Enteric fever and Homoeopathy

Enteric fever and Homoeopathy

ABSTRACT- Typhoid is the common monsoon disease prevailing , the disease that has a wide variety of symptoms and complications , homoeopathy has a great role in treatment of typhoid .

Many Homeopathic remedies have been prescribed according to Totality of symptoms as per case and reports have also been published. 

KEYWORDS – typhoid  fever  ,  infectious disease , Homoeopathy.

DEFINITION– Typhoid fever is the result of systemic infection mainly by S. typhi found only in man. The disease is clinically characterized by a typical continuous fever for 3 to 4 weeks relative to bradycardia with involvement of lymphoid tissue~ and considerable constitutional symptoms. The term “enteric fever” includes both typhoid and paratyphoid fevers. The disease may occur sporadically, epidemically or endemically.

 TYPE OF ENTERIC FEVER .

1. Typhi 

2. Paratyphi. A, B, C 

HISTORY OF TYPHOID DISEASE.

Mary Mallon was born in Ireland and emigrated to the United States in 1883 or 1884.

Who was cook ,she was supposed to spread typhoid and popularly known as’ typhoid mary.

Epidemiology–.INDIA – Typhoid fever is endemic in India. Reported data for the year 2013 shows 1.53 million cases and 361 deaths. Maximum cases were reported from Bihar (261,791 cases with 2 deaths) followed by Andhra Pradesh (233,212 cases with 5 deaths). The other states having large number of cases are, Uttar Pradesh (223,066 cases and 161 deaths), Madhya Pradesh (114,578 cases and 28 deaths), West Bengal (108,695 cases and 39 deaths), Maharashtra (82,852 cases and 1 death), Odisha (53,743 cases and 35 deaths^. In November 2021 the incidence of typhoid fever in Madhya Pradesh was  incidence 305 (255–419) urban 30.7 %

As of 2019 estimates, there are 9 million cases of typhoid fever annually, resulting in about 110 000 deaths per year

CAUSES.

Typhoid  is caused by the bacteria s.typhi and spread through food ,drinks and drinking water that are contaminated with infected fecal matter .Some people are asymptomatic carriers of typhoid ,meaning that they harbor the bacteria but suffer no ill effects .others continue to harbor the bacteria after their symptoms have gone sometime , the disease can appear again.

CLINICAL FEATURES:  

    First week – 

• Fever , 
• headache, 
• myalgia ,  
• Relative bradycardia, 
• constipation ,
• diarrhea 
• vomiting in children.

    End of first week –

• rose spots on trunk ,
• splenomegaly.
• cough 
•  abdominal distension 
•  diarrhea.

     End of second week- 

• delirium 
• complication 
• coma 
• death [if untreated

^{Complication  of enteric fever :}                                                      

• ^{Bowel                                   1.Perforation              2.Haemorrhage} 

• ^{SEPTIC FOCI                    1.Bowel and joint infection.}   

^{2.Cholecystitis.}

^{3.Meningitis.}

• ^{TOXIC PHENOMENA       1. Myocarditis.}

                                                            ^2.Nephritis.

• ^{CHRONIC CARRIAGE      1.Persistent gallbladder carriage}                   

Differential Diagnosis:

1. Dengue fever.
2. Malaria.
3. Amoebiasis.
4. Leptospirosis.
5. Q fever .
6. Tularemia.
7. Melioidosis.
8. Giardiasis.
9. Bacterial gastroenteritis.
10. Rickettsial infection .
11. Toxoplasmosis.
12. Brucellosis.
13. Tuberculosis.

Investigation 

( a) MICROBIOLOGICAL PROCEDURES : The definitive diagnosis of typhoid fever depends on the isolation of S. typhi from blood, bone marrow and stools. Blood culture is the mainstay of diagnosis of this disease. 

(b)SEROLOGICAL PROCEDURE : Felix-Wida! The test measures agglutinating antibody levels against 0 and H antigens. Usually, 0 antibodies appear on day 6-8 and H antibodies on day 10-12 after the onset of disease.

