65^th LMHI Congress 

Los Angeles CA

2010.

DENGUE FEVER Epidemics Rio de Janeiro 2008

Genus Epidemicus

Dr Claudio C. Araujo M.D. FFHom (Lon.) et al.

Abstract: Dengue Fever is an archetypal acute epidemic disease, occurring seasonally in Brazil.  The classic homeopathic approach described in the Organon and later elaborated by Kent is employed: first identify the epidemic in its main features ‒ the genus epidemicus ‒ and determine the pool of remedies corresponding to this picture.  From this group of remedies, the idiosyncratic symptoms of each patient refine the analysis and determine the remedy for him/her. In this epidemic, individualizing symptoms often concerned the need for covering or for quiet, and speed of onset of the disease, and produced many cures. Hahnemann’s method is valid in any land and time.

 

ACKNOWLEDGMENTS

 

Thanks to Dr. Cynthia Carvalho M.D., Dr. Elizabeth Valente de Souza M.D., Dr. Maria Julieta Figueiredo Mascarenhas M.D. and Dr Fernando Sant'Anna M.D. All the data used in this study were coming from their patient´s clinical cases.

Thanks also to our colleagues from Letra Homeopathica, through encouragement and support and participation in the analysis of the material. Dr. André Pessanha M.D., Dr. Angela Moscoso M.D., Dr. Daniela Alves M.D., Dr. Jorge Frederico Fortes M.D., Dr. Louis Barros M.D., Dr. Marly Guedes M.D., Dr. Mariza Salgueiro M.D and all colleagues who have been studying and contributing to the Homeopathic Science.

INTRODUCTION

The summer of 2008 in Rio de Janeiro was once again the scene of an overwhelming epidemic of Dengue Fever (DF). We had known for some months that a new subtype of dengue fever would be among us. DF subtype DEN-1 is the oldest and best known, with its classic symptoms so similar to Eupatorium per. DEN-3 Subtype appeared in 2002/2003, with extreme violence, infecting hundreds of thousands of inhabitants. We were waiting for the announced arrival of DEN-2. The chief treatment from the national health service is hydration; hypovolemic shock is the commonest cause of death in DF patients. A team of homeopathic doctors worked together to determine the genus epidemicus, then treated hundreds of patients homeopathically. We did not use the results of previous research on the genius epidemicus for DF, such as the studies on DEN-3 or DEN-1. This new infection is caused by a different subtype, plus climatic conditions are not exactly the same as before, and the human population affected could have different ethnic or age-related trends. Research results and previous treatment were ignored and new research was made.

METHODOLOGY

The methods are those described by Hahnemann (Organon §99-102), improved by Kent (“Typhoid Fever,” “Diphtheria,” and “The trend of thought necessary to the Application of the Homeopathic Materia Medica, or a Rational Use of Curative Agents” in Lesser Writings), and detailed in the book Acute Cases in Homeopathy (Araujo, 2007). The steps of the method are clear and should always be followed to the letter. Otherwise we take the risk of failing to help our patients. Although the method is always the same, the case histories of the current epidemic will provide a new picture of the disease even when the vector is absolutely the same.

It is not our intention here to describe the full method, just remember that it is composed of four steps, after the identification of the epidemic:

1) A homeopathic anamnesis of a significant group of acute cases.

2) The organization of these symptoms, as if it they were part of a pathogenesis.

3) A selection of pathognomonic symptoms, so to say, generals, particulars and mental symptoms, those who best represent the current image of the epidemic disease.

4) At last, a repertorisation of these symptoms, in order to obtain medicines that covers all the symptoms for the present illness.

 

Step 1: Organizing the symptoms into Original Anamnesis

Once in possession of clinical data, we arranged them in a form to resemble a classic proving pathogenesis. We used 26 cases to produce this Original Anamnesis. These "provers" were individuals who contracted the disease and showed how the virus affects the human body. The patients' symptoms were then organized according to sequence we find in Hering´s Materia Medica: Mind, Vertigo, et cetera.

