this Phosphorus is absolutely right. She looked at me and at the father and said, “Are you joking?” I said that I was serious. When do you want it, tonight or tomorrow ? If you want the child to be well this evening, give Phosphorus 50m.

If you want this by tomorrow morning, give Phosphorus 10m. It was interesting that the parents knew homoeopathy. The mother saw the condition of the child and said: “50m? Isn’t that too high?” She affected me. You always have to take everything into consideration. May be, it is some intuition. For the mother? And I said, “Okay, give the child Phosphorus 10m”. What happened?

Response: The fever came-back? (Laughter)

George: Wait until you hear the whole story. They immediately brought one dose at 2 0’clock -around 1.30 to 2 o’clock in the evening. This was one dose of Phosphorus 10m. By 8 0’clock they phoned me in an exhilarated state that the child was propped up in bed, the

dehydration was completely gone, the tongue was absolutely normal, the cracking of the lips was almost not visible after four to five hours. The child said: “I would like to eat some ice cream.” (laughter) And then the night went by and the next morning at 10 0′ clock they phoned me. The fever had started rising again. I said, “Give another dose of 10m.” Another dose was given at 10m. and this was by 10 o’clock. By 11 o’clock the fever was down and the child was better. By 12.30 or 1 o’clock (noon time), the fever was again up. The fever started coming up and the child again complained of headache. By 1 o’clock the next day I said, “Give a dose of50m.” This child took a dose of 50m. From that day to this-one year- the child has not had a cold or anything. She has never felt so well. The whole thing was that we never gave Phosphorus in all these four years as a constitutional remedy. We prescribed the constitutional remedy during the acute attack, fortunately because it was so severe, and the constitutional remedy held the child up. It not only took away the symptoms immediately, but this child left the hospital the third day !

There is another interesting question, which you will answer easily now. You see, what happened actually, was that on the third day the child developed large, oozing nodosities on her legs which were red. Erythema nodosum.

Audience Member: That would make me nervous.

George: They said, “Oh, now we will have to give the child Penicillin,” They said:” Now there is a terrible streptococcus and we will have to give Penicillin.” And they took the child and made an examination and the count was 2,500, which is quite high. They said that if the child did not take the Penicillin, she would definitely have complications. With erythema nodosum, with the tests so high, the child has no fever. She is in good condition. Her spirits are back. The child’s parents are doctors and what are you going to do? Of course, you know the answer now, but I said, “I take the whole responsibility.” I said, “Leave that child with that Phosphorus 50m. Do not give anything at all.” If the remedy had worked so well, it will definitely take care of the whole thing. Do not be misled and leave the child, when you think a remedy has taken care of it. Like with the measles. You give Sulph. and something is working. But you know that it does not work.

When I prescribed during the measles, I prescribed Sulph. The parents said, “This is helping.” But we expect much more drastic effects in Sulph. in such cases. And when they say that the patient is a little bit better,. you know that it has done nothing. So, do not think that the remedy has acted where it has not and let the child go home. I take responsibility. You can take the responsibility only when you know that you are absolutely sure. Here the effects are so dramatic that nobody can deny the fact. This is teaching case 1: If I had found Phosphorus and had given it from the very beginning this child would never have gone through all this suffering.

Response: How do you know that?

George: We know that from similar cases. Of course, that is a very good question. We cannot test the child on both conditions at the same time. We know from similar cases, when we have seen children developing, where acute diseases are slightly affected. Whereas another child in whom you have not found it, you have not really helped. Again, if the child had not taken so many antibiotics two or three times and another series of Penicillin -so the whole system of the child went down. So eventually measles developed into meningoencephalitis. That is why we must have a weak organism to develop a serious condition. We make it weak. We helped the child go into the encephalitis by giving all the antibiotics, during homoeopathic treatment or course. The homoeopathic treatment did not make the child weaker, but it did not help either.

Response: How do you know that?


George: It did not help. You cannot help with the homoeopathic remedy once you prescribe in this way. You prescribe one remedy and you wait. There is no harm at all.

