Abstract: Pyrexia has been considered to be a physiological protective mechanism for a long time. Recent years have shown the rise in the cases of pyrexia of different origins. The disrupted lifestyle and metabolic diseases in patients such as hypertension, diabetes and thyroid disorders favors the infections along with haphazard use of antibiotics leading patients to the resistance that restricts the use of drugs from modern medicines. As the nature of fever varies according to the response, immunity, severity and viral load it is better to opt for homoeopathic individualized medicine. Considering the above points this article talks about a large order of plant groups that is compositae family consisting of various fever remedies.
Keywords: pyrexia, infectious fever, compositae family, homoeopathy, fever remedies.
Abbreviations: NSAID- non-steroidal anti-inflammatory drugs
Pyrexia also known as fever commonly is a functional protective response of body characterised by the rise of body temperature above the normal range that is 98.6F. It is often a secondary response to certain stimulus. Pyrexia is considered as the symptom and not the disease although it is an acute protective response of the body it should be treated carefully as hyper pyrexia causes damage to the brain cells after a certain point and altered metabolism can create emergency. Though being the acute condition it causes dehydration and energy waste of organism, in modern medicines drugs like NSAIDs and aspirins are made to combat pyrexia but may causes different side effect so it should be treated with more effective line of treatment. Recent studies have shown efficacy of homoeopathic remedy nux vomica in cases of pyrexia.1 Deep knowledge of materia medica as well as more clinical studies are required to give the assured treatment.
Types of pyrexia
According to the temperature levels, pyrexia can be classified as hypothermia: temperature below the 93-degree f. or 35 degree c.
Mild pyrexia: temperature ranging in 99-100 degree Fahrenheit
Moderate pyrexia: temperature ranging in 100-103 degree f.
Severe pyrexia: temperature ranging in 103-105 degree f.
Hyperpyrexia: temperature above 105 degrees f.2
Pathophysiology of fever
Normal body temperature is maintained by thermoregulatory centres in the hypothalamus of the brain. The cascade of febrile response is taken as further, In case of some external stimuli mainly one among infection, inflammation and trauma. The production of inflammatory cells such as the macrophages starts. It causes the activation of both neural and humoral pathway of body response. Via neural pathways vagus nerve and some cutaneous nerves send response to the brain. Through the humoral pathway some pyrogens such as cytokines and interleukin-1 are produced. The secreted interleukin-1 cause the activation of the thermoregulatory points in the brain at hypothalamus especially the organum vasculosum. This leads to the synthesis of the prostaglandins which increases the thermostatic set point of the body. All these events leads to the febrile response which is induced by the vasoconstriction, finally causing the rise in the temperature and shivering. 3,4,5
Common causes of fever
The common causes of fever can be enlisted as:
1.Infection by bacteria virus and parasites is the most common cause
2.Inflammation where the four major inflammatory signs are also observed including redness, pain, heat and swelling. Also, seen in some casse of autoimmune diseases and malignancy
3.Fever induced by drugs
4. Endocrine fever where there is disturbance in thyroid hormones causes the lack of regulation of metabolism ending up as fever.2
Patterns of pyrexia
Fever is divided into 3 types as:
1. Sustained/continuous fever
2. Intermittent fever
3. Remittent fever
In sustained/ continuous type of fever, temperature does not rise more than 1°C, i.e. 1.5 °F but also never touches normal. This type of fever characterises lobar and gram negative pneumonia, bacterial meningitis, typhoid, urinary tract infection.
In intermittent fever, fever is noticed only for particular hours in the day. This type of fever can be seen in malaria, tuberculosis, lymphomas, kala-azar, etc.
In remittent fever, temperature rises more than 2°C daily and never reaches normal. This type of fever is mostly seen in infective endocarditis, rickets infection, brucellosis.4
Details of compositae family
The compositae family belongs to the plant kingdom where perennial herbs and annual herbs are included. This family is also known as the asteraceae, the massive order of family consisting of around 60 homoeopathic drugs containing well proved and partially proved remedies. Herbs have been found to be effective since ancient times used by different schools of medicine.6
The common physical symptoms expressed by the drugs of compositae family6
- Marked febrile illness
- Short term and long term effect of trauma
- Sore lame bruised feeling
- Broken and beaten sensation
- Severe pain and soreness in joints
- Marked congestion
- Haemorrhages bright and profuse
The common mental symptoms expressed by the drugs of compositae family7
- Confusion of mind , absent minded.
- Marked restless feeling.
- Wants freedom.
- Fear of being hurt , injections, operations, falling.
- Generalised anxiety.
Commons ailments of compositae family drugs6
Injury, trauma, shock, infections, grief, bad news, anger suppression.