This list of symptoms from which we derived the "genus epidemicus" was built from cases collected by Dr. Julieta Figueiredo (no asterisk), Dr. Cynthia Carvalho (*), Dr. Elizabeth Valente de Souza (**) and Dr. Fernando Santana (***). After each symptom is the reference of the author. If more than one patient produced a symptom, the number is recorded in parenthesis after the symptom. For example, the first symptom - cannot be held or will cry or groan, during fever – was originated in the cases of Dr. Julieta Figueiredo and appears twice in her clinical reports.

Symptoms similar in type were grouped into separate paragraphs. They were not named as if they were themes, but this organization gave us a faster recognition of the pathogenetic tendencies of a given substance, in our case here, the virus.

Due to the fact that Rio de Janeiro has suffered successive infestations of the different types of DF, all three subtypes were likely to be present among the reported cases, i.e. the 26 reference cases likely represented all three subtypes of dengue, DEN-1, DEN-2 and DEN-3. Nonetheless, the clinical results showed that the vast majority of cases were DEN-2 subtypes. The main DF agent in 2008 was the DEN-2 subtype and it is towards it that we directed our study. The clinical image of DEN-3 subtype was very clear in our memory, so it was not difficult to differentiate the clinical cases of both subtypes. 

The symptoms of the 26 reference patients, when arranged, produced the following Original Anamnesis

 

M

 

He can not be touched or kept in his mother´s lap; cries, groans; during fever. (2)

Body aches won’t be touched or carried in her mother´s lap. (2)

Fear of physical examination and blood tests; anxious and cries; biting her nails.

Does not want to be touched, angry, > when her mother holds her hand to help her to sleep.

The child cries out desperately, had to be grabbed by five nurses so they can do intravenous hydration. He fights, clenching his teeth or do not want to take the homeopathic medication. He cries out loud, saying that they are hurting him with the needle. But still manages to answer to the anamnesis. He reports that the clinical picture began with the impression that he had been punched in the face and beaten with a stick on the back. (This child got better after Bell. 30CH in a few hours).

Very angry, he does not want to drink. Kicks the mother and anyone else who touches him. He´s hiding his face. Irritability, alternating with drowsiness.

Intolerance, with irritability, < from light and noise. *

Want to stay quiet and prefers to stay in bed rather than on his mother´s lap.

 

Sensation of weight in his eyes; gets better with eyes closed, quiet. **

Prostrate, eyes closed, lying on the mother's lap. (2)

Doesn´t want to be bothered. (2)

Does not want to talk.

He wanted to lie down, with eyes closed. **

 

At the beginning of the disease she was as if normal, wanted to go to school, said she was fine, did not want to stay home. **

He wanted to watch TV anyway. **

He was prostrated, lying down, but only the first day. Then he wanted to play soccer, although he was feeling too much aching in his body.

 

Desires to be in his mother´s lap. (2)

Restless during fever, can not sleep. (3)

Restless with abdominal pain, stirs in bed. *

During the night he gets more agitated. **

Crying during headache.

Moaning. *

Cries when his friends call him, saying he wants to go home. *

Delirium; during the night; with high fever, says he is playing with friends, calls his friends, with saliva in the mouth. **

He calls for the attention of his grandmother, saying that blood was coming out of the catheter of a boy (patient) in front of his bed and asks his grandmother to call the nurse ** (a child who was known to be already sympathetic).

 

 

Vertigo

 

Dizziness, <by motion, < in the bus that took him to hospital.

Vertigo, during the fever.

Vertigo as he might fall aside, when getting out of bed.

Dizziness on the first day when standing; these symptoms disappeared after he got better **

 

Head

 

Headache, throbbing pains, < during fever.

Headache, as if pressing his head.

 

Headache at the temples and forehead. *

Frontal headache. *, **

 

The clinical picture began with a headache in the evening. The pain is strong, but relieved by cold applications. Pain is worse in the left temple. *

Headache, with a burning sensation.

He put his hand on his head during a headache.

 

"It feels like a truck ran over my head" (> after Bell. 30CH).

Head "exploding" *

Headache was becoming more intense. *

 

Eyes

 

Eye pains, worse when he shut down his eyes.

Eye pain. *

 

Pain behind the eyes. *

 

Hyperemia in the right eye, with feelings of "dust".

