AN APPROACH TO FEVER THROUGH

BOGER BOENNINGHAUSENS
CHARACTERISTICS MATERIA MEDICA &
REPERTORY
Dr Sandhya Rastogi, Lecturer
Dr B R Sur Homoeopathic Medical College & Hospital
Boger Boenninghausens characteristics Materia Medica and Repertory by Dr.
Cyrus. M. Boger is one of the greatest pieces of homoeopathic literature, based on
the original Repertory of
the
Antipsoric
Remedies . The compilation of Boenninghausens
characteristics Materia Medica and Repertory represents
the combined wisdom and experience of two masters, Dr
Boenninghausen and Dr Boger.
BBCR is an extended form of Repertory of Antipsoric
where
Dr Boger added
Time, Aggravation,
Amelioration, concomitant and many medicines and
rubrics drawn from his own experiences and other
sources in most of the chapters. Dr Boger made few
changes
in
arrangements
as
compare
to
Boenninghausens original work. He added Pathological
type of fever in Fever section, which can be used as
reference for final selection of the medicine. Blood and
circulation chapter, which is given under fever section,
though it is not related to fever but it can be referred if the symptoms related to
congestion, palpitation, heart beat, pulse are prominent during fever. Dr Boger
added Time modality, Aggravation, Amelioration and Concomitants to each of the
subchapters of Chill, Heat and Sweat to give completeness to the Fever section of
BBCR.
The Fever section may be considered to be Self contained Repertory of Fever
within this large repertory, which is of immense value in the selection of remedy.
Fever section of BBCR unless studied carefully is confusing in its arrangements of
heading and rubric. The basic arrangement of Fever section in BBCR, contains
seven chapters. The concomitant section to Chill, heat and sweat is very

systematically and elaborately arranged. Concomitant subsection starts from

mind, head, external head, eyes, vision, till sleep as per the basic arrangement of
the chapter given in BBCR.
The section of compound fever, can be useful when all three stages of fever chill,
heat, sweat is not seen in the patient. Again sub sections partial cold, partial heat
and partial sweat do not apply in case of fever only but are useful in non febrile
cases as well.
Fever section of BBCR is given as follows

FEVER
1.
2.
3.
4.
5.
6.
7.

PATHOLOGICAL TYPES
BLOOD
CIRCULATION
CHILL
HEAT AND FEVER IN GENERAL
SWEAT
COMPOUND FEVER

Pathological fever mentioned in pathological types of fever

Adynamic
Bilious
Catarrhal
Cold :Taking, from
From :On head :On feet
While sweating
Dentition
Gastric :Hectic
Infectious, grippal, exanthematous, typhus,
Inflammatory
Intermittent and periodicity :In general Yearly
Hour, at same
2 to 3 months
1 to 3 days

1 to 4 days
2 or 3 months
Daily twice
Days :Alternate
2 to 3 days
3 to 4th
4th
7th
8th
10th
10 to 14th
14th
14 days agg., then 14 days amel
21st
Quotidian
Double :Recurring at the same hour
At 4 P.M. lasting until 8 P.M.
Tertian
Double
Quartan
Measles
Milk (lactation)
Puerperal
Periodicity : See Intermittent.
Putrid fevers
Quinine fever, (abuse of)
Rheumatic fever
Periodically, wandering :Scarlet fever (true, smooth
Irregular
Septic
SmallSudoral fever, febris helodes
Thermic
Traumatic fever
Typhoid fever
Typhus fever
Worm fever
Yellow fever

BLOOD.
CIRCULATION.
FEVER, CHILL, ETC.
Chill
Partial chill
Coldness.
Partial coldness.
Sense of partial coldness.
Shivering.
Time.
Aggravation.
Amelioration.
Concomitants.
HEAT AND FEVER IN GENERAL.
Heat and Fever in general.
Partial heat
Time
Aggravation
Amelioration.
Concomitants
SWEAT.
Sweat.
Partial sweat
Time.
Aggravation.
Amelioration
Concomitants.
COMPOUND FEVER.
Beginning with chill
Beginning with shivering
Beginning with heat.
Beginning with sweat

AN OVERVIEW ABOUT FEVER

The term fever is defined as a raised central temperature beyond 37C or
98.4 F. Temperature beyond 105 is referred to as hyperpyrexia. Fever is

perhaps the most common manifestation of ill health from the minor cold to the
major AIDS or carcinoma . Fever occurs when various infectious/ non infectious
processes interact with the hosts defense mechanisms. In practice all infections
may not associated with fever.
Fever can be categorized as
1. Fever with short duration with localizing signs for which the diagnosis can be
established by clinical history and physical examination with our without
laboratory test
2. Fever without localized signs for which the history and physical examination do
not suggest the diagnosis but laboratory test may establish an etiology.
3. Fever of unknown origin (POU) the POU, denote documented fever of one
week duration, defying diagnosis after one week of intensive investigation
Chills are subjective symptoms and accompany any acute infection. Rigors are
muscular contractions visible as shivering and often precede acute rise of body
temp. as in malaria, urinary infection or abscesses .
AETIOLOGY/ DIFFERENCIAL DIAGNOSIS
1. INFECTIONS
Typhoid Fever CONDITIONSHepatitis
Leptospirosis
Tuberculosis
Malaria
2. MALIGNANCIES
Leukemia
Lymphoma
3. AUTOIMMUNE condition JOINT/CONNECTIVE TISSUE DISEASE
Rheumatoid arthritis
Rheumatic fever
Systemic lupus erythematosus
4. OTHERS / Miscellaneous
Drug-induced
Inflammatory bowel disease
Liver disease: Cirrhosis and granulomatous hepatitis
Sarcoidosis
Drug reactions
Thyrotoxicosis