Dietary and lifestyle changes in typhoid as per  W.H.O.

On the typhoid diet, you should opt for foods lower in fiber, such as cooked vegetables, ripe fruits, and refined grains.It’s also important to stay hydrated and drink plenty of water.

        Do’s

• Cooked vegetables: potatoes, carrots, green beans, beets, squash
• Fruits: ripe bananas, melons, applesauce, canned fruit
• Grains: white rice, pasta, white bread, crackers
• Proteins: eggs, chicken, turkey, fish, tofu, ground meat
• Dairy products: low fat or fat-free pasteurized milk, yogurt, cheese, and ice cream (as tolerated)
• Beverages: bottled water, herbal tea, coconut water, juice, broth
• Rest well.               

Don’ts

• Raw vegetables: broccoli, kale, cauliflower, cabbage, onions
• Fruits: dried fruit and raw berries, pineapple, and kiwi
• Whole grains: quinoa, couscous, barley, buckwheat, brown rice
• Nuts: almonds, pistachios, macadamia nuts, walnuts
• Seeds: pumpkin seeds, flax seeds, chia seeds
• Legumes: black beans, kidney beans, lentils, chickpeas
• Spicy foods: hot peppers, jalapeños, paprika, cayenne pepper
• Fatty foods: donuts, mozzarella sticks, fried chicken, potato chips, onion rings
• Do not exercise ,bath, sleep during the day, or suppress natural urge 

Do not drink contaminated water

Homeopathic viewpoint

According to aphorism 73 in organon of medicine

 Typhoid fever comes under the acute disease which is caused by transient explosion of latent psora due to some exciting cause and in its footnote Dr. Hahnemann says that irrespective of its name, the febrile condition is to be treated according to its several peculiarities^.

Some Homoeopathic medicines for typhoid

• Baptisia : diarrhea or dysentery during typhoid .Stool very offensive with rumbling in the abdomen.
• Bryonia : given in alternation every two hours often helps cure and does not allow complications to develop. baptisia acts as an antibiotic to typhus in tincture form.
• Cuprum met: when there is unconsciousness. One does every 12 hours. Urine may be a suppressed weakness. restlessness.
• Gelsemium :to be used in the early stages when there is a lot of headache.
• Phosphorus :if complicated with pneumonia.
• Rhus tox: triangular tip of tongue and diarrhea restlessness is always present .
• Acidum mur :it is used in very grave conditions when there is bleeding from the rectum or the patient becomes unconscious .
• Arsenicum album :it does good in all sorts of fevers provided its symptoms –restlessness ,unquenchable thirst ,drinks often but little ,sweats ,etc. are present  appearance of dead scales of the skin on the lips is also one of the good indication for its use .the patient feels chilly.
• Arum triph.:if there is delirium or diarrhea or both.
• Absinthinum: if there is sleeplessness, along with the fever.

                                                                                                                     REFERENCES:

1. Penman ID, Ralston SH, Strachan MWJ, Hobson R, editors. Davidson’s principles and practice of medicine. 24th ed. London, England: Elsevier Health Sciences; 2022
2. Krishna Das KV. Textbook of Medicine. 5th ed. New Delhi, India: Jaypee Brothers Medical; 2008.
3. Kalra SP, Naithani N, Mehta SR, Swamy AJ. Current trends in the management of typhoid fever. Med J Armed Forces India [Internet]. 2003;59(2):130–5. Available from: http://dx.doi.org/10.1016/s0377-1237(03)80060-6
4. Who B. Background document:The diagnosis, treatment and prevention of typhoid fever. Geneva, Switzerland; 2003.
5.Hahnemann S. Organon of medicine. New Delhi, India: B Jain; 2023.
6. Boericke, William Boericke’s new manual of homoeopathic materia medica with repertory. D-157 sector 63 Noida U.P.(India): B. jain publishers (P) LTD,40th Impression 2017