 

She said the eyes were hurting, as if toast crumbs were in the eyes (she had eaten toast for breakfast). The eyes itch and burn. (**)

"Every time the light is on, it kills me." (Photophobia)* 

 

Face

 

Pale face and lips during vomiting, fever and diarrhea.

Pallor.

Hypochromia around the lips.

Face red, during fever. (2)

Face red, during fever. *

 

Edema.

Swelling around the eyes. *

 

"It seems I took a punch in my face."

Expression of suffering during the fever. (2)

Mouth

 

Pallor of mucous membranes.

Red gums.

 

Cracks on the surface of the tongue.

 

 

External throat

 

With the fever he is sweating on the neck and back. **

 

Stomach

 

The water tastes bad, does not want to drink water. *

No thirst during the fever. (7)

She says she is very thirsty and strives to drink four liters of water per day, otherwise her mouth gets dry and cracked. *

Very little thirst, does not eat or drink anything. *

The small amount of water that he accepted, when offered, was taken bit by bit and then he asked for ice. *

In the beginning he was not thirsty. The thirst came only when he began to improve. *

 

Then he asked for cold water all the time. *

The water did not quench the thirst. *

He felt very thirsty, "I want ice water, a cupful every 20 minutes." **

 

He asked for ice cold water, and after he drank, he vomited immediately. *

He vomited the water drunk after 10 minutes or so. *

Vomited immediately, after drinking or eating. *

Vomiting after eating and drinking.

In the morning she woke up at 7 a.m., ate watermelon, melon and vomited. Took orange juice and also threw up at 10 o'clock. **

He slept well and did not want to eat anything. He was nauseated and with high temperature, vomited water at 11 o'clock. **

Vomiting with prostration, during fever.

Vomiting was very dark, "like black beans" (hematemesis).*

Vomiting of blood, part of the vomiting of blood is bright red and the other part is of dark blood like coffee grounds. *

Vomiting yellow *

He had nausea, diarrhea, everything is making him sick. **

Had nausea and vomiting. *

 

Decreased appetite. **

Poor appetite.

Desire for sweet.

 

Abdomen

 

Mild abdominal pain.

Pain in the abdominal region. **

Abdominal pain, some days before fever starts.

Abdominal pain, headache and vomiting.

Abdominal pain and vomiting. *

Intense abdominal pain and vomiting. *

 

Worsening of abdominal pain when lying on stomach. Improved when lying on his back. *

 

Cannot be touched, protects the abdomen and cries during the fever.

He is rubbing his hand on his belly, lightly. *

 

The abdomen was very swollen, "like a ball." *

 

 

Rectum

 

Diarrhea with prostration, during fever.

 

Watery diarrhea. *

Black stool. *

Loose stools.

 

 

Chest

 

Chest pains on the left side, < by compression, as if he had a heart stroke and he must rub the spot with his hand.

Severe stabbing pain in the chest, preventing deep breath.

 

 

Respiration

 

Panting, during high fever.

 

 

Fever

 

Fever, suddenly.

Fever of 39.4º C, sudden onset. *

 

Fever is < at night.

Fever 38^o C at night. (2)

High fever, 39/40^o (7)

Fever 40° C, which does not subside with antipyretics.

Even with antipyretics, the fever did not reduce to less than 38.5 ° C. *

Fever reached 39.4º C **

High fever, continuous.

 

Low fever, rising in the evening.

High fever, slow start.

Fever starts low and increases over the first three days. (2)

Fever "is coming up:": 37, 38, 39 ...

He then started with 40º C (after ten days of onset) **

 

The fever disappeared and he started vomiting. *

On the same day the fever is gone, the head pains began. *

It started with fever for five days: high fever, vomiting, he wanted only to lie down**

 

 

Chill

 

Chills during fever. (2)

He feels very cold, but does not have tremors and chills. *

Never had any chills. *

He feels cold during the fever.

 

 

Perspiration

 

Night sweats during the fever.

When fever started, in the begining, there was no sweating after antipyretics *

After the fever, the sweat was cold and in small quantities. *

Profuse perspiration, his mother had to change the the bedclothes from time to time, < during sleep *

 

 

Extremities

 

It starts with pains in the legs, suddenly.

