This section is from the book "Hartmann's Theory Acute Diseases And Their Homoeopathic Treatment", by Charles J. Hempel. Also available from Amazon: Theory of acute diseases, and their homoeopathic treatment.
With respect to their type, those different forms of fever may be divided into continuous, remittent, or intermittent, irrespective of their fundamental character. Continuous fevers are such as exhibit the same phenomena during their whole course and rage with the same intensity from the commencement of the disease to its crisis. Fevers are called remittent when they exhibit, it is true, the same phenomena during their course, but with a periodical increase and decrease of intensity. Intermittent fevers are such as are characterized by remissions of a definite or indefinite length, during which the patient sometimes appears perfectly healthy.
Fevers may likewise be divided into sporadic, endemic, epidemic, and still other classifications might be established, which, having no practical value, are here omitted. We content ourselves with recalling to the minds of our readers what has been said page 41 about the influence of the permanently prevailing, endemic or epidemic character of disease in a certain region upon any of the above mentioned forms of fever; this influence deserves the closest attention in the selection of a remedial agent and is greatly concerned in the ultimate result of the treatment.
§ 15. To establish a prognosis in fevers, is not so very easy, inasmuch as the momentary indications, which are frequently deceptive, are by no means sufficient; a prognosis which is to be well founded and to bear the highest character of probability, must be based upon a correct estimate of all the circumstances and of the whole image of the disease, upon a careful consideration of the constitution, disposition, age and external condition of the patient, of the state of the weather, of the season, and the simple or complicated character of the fever; a good deal of discretion is required to establish a good prognosis. Although it is impossible to foretell the issue of the fever at the very commencement of the disease, inasmuch as the practitioner cannot possibly foresee all the hurtful influences which may complicate the course of the disease and interfere with the treatment: yet the homoeopathic physician, confiding in his therapeutic law by virtue of which the well-chosen homoeopathic specific will act directly upon the focus of the disease and excite a corresponding curative reaction in the organism, is enabled to prognosticate with tolerable certainty the termination of the disease, provided the above mentioned conditions of a well-founded prognosis are fulfilled.
The prognosis is generally favourable, when the patient has a vigorous constitution and has led a regular mode of life; when the pulse is regular, soft, not too frequent; when the breathing becomes freer and more regular; when the nervous system is but little affected and the expression of the countenance is natural; when the general and especially the muscular strength is good; and, lastly, when the secretory and excretory functions are not interrupted.
The prognosis is unfavourable when the constitution of the patient has been weakened by former excesses or by violent diseases, when, therefore, the strength of the patient must be greatly prostrated and the reaction very deficient; when the pulse is very frequent, weak, and irregular; when the nervous system is violently affected, the patient is delirious, and the hands and tongue tremble; when there is subsultus tendinum, floccitation, hiccough. It is likewise an unfavourable symptom, when the patient remains extended on his back without ever changing his position, or when he settles downward in his bed. Unfavourable symptoms are likewise: general apathy; involuntary emission of urine and involuntary alvine evacuations; retention of urine; complete alteration of the expression of countenance (hippocratic countenance); convulsions; loss of sight; dropping of the lower jaw; irregular breathing when there is no particular affection of the chest; hurried, superficial breathing, interrupted by occasional sobs; difficult deglutition, or a noise when swallowing, • as if the swallowed substance fell into the stomach; cold extremities, with cold clammy sweats, etc.
There remains to be stated, that the occurrence of only one unfavourable symptom does not constitute an unfavourable prognosis, but the prognosis is unfavourable when several of the aforesaid phenomena occur simultaneously.
§ 16. Fevers may terminate in three different ways. These terminations are, (a,) recovery; (b,) passage into another disease; (c.) death. The fever terminates in health when it runs through its course regularly, when the critical changes occur regularly, are duly appreciated by the physician, and are not disturbed by external pernicious influences; when the constitution of the patient has not been weakened by other causes and the more important organs have not been disturbed. We frequently notice the fact, that patients who recover from a fever, feel better after the fever than they did before. The fever passes into another disease when the favourable conditions which have been mentioned in the preceding paragraphs, do not occur. Either the whole character or only the external form of the disease is changed; or else the disease invades a totally different part of the organism (metastasis), or it assumes a new form by metaschema-tismus. Death is to be prognosticated when the functions of a noble organ have been disturbed, in consequence of inflammatory affections, disorganizations (a cure is frequently effected under those circumstances, by homoeopathic treatment), suppuration, gangrene, or in consequence of a complete prostration of strength, and consequent cessation of the organic functions.
§ 17. It would be a foolish undertaking to indicate a general method of treating fevers according to homoeopathic principles; it would be a useless filling up of space, inasmuch as no physician would venture to prescribe a single remedy without having carefully examined the group of symptoms to which the remedy is required to correspond. It is almost superfluous to remark that a cure according to homoeopathic principles cannot be effected unless the pathogenetic effects of the remedial agent are entirely similar to the perceptible phenomena of the disease. Ebermaier says, in his Clinical Pocket-Manual: "Those physicians have been most successful in the treatment of fever who have employed the simplest methods of cure, no matter how frequently the epidemic diseases, the habitual morbid influence of a region, and the methods of treatment may have changed." Is there a simpler and at the same time more natural method of cure than homoeopathy, which accomplishes so much with simple means specifically adapted to each single case. An important object in the treatment of fever is a suitable diet, which we mention here generally, and to which we shall refer in our chapters on the special treatment of fever. The physician will have to exercise his own discretion in adapting it to the wants of the patient in every single case. Fever patients generally use but few things, but every thing which the patient ought to do and not to do, requires to be carefully stated.* The first thing which the physician has to attend to, is the patient's habits; these have to be duly considered in prescribing a diet for the patient. The patient ought not to be removed from a bed to which he is accustomed, nor ought he to be transported into a different bedchamber; if he has been accustomed to quiet, let quiet be preserved; if he has lived amidst noise and prefers it, let him continue the enjoyment of it; if the patient has favourite drinks, such as brandy, wine, coffee, etc., the physician has to consider the age of the patient, and the length of time during which those beverages have been his favourite and habitual drinks; and the physician will determine accordingly whether the patient can be suddenly deprived of them without injury. In fevers the patients do not find it very difficult to abstain from those things, as there exists generally an aversion to them.*