Otherwise we would have no proving. A proving is done with the idea, as Hahnemann said, of helping the person. The provings are helping a person finally. What is a proving? A proving is a remedy given which is not the exact remedy which the person needs and

therefore is not a cure, but it is a remedy which is close enough to produce symptomatologies. That is how a proving is done. You give a remedy which is close enough to the sensitivity of the patient, not the exact remedy, but close. Then produce an aggravation of the symptoms -a proving -and that is considered a good thing to do. If you want to prove a remedy every three months and your health is good and you can get some benefit from that, you can do it. Hahnemann suggested this to his students and he was doing this himself.

There is no danger from that. The danger comes from the kind of homoeopathy which is

given, say, in the morning Magnesia carb. 200; at noon, Calc-c.1m; and in the evening, Graphites1m. And in the morning we have another course where Ant-c. 200m. is given, then Gelsemium 10m; and then Phosphorus 200m. On the third day we have another scheme and then we repeat it again. We start from the first day. Who knows what is happening? If that person continues to take all these remedies for six months or a year, you have a person who is proving. God knows what!

Question: What do you think would have happened if you had given a lower dose of Phosphorus? Would it just have taken longer?

George: Again that is good question. You have to remember that the more clear the case is, the higher you can go, and the more immediate will be the effects. Even in organisms which are exhausted and which are weak.

If you read all the literature, you will see that all the good homoeopaths who were living around the 19th century and the beginning of the 20th were very good and they gave very high potencies. If we had given in that case 200, before we reached 50m, where the child needed action, it would have taken us 3,4 or 5 days. If we give that with little effect, then you have to wait for the return of the symptoms, repeat 200, then 1m, then 10m and then 20m. It appeared that the child NEEDED 5Om. It was by chance – I would not say completely chance -that I said, “Do you want your child to be cured tonight?” There is a possibility that if I had ordered 50m the child would not need repetition of any other remedy. And that was proven (confirmed). When she took the 50m there was a beautiful recovery.

Question: Why did you repeat the 10m, instead of going ahead with the 50m?

George: That is a good question. When you have started with one remedy and it has an effect, do not discontinue it immediately and jump to another. When you have given a remedy and it has acted beautifully in one potency, try it again in the same potency before you jump to the higher potency. This is a general rule for acute and chronic cases.

Question: Even when the case has not been antidoted, you would still eat the same potency? If there was just a relapse?

George: In that case …I am absolutely clear about it …but in order to gain time I do that. That means that in a case where there is a relapse, before the person has any time to do anything to spoil it, I jump one. But sometimes I have found, as I told you, that a 200 which had acted in a doudenal ulcer, in the relapse I went up to 10m and it did nothing. Then I repeated 10m and there was nothing. Then I had to go back to 200. and this worked.

Audience Member: Kent says that you give the same potency twice all the way up, as long as there is action.

George: Yes. This is a general rule. When a remedy has acted. Do not give up the potency immediately. Try it once. If there is a relapse, go one step higher.

Audience Member: That is interesting, because I have seen the opposite quite frequently in my practice. As I said before, I was trying to follow Kent’s dictum on that. If they were not on top of your things that would antidote, if I repeated it, it would not work.

George: Anyhow, you cannot avoid losing sometimes, especially with chronic cases. Because there are no clear indications which will tell you to repeat the same remedy, the same potency, or go one step higher. There are no such indications which I can give you to work with where you will avoid repeating the first potency. A good strategy is to go up. You have given one remedy in a chronic case in a potency. Then he comes in after six months and says, ” I have relapsed.” You may go to 50m. If that does not work, then go back to 10m. Usually that 50m will cover the case and will work. So you can avoid the one step. You have 10m here. Then there is a relapse and you give 10m. Then there is another relapse and you use 50m.

If you go from 10m to 50m immediately, you have nothing to lose. Sometimes, but seldom, you will have to come back to 10m. But there are other old master homoeopaths who would say, “Never change your potency as long as it is working even a little.” They say, “Even if it works for one month or twenty days, do not give it up. Then you can go higher.”