Leg pains on the first day, along with the onset of headache and high fever. *

 

Leg pains, < on flexing and relaxing.

 

Pain in the arms and joints of the elbows and knees, <motion.

Pain in the joints of the fingers.

Joint pain, especially in the ankles and wrists. *

 

Swelling of feet and hands.

Edema of the legs. *

Edema of hands and feet.

Edema of the legs

 

Restless feet, he rubs one against one another

 

 

Back

 

Neck pain on moving his head and touching the neck.

 

 

Skin

 

Red spots with rash, < in the upper limbs.

Morbilliform rash on arms and legs.

Petechiae on face and arms. *

 

Itching throughout the body, mostly on arms.

Skin itching. *

Goose-flesh, itching *

On the morning of fourth day, sudden onset severe itching all over. At night the skin was very red, the morning was still itching, rash all over body (> with Bell. 30CH). **

It started with itching in the lower third of the legs and feet. **

 

 

Sleep

 

Sleepiness during fever. *

 

 

Generals

 

Sudden onset (3) *

Start slow, with frontal headache, low fever.

"The fever went up 37, 38, 39 C" (the symptoms appeared gradually) *

He started his symptoms on Friday, 10 days ago.

 

He started hot, not wanting to wake up, with 38.5 C **

Prostration. (5)

Depletion due to diarrhea and vomiting. (3)

Prostration .*

He was prostrated, lying down, but only the first day. Then wanted to play soccer, but was aching all over.

It started with fever for five days, high fever, vomiting, he just wanted to lie down**

A week ago woke up with 39 C. He only wanted to sleep, no appetite, sick. Four days later, the result of the platelet count showed 45,000. Fall down and can no longer arise. **

He started hot with fever, didn´t want to wake up**

 

Dehydration due to diarrhea and vomiting. (2)

 

Feeling of being on fire, with chills, he wanted to be covered.

The patient is cold, with the body very warm, has ice cold hands and feet and asks for a bath. **

 

Lying curled on his side. (3)

Lying on his back or on at his side

 

Aversion to be covered, during the fever. (3)

Does not want to wear his T-shirt, prefers it off, even in air conditioning.

During the fever, he asks to take off the covers, is very stifling hot, always has been. *

He felt hot, then perspires on the feet and face. After the sweat is gone, he began to feel cold. **

He was 39^o C and did not want blankets or sweater, wants to be uncovered, only short pants. **

Feels cold and want to cover. (4)

He was feeling cold during the fever and was covered.*

He is chilly and wants to stay covered. **

Asks to be covered; at the beginning he was chilly. **

 

Hematocrit 49%, then 40%.

Platelets 92,000 and 5000 leukocytes.

Patient with 41,000 platelets **

On the first day blood tests have shown 250,000 platelets, which then fell to 100,000, then 91,000, 66,000, and as low as 42,000. **

Four days after the onset he had 45,000 platelets. The patient is prostrate, can not even stand up. He is most of time in bed. On the same day another blood test show 18,000 platelets, but the next day the tests had shown 27,000 platelets. **

AST and ALT increased, in all patients. ***

 

 

Step 2 – Determining the Genus Epidemicus 

 

 

The first group of symptoms, the pathognomonic symptoms of the disease, was created after the following idea:

 

Which were the remedies that could produce a clinical picture that featured an acute infection with high fever, no thirst, with much prostration and a hemorrhagic tendency, i.e., a picture similar to the current illness?

 

This idea comes from Kent, who says that the curative homeopathic remedy should correspond to the pathognomonic symptoms of the disease, and its nature. The chosen remedies should be able to mimic the given disease, including itsr rate of onset and pathological potential.