Categorization of compositae family according to the symptoms manifestation6
- Convulsion remedies
- Fever remedies
- Injury remedies
Fever remedies of compositae family:
- Arnica montana: Dr Phatak has mentioned that it can be useful in intermittent, typhoid, septic, traumatic fevers. Febrile symptoms closely related to typhoid fever along with the shivering over the whole body. Redness of head, with coolness of rest of body. Internal heat; feet and hands cold. Chilly with heat and redness of one cheek. Head or face alone hot, body cold. Must uncover but cannot because of chills. Sweat is characterized as nightly sour sweats. Mentally patient is drowsy indifference and sleeps in between the answers. Patient develops touch aversion. Gets angry when obliged to answer. Anguish and irritability can also be observed. Lilienthal talks about arnica as remedy for congestive malarial intermittent. Rheumatic fevers.8,9,10,11
- Chamomilla: Useful in the spring fever and quotidian fevers. Dr Phatak has explained Chamomilla’s fever as chilly but gets overheated easily. Coldness of one part, with heat of another. Aggravation by uncovering. Alternate chill and heat. Feverish from suppressed discharges. Sweat on head. Thirst during a long lasting fever.10 As per Clarke, pulse in fever small, tense, accelerated. starts during sleep, and furious delirium. Mentally patient gets irritable and snappish.9 M.L. Tyler has explained it as easily chagrined to anger, dullness of senses, piteous moaning and tossing in bed due to pain.13
- Eupatorium perfoliatum: all types of infectious and non-infectious fever mainly influenza, dengue and malaria. Has a marked chill stage. Dr Boericke has mentioned that perspiration relieves all symptoms except headache. Chill between 7 and 9 am, preceded by thirst with great soreness and aching of bones. Nausea, vomiting of bile at close of chill or hot stage; throbbing headache. Knows chill is coming on because he cannot drink enough. 8.Farrington mentioned that chills start from the back. 12Heat with great weakness and cannot raise the head explained by Lilienthal.11Clarke has given important symptoms as fever commences in morning; attended with painfulness, trembling, weakness, and soreness; but little or no perspiration. mentally moaning and restlessness is observed during heat, shrieking, fear and restlessness due to pain, severe prostration of mind.9
- Eupatorium purpureum: works well in cases of dengue and malaria. Boericke mentions no thirst during chill, but much frontal ache. Chill starts in the back, mainly the lumbar region. Violent shaking, with comparatively little coldness. Bone-pains. Chill with the thirst. Long lasting heat with dizziness and weakness in apyrexia.8
- Absinthium: Farrington mentions usefulness of remedy in typhoid fever. Some obstinate fevers of autumn. Chill heat with drowsiness and sleep. thirst in all stages. Mental dullness and indifference can be observed.12
- Abrotanum: High rheumatism fever. Hectic fever, with chilliness and weakness. At mental sphere confusion, prostration and difficulty at thinking can be observed.9
- Calendula officinalis: Boericke explained the chill as coldness, great sensitiveness to open air; shuddering in back. Phatak explained about its warm skin. Heat in the evening. Great heat, in the evening when in bed, accompanied with moisture on the feet, which are burning. Fearful of something will happen, hypochondriacally anxious.8
- Senecio aur: useful in hectic fevers. Clarke explained symptoms as Chilly after taking a cold; followed by heat and sweat. Moderate thirst. Chilliness followed by urging to urinate.-Copious warm sweat towards morning; catarrh. Heat of forehead. Hot flushes day and night. Sweat of forehead.Disposition to perspire.9 Phatak gave a symptom of hectic fever, with anorexia.10
- Solidago virgaurea: Rheumatic fever. Very frequent pulse. High fever.9
10.Taraxacum officinale: useful in hepatic and bilious fever. Farrington mentioned its usefulness in typhoid fever.12 Clarke mentioned chilliness, after eating and drinking. Chilliness, shivering. Headache is pressive. Chill in the open air. Heat at night on waking, esp. on face and hands. Violent night-sweats, mostly before midnight, when just going to sleep. Very tiring perspiration, causing biting on the skin.9
11.Wyethia helenioides: Chill 11 a.m.; thirst for ice-water during chill; no thirst with heat; profuse sweat all night; pains in back and limbs, at times jerking; six days later, with intense headache ,Cold sweat over whole body, which soon dies off, and comes again and goes as if by flashes. Fever and pains all over body, with inflamed tonsils.9,10
12.Millefolium: Continuous high fever. Pulse accelerated and contracted.-Chilliness with pain in kidney. Fever heat with thirst. Heat in hands and feet.-Colliquative perspirations.8,9
Conclusion: Compositae family consists of a wide range of remedies which are useful in the different types of pyrexia although some remedies are lacking in clinically verification. Hence, a more detailed and evidence based study is needed to validate the result.
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1: Dr Suvarna Patil, MD.Hom, Professor, Guru Mishri Homoeopathic Medical College and Hospital Shelgaon, Jalna. (Maharashtra University of Health Science, Nashik)
2: Dr Dipali S. Sonar, MD Scholar, Department of Repertory, Guru Mishri Homoeopathic Medical College and Hospital Shelgaon, Jalna. (Maharashtra University of Health Science, Nashik)