Audience Member: I just wanted to say about the Phosphorus I had read somewhere about higher fevers, other than Ferr-p., in a child with a normal disposition and no change in high fever, that phos. will often work.

George: That is interesting, but in this case I had just simply lost the remedy. It is not that there were no symptoms. If you remember that at a certain stage the mother said, “The child has fear of the dark which has developed.” Then she had developed thirst So that means that I had lost track of the remedy. The symptoms were there. I do not believe very much in blind kinds of prescriptions. In desperation you may have to do it sometimes. But it is blind. And never, never ask the mother if she wants the child to be better by tonight There are so many suggestions concerning different remedies that you can give blindly, like Thuja, like Sol., like Sulph., like …and now Phosphorus Which one?

What you can do is to change the pattern a little bit. If you leave it alone it will come back. Always on the same level. You are working on the same level. You cannot make a person change his level of health with a homoeopathic prescription. With allopathic prescriptions you change the level. You see, he had skin eruptions. Now he has anxiety,

fears, and all these mental changes and changes in levels of health. Real changes! Whereas with the homoeopathic remedy you cannot do that. You cannot make a person change their level. He is on the same level, but changing the symptoms. He more or less stays on the same level. You prescribe one remedy and there is no harm at all.

Question: If you suppress with an inappropriate homoeopathic remedy, will that not change their level even if their energy goes down?

George: That will not change the level. If you suppress, you will see the suppression in a while, and then it will come back by itself. But if you don’t wait, you will give the wrong prescription. If he says, “I feel worse”, and you give another remedy, and in the evening another remedy. This means the wrong kind of prescription. It has to be done for a long time. In France or Germany, you can go into a pharmacy and take a bottle of Cimx and take it for a long time. This kind of prescription you can take with different remedies and you cannot do any harm. You take for three months, or one month, 3,4, or 5 remedies every day in different potencies, probably some of them will be close and will do something. Kent was talking about that same thing, about doctors who would prescribe high potencies haphazardly, and too many at the same time. There can be real trouble! There can be no trouble in giving one remedy and waiting for one month to see in a chronic case.

If we have time I will relate a very dramatic case in which during the course of treatment I made a mistake. You will see that the suppression was dangerous. The life of the person was in danger. Still there was nothing fatal. I have never seen trouble arising from a homoeopathic prescription in my practice, and I have seen, more or less calculated from the number of files, about 60,000 eases so far. This is quite a lot

Question: By that you mean a permanent lasting…

George: Permanent and lasting. Because I follow this system of treatment I shall relate a case to you, if I find it again, and you will see what happened by the wrong treatment.

Question: If you give the wrong remedy by mistake, what would you do? Immediately give the right remedy? Wait for a week or so?

George: How do you know when you have given the wrong remedy?

Question: You picked up the wrong vial or something?

George: Oh, the wrong vial? Just give the right remedy without hesitation. You can give the right remedy immediately. There is no problem there. In a remedy that has been given by chance, it is very seldom that it will have any relation to the case. It is like taking nothing.

Audience Member: I did that once, and it turned out to be a very excellent remedy.

George: That was definitely by the Higher Powers. It happens sometimes that things are organized by higher intelligences. He can walk inside and tell you the remedy sometimes.



About the author

George Vithoulkas

George Vithoulkas is an Honorary Professor of the Moscow Medical Academy, Professor in the Kiev Medical Academy, Honorary Professor at the University of the Aegean, Greece, Collaborating Professor in Basque Medical University (2001-2004) and Doctor Honoris Causa of "Doctor ViktorBabes" University of Medicine and Pharmacy of Timisoara in Romania. In 1995, he established International Academy of Classical Homeopathy in Alonissos, of which he is the director. In 1996, he was honored with the Right Livelihood Award (also known as Alternative Nobel Prize) "for his outstanding contribution to the revival of homeopathic knowledge and the training of homeopaths to the highest standards".

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