 

 

Eight symptoms/rubrics were used to represent this initial group. Rubrics were used from the software repertory program Synthesis. Some were combined and summed to assure the inclusion of all pertinent remedies. Synthesis designates summed rubrics with letters (a) and (b). There resulted four symptoms:

 

GENERALS - WEAKNESS - acute diseases – during (b)

GENERALS - WEAKNESS - fever - during - agg. (b)

GENERALS - HEMORRHAGE - orifices of the body, from (a)

GENERALS - HEMORRHAGE – acute (a)

GENERALS - HEMORRHAGE - blood - non-coagulable (a)

GENERALS - HEMORRHAGE - Mucous membranes, from (a)

FEVER - INTENSE heat

STOMACH - THIRSTLESS - heat; during

 

 

The tendency of DF to lower the platelet level was shown on the blood tests of all the reference cases. We don’t have in our repertories a rubric for this decreasing platelet count, so as a substitute we used the rubric “Hemorrhage” – the major consequence of this blood finding.

 

Using Synthesis, twenty remedies are present in the four groups of rubrics:    Table 1

 

 

1	1234	1	F  FEVER.- INTENSE heat	94
2	1234		S STOMACH - THIRSTLESS heat; during	124
3	1234	1a	GENERALS - WEAKNESS acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE orifices of the body, from	26
6	1234	1b	GENERALS -HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS HEMORRHAGE- Mucous membranes, from	29

 

 

Repertory 1.

 

	phos.	apis		ars.	puls.	arn.	lach.	acon.	bell.	nat-m.	nit-ac.
	4/10	4/9	4/9		4/9	4/8	4/8	4/7	4/7	4/7	4/7
1	2	2	3		3	3	2	3	3	3	1
2	2	3	2		3	1	2	1	1	1	2
3	2	1	1		-	-	-	-	-	-	-
4	3	2	3		2	2	1	1	1	2	1
5	3	-	-		-	-	2	-	-	-	-
6		-	-		1	-	-	2	2	-	-
7	3	2	1		1	2	3	-	-	1	3
8	1	-	1		1	1	1	-	-	-	1

 

 

 

 

 

 

 

The repertorisation results showed us twenty remedies that can be used in the treatment of this particular epidemic. They all have the image of the disease ‒ the genus epidemicus ‒ and all are able to heal acute cases with these symptoms.

But we need to distinguish further in order to get the right homeopathic remedy for each individual patient. Now the individual general symptoms must be brought into the study.

 

 

Step 3. Establishing More Differentiated Symptom-Pictures 

 

 

This is done by adding the general symptoms. One of the general symptoms that stood out is that a group of patients wanted to be covered, and another group had an aversion to cover during the acute stage of fever.

If we add to our first group of symptoms the rubric, aggravation of the general condition when uncovered, also the desire to be between blankets, only seventeen remedies cover all these symptoms.

 

 

Table 2.

 

1	1234	1	FEVER - INTENSE heat	94
2	1234	1	STOMACH - THIRSTLESS - heat; during
3	1234	1a	GENERALS - WEAKNESS - acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS - fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE - orifices of the body, from	26
6	1234	1b	GENERALS - HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS - HEMORRHAGE - Mucous membranes, from	29
9	1234	1	CHILL - UNCOVERING, undressing agg.	69

 

Repertory 2.

 

	phos.	apis	arn.	ars.	puls.	nux-v.	acon.	bell.	chin.	lach.
	5/12	5/11	5/11	5/11	5/11	5/10	5/9	5/9	5/9	5/9
1	2	2	3	3	3	2	3	3	1	2
2	2	3	1	2	3	1	1	1	1	2
3	2	1	-	1	-	1	-	-	2	-
4	3	2	2	3	2	3	1	1	2	1
5	3	-	-	-	-	-	-	-	2	2
6	-	-	-	-	1	-	2	2	-	-
7	3	2	2	1	1	-	-	-	1	3
8	1	-	1	1	1	1	-	-	-	1
9	2	2	3	2	2	3	2	2	3	1

 

 

We decided that the desire of being  covered or uncovered  is the first of the major differences in the groups of patients.

Starting with the initial group of twenty remedies for the genus epidemicus, (pathognomonic symptoms of the disease), then considering the general symptom uncovering ameliorates, only four remedies cover all five symptoms: Apis, Puls., Ip. and Sulph.

 

Table 3.