Hypothalamic lesions
TYPES OF FEVER
The pattern of temperature changes may occasionally hint at the diagnosis
1.Continuous fever: Temperature remains above normal throughout the day and
does not fluctuate more than 1 C in 24 hours, e.g. lobar pneumonia, typhoid fever,
urinary tract infection, brucellosis
2.Intermittent fever: The temperature elevation is present only for a certain
period, later cycling back to normal(i.e. Normal temp. between fever episodes),
e.g. malaria, pyaemia, or septicemia. Following are its types:
Quotidian fever, with a periodicity of 24 hours, typical of Plasmodium
falciparum malaria
Tertian fever (48 hour periodicity), typical of Plasmodium vivax or
Plasmodium ovale malaria
Quartan fever (72 hour periodicity), typical of Plasmodium malariae malaria.
3.Remittent fever: Temperature remains above normal throughout the day and
fluctuates more than 1 C in 24 hours, e.g., infective endocarditis.
4.Hectic
when the difference between peak and trough temperature is great (1.4C or more)
Hectic fevers, because of wide swings in temperature, are often associated with
chills and sweats. This pattern is thought to be very suggestive of an abscess or
pyogenic infection such as pyelonephritis
5.Pel-Ebstein fever: A specific kind of fever associated with Hodgkin's
lymphoma, being high for one week and low for the next week and so on.
However, there is some debate as to whether this pattern truly exists

CLINICAL APPROACH TOWARDS THE PATIENT OF FEVER

a)
b)
c)
d)
e)
f)
g)
h)

Presenting complaint
Age
Onset
DurationFever pattern
Time
Aggravation.
Amelioration

i) Associated complaint
Fever may be associated with the symptoms like cough, coryza, diarrhea,
vomiting, headache, urinary symptoms , convulsions, joint pain, abdominal pain,
throat pain, earache with discharge, rash , swelling of parotid gland, etc shall be
considered
Past history, family history, miasm & diathesis should be taken into
consideration for diagnosis of the disease, and diagnosis of person should be done
through Physical and mental generals
PHYSICAL EXAMINATION
General and
systemic examination
INVESTIGATION
In presence of obvious cause , specific test may be required to confirm
diagnosis of disease
CASE PROCESSING
After analysis and evaluation of the symptoms, as per Dr Boger, concept of
totality of the patient with primary symptoms of fever should be as follows:

REPERTORIAL TOTALITY
1. Cause
2. Chill.
Time
Aggravation
Amelioration
concomitant
3. Fever
Time
Aggravation
Amelioration
concomitant
4. Sweat
Time

 Aggravation
Amelioration
concomitant
5. Physical general
6. Mental general
7. Pathological type for final selection of the drug
Here fever may be considered as primary symptom and associated
symptoms as concomitant. On the basis of complete symptom we will get
the group of similar medicines. The philosophy of Dr Boger is based on
particular to general, so the group of medicines we will get from particular
symptoms and to find the similimum we will differentiate through general
symptoms.

A CASE OF FEVER
A boy of age 15 yrs came to me with a complaint of fever 102 0 c since 2 days
with body ache and restlessness. On the day of reporting, rashes appear all over
the body. Earlier his mother was not worried as she thought that because of heat
(summer) fever might be there. But as she saw eruptions, she was concerned &
rushed for consultation .
Since morning patient had red vesicular rashes on back, chest and face. Fever
rises more in the evening and night and decreased in the morning, There is
fluctuation of temp. more than 10c but remain above normal in the day time. Fever
gets aggravated after eating and drinking.
During fever, patient complains of severe itching all over the body with
headache. Sweating leads to more itching. Redness of face is observed. He wants
to press his head but without any relief. There is loss of appetite, drink of glass
of room temperature water at frequent intervals, tongue moist. He cannot sleep
whole night, keeps roaming with restlessness and feel sleepy in morning when his
fever gets decreased. He shows anger towards her mother during fever.

As per Dr Boger, concept of totality of the patient with primary symptom as

fever the following rubrics were selected :
Heat and fever in general: Heat and burning in general
Heat and fever in general: time night
Heat and fever in general: aggravation eating after
Heat and fever in general: concomitant Head pain, headache
Heat and fever in general: concomitant appetite aversion food in general
Heat and fever in general: concomitant thirst little at a time
Heat and fever in general: concomitant sensations and generalities
restlessness, bodily
Heat and fever in general: concomitant skin eruption
Heat and fever in general: concomitant skin itching
Heat and fever in general: concomitant mind vehemence
Sweat: itching, causing
Fever pathological types: infectious grippal, exanthematous

REPERTORIAL ANALYSIS
Result : Rhus tox 29/10, Ars Alb 25/9, Sulph 19/9

Final drug selection

The final choice of remedy is Rhus Tox 0/1 QID for 4 days as
The eliminating rubric is considered : pathological fever, infectious
exanthematous it covers Rhus tox .
In BBCR rubric for chickenpox is Varicella, only two medicines are given:
Ledum P and Rhus tox
During Fever, patient is restless & keeps moving in the room, with anger.
CONCLUSION
The administration of similimum helped patient in early recovery within 4 days
without scars and preventing him from further complications (secondary
bacterial infection).

REFERENCES
1.
2.
3.
4.
5.
6.

An overview of repertories for PG students by Dr. D. P. Rastogi

Paediatrics in homoeopathy an approach by institute of clinical research
Essentials of repertorization by Dr. Shashi Kant Tiwari
Reperire by Dr. Vidyadhar Khanaj
https://en.wikipedia.org/wiki/fever
www.webmd.com/first-aid/fevers-causes-symptoms-treatments
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