 

 

1	1234	1	FEVER - INTENSE heat	94
2	1234	1	STOMACH - THIRSTLESS - heat; during	24
3	1234	1a	GENERALS - WEAKNESS - acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS - fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE - orifices of the body, from	26
6	1234	1b	GENERALS - HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS - HEMORRHAGE - Mucous membranes, from	29
9	1234	1	CHILL - UNCOVERING, undressing - amel.	14

 

Repertory 3.

 

	apis	puls.	ip.	sulph.	phos.	ars.	arn.	lach.	acon.	bell.
	5/11	5/10	5/8	5/6	4/10	4/9	4/8	4/8	4/7	4/7
1	2	3	1	1	2	3	3	2	3	3
2	3	3	2	2	2	2	1	2	1	1
3	1	-	-	-	2	1	-	-	-	-
4	2	2	1	1	3	3	2	1	1	1
5	-	-	2	-	3	-	-	2	-	-
6	-	1	-	-	-	-	-	-	2	2
7	2	1	1	1	3	1	2	3	-	-
8	-	1	-	-	1	1	1	1	-	-
9	2	1	2	1	-	-	-	-	-	-

 

 

 

Continuing our repertory study, let's step by step add other general symptoms that were present in the clinical cases. 

 

If those patients having the pathognomonic symptoms and a desire to be covered also want to be quiet, as some patients reported, we have only: Arn. Ars., Bell., Bry., Chin., Lach., Nat-m. and Nux-v.

 

Table 4.

 

1	1234	1	FEVER - INTENSE heat	94
2	1234	1	STOMACH - THIRSTLESS - heat; during	24
3	1234	1a	GENERALS - WEAKNESS - acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS - fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE - orifices of the body, from	26
6	1234	1b	GENERALS - HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS - HEMORRHAGE - Mucous membranes, from	29
9	1234	1	CHILL - UNCOVERING, undressing	69
10	1234	1	MIND - QUIET; wants to be	67

 

Repertory 4. 

 

	arn.	ars.	bry.	nux-v.	bell.	chin.	lach.	nat-m.	phos.	apis
	6/12	6/12	6/11	6/11	6/10	6/10	6/10	6/9	5/12	5/11
1	3	3	2	2	3	1	2	3	2	2
2	1	2	1	1	1	1	2	1	2	3
3	-	1	-	1	-	2	-	-	2	1
4	2	3	2	3	1	2	1	2	3	2
5	-	-	-	-	-	2	2	-	3	-
6	-	-	-	-	2	-	-	-	-	-
7	2	1	-	-	-	1	3	1	3	2
8	1	1	1	1	-	-	1	-	1	-
9	3	2	1	3	2	3	1	1	2	2
10	1	1	4	1	1	1	1	1	-	-

 

 

If we add to this new group of symptoms the ones that tell us the nature of onset, i.e., its pace, which is also a general symptom, we have two possibilities. The first is: wants to be covered, wants to stay quiet, and the disease is sudden in onset. Only three remedies cover this picture: Ars, Bell, and Nux-v.

 

Table 5.

 

1	1234	1	FEVER - INTENSE heat	94
2	1234	1	STOMACH - THIRSTLESS - heat; during	14
3	1234	1a	GENERALS - WEAKNESS - acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS - fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE - orifices of the body, from	26
6	1234	1b	GENERALS - HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS - HEMORRHAGE - Mucous membranes, from	29
9	1234	1	CHILL - UNCOVERING, undressing agg.	69
10	1234	1	MIND - QUIET; wants to be	67
11	1234	1	GENERALS - PAIN - appear suddenly	80

 

 

Repertory 5

 

	ars.	bell.	nux-v.	phos.	puls.	arn.	acon.	bry.	nit-ac.	chin.
	7/14	7/13	7/13	6/13	6/13	6/12	6/11	6/11	6/11	6/10
1	3	3	2	2	3	3	3	2	1	1
2	2	1	1	2	3	1	1	1	2	1
3	1	-	1	2	-	-	-	-	-	2
4	3	1	3	3	2	2	1	2	1	2
5	-	-	-	3	-	-	-	-	-	2
6	-	2	-	-	1	-	2	-	-	-
7	1	-	-	3	1	2	-	-	3	1
8	1	-	1	1	1	1	-	1	1	-
9	2	2	3	2	2	3	2	1	1	3
10	1	1	1	-	-	1	-	4	-	1
11	2	3	2	1	2	-	2	-	3	-

 

 

 

But if a patient wants to be covered and quiet, and the disease comes on slowly: Only Bry. and Chin come into question.

 

Table 6.

 

1	1234	1	FEVER - INTENSE heat	94
2	1234	1	STOMACH - THIRSTLESS - heat; during	24
3	1234	1a	GENERALS - WEAKNESS - acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS - fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE - orifices of the body, from	26
6	1234	1b	GENERALS - HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS - HEMORRHAGE - Mucous membranes, from	29
9	1234	1	CHILL - UNCOVERING, undressing	69
10	1234	1	MIND - QUIET; wants to be	67
11	1234	1	GENERALS - PAIN - appear gradually	15

 

Repertory 6 

 

	bry.	chin.	arn.	ars.	nux-v.	acon.	bell.	lach.	nat-m.	phos.
	7/12	7/11	6/12	6/12	6/11	6/10	6/10	6/10	6/9	5/12
1	2	1	3	3	2	3	3	2	3	2
2	1	1	1	2	1	1	1	2	1	2
3	-	2	-	1	1	-	-	-	-	2
4	2	2	2	3	3	1	1	1	2	3
5	-	2	-	-	-	-	-	2	-	3
6	-	-	-	-	-	2	2	-	-	-
7	-	1	2	1	-	-	-	3	1	3
8	1	-	1	1	1	-	-	1	-	1
9	1	3	3	2	3	2	2	1	1	2
10	4	1	1	1	1	-	1	1	1	-
11	1	1	-	-	-	1	-	-	-	-

 

Once these analyses came to light, we kept them as ‘pre-repertorizations.’ In daily practice, when dealing with dozens of cases of dengue, these gave us the opportunity to find the remedy and treat many cases in a short time. This technique was used by Kent and his students during the various epidemics that occurred in the U.S. at the beginning of the 20^th century. In fact this particular group of symptoms was the predominant one in this epidemic, and Bryonia was used more than any other remedy, with great success.

 

There was a group of patients who wanted to be uncovered. As we saw before, from the first twenty remedies that have the pathognomonic symptoms of the disease, there are four remedies that want to be uncovered: Apis, Ip., Puls. and Sulph. If a patient who wants to be without covers wants also to be quiet, undisturbed, only Sulphur cover all the rubrics. That is, if we were dealing with a patient who had acquired Dengue Fever in 2008, and we found him in bed, uncovered during the fever and wanting to be left alone undisturbed, Sulphur was surely his correct medication.

 

Table 7.

 

1	1234	1	FEVER - INTENSE heat	94
2	1234	1	STOMACH - THIRSTLESS - heat; during	24
3	1234	1a	GENERALS - WEAKNESS - acute diseases - during	51
4	1234	1a	GENERALS - WEAKNESS - fever - during - agg.	94
5	1234	1b	GENERALS - HEMORRHAGE - orifices of the body, from	26
6	1234	1b	GENERALS - HEMORRHAGE - acute	7
7	1234	1b	GENERALS - HEMORRHAGE - blood - non-coagulable	65
8	1234	1b	GENERALS - HEMORRHAGE - Mucous membranes, from	29
9	1234	1	CHILL - UNCOVERING, undressing - amel.	14
10	1234	1	MIND - QUIET; wants to be	67

 

Repertory 7

 

	sulph.	apis	ars.	bry.	puls.	arn.	lach.	bell.	ip.	nat-m.
	6/7	5/11	5/10	5/10	5/10	5/9	5/9	5/8	5/8	5/8
1	1	2	3	2	3	3	2	3	1	3
2	2	3	2	1	3	1	2	1	2	1
3	-	1	1	-	-	-	-	-	-	-
4	1	2	3	2	2	2	1	1	1	2
5	-	-	-	-	-	-	2	-	2	-
6	-	-	-	-	1	-	-	2	-	-
7	1	2	1	-	1	2	3	-	1	1
8	-	-	1	1	1	1	1	-	-	-
9	1	2	-	-	1	-	-	-	2	-
10	1	-	1	4	-	1	1	1	-	1

 

 

 

If the repertorisation results did not indicate a narrow choice of medications after we added the pathognomonic and general symptoms, we would add more symptoms in this order: first, more general symptoms (if they are present in the case) then, if that still did not clearly indicate a remedy, we should add the individual particular (local) symptoms. If we still have not reached the right remedy at this point, we need to add the patient´s mental acute condition.

 

 

Conclusions

 

The physician can derive several specialized symptom-pictures, but the initial core group of symptoms and remedies must always be present. So we kept in our Synthesis, for the DF 2008 epidemics, several "pre-programmed" repertorizations, and when facing the various cases of the same epidemic, we started choosing from one of these various recombinations of symptoms.

 

Each new epidemic of the same disease requires a full new study. We must never base our prescriptions on the past study results of the late epidemic. Not only because it´s due to a different virus subtype (as was the case of dengue fever) but even with an apparent recurrence of the same virus. A group of cases should be selected and studied and a new group of remedies that cover the genus epidemicus must be selected. Otherwise we will face a lack of results from homeopathic treatment, when in fact homeopathy can treat any case of acute illness.

 

The combination of factors, rubrics and symptoms is a safe, secure approach to the homeopathic remedies, without indicating, however, the final result. We must never reach the bed of the patient with a pre-determined medication. This technique allows a first approximation, but as it was said earlier, the particular symptoms and even acute mental symptoms in the case will have the final word in the remedy’s choice.

 

The Materia Medica of the indicated remedies should be revisited to confirm the similarity between remedy and individual disease.

 

As to so-called homeopathic formulas touted on the internet: sick people, desperate for help, sometimes make use of these “healing” formulas, which only undermine the seriousness and effectiveness of homeopathy. We seriously oppose this type of homeopathic treatment, and instead, we offer to the people our studies and our care. This should be explained, clarified and publicized so that our precise results could be seen and understood as they really are.

 

This was the core group of symptoms/rubrics of the 2008 DEN-2 subtype epidemics in Rio de Janeiro, Brazil:

 

 

Pathognomonic DEN-2 Subtype symptoms

 

GENERALS - PAIN - appear gradually

GENERALS - HEMORRHAGE - acute

GENERALS - HEMORRHAGE - blood - non-coagulable

GENERALS - HEMORRHAGE - Mucous membranes, from

GENERALS - HEMORRHAGE - orifices of the body, from

STOMACH - THIRSTLESS - heat; during

FEVER - INTENSE heat

GENERALS - WEAKNESS - acute diseases - during

GENERALS - WEAKNESS - fever - during - agg.

CHILL - UNCOVERING, undressing

MIND - QUIET; wants to be

 

 

 

The homeopathic remedy that was at the center of the 2008 Dengue fever epidemics was Bryonia alba. We could not keep track of statistics, there were hundreds to treat every day, with everything happening at once. The usual dose was 200 C once every 3-4 hours. Recovery was speedy, usually occurring in 24- 48 hours. Of couse many others were used with great results, but Bry. was very useful for the majority of cases

 

 

Bibliography

 

 

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Araujo, Claudio C., Casos Agudos em Homeopatia, Rio de Janeiro, Ed. Cultura Médica, 2007

 

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Araujo, Claudio C., The homeopathic consultation and its main purposes, Proceedings of the LMHI Congress, Luzern Swiss, 2006

 

Hahnemann. Samuel, Organon of Medicine, 6^th Edition, Calcutta, M. Bhattacharyya & Co., 1965

 

Hahnemann, Samuel, Materia Medica Pura, New Delhi, Jain Publishing Co., (original Edition 1830)

 

Hahnemann, Samuel, The Chronic Diseases, their peculiar nature and their homeopathic cure, New Delhi, Jain Publishers, 1975

 

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Kent, James T., Lectures on Homeopathic Philosophy, New Delhi, B. Jain Publishers, 1974

 

Kent, James T., Lectures on Homeopathic Materia Medica, Calcutta, R. Sinha Roy (original edition 1904)

 

 

Schmidt, Pierre, The Art of Case Taking, New Delhi, B. Jain Publishers, 2003

 

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