Severe malaria

Malaria with evidence of any organ dysfunction as per the WHO-defined severity at any time during acute illness is severe Malaria. Individuals with severe malaria may present with altered sensorium, convulsion, allegory, deep jaundice, shock, disseminated intravascular coagulation, bleeding manifestations, or breathlessness. Mortality with severe malaria falciparum approaches 100% if untreated and 10-20% with treatment

Cerebral Malaria

Patients may present with impaired consciousness with or without convulsions in the absence of hypoglycemia. Sever AneamiaSever anemia occurs more commonly in children than adults and it is due to intravascular haemolysis

JaundiceIt 

Is the most common complication seen amongst patients with severe malaria, mild jaundice with indirect hyperbilirubinemia can occur due to hemolysis. however, some patients with severe malaria develop deep jaundice and conjugated hyperbilirubinemia due to liver dysfunction. Acute kidney injuryAKI may occur due to hypovolemia due to vomiting and dehydration, sequestration of parasites, sepsis, hypotension, or hemoglobinuria resulting from intravascular hemolysis. Patients develop metabolic acidosis
due to AKI as well as hyperlactatemia resulting from anaerobic respiration in the tissue. Black water fever is the term used for severe intravascular hemolysis resulting in dark color urine due to hemoglobinuria and is often precipitated by quinine. Acute respiratory distress syndrome Noncardiogenic pulmonary edema may develop due to leaky capillaries. It is more common with p.vivax
than p. falciparum. 

 Diagnosis

Peripheral smear examinationThe gold standard for diagnosis of malaria is a demonstration of asexual forms of the parasite in stained peripheral blood smears. 

Homeopathic treatment for malaria 

According to the organon of Medicine Homoeopathic medicine should be given in the decline phase or fever or afebrile to avoid aggravation. Homeopathic Medicine can also be useful in cases of complications.

Homeopathic medicine for malaria

• CHINA: Intermittent, paroxysms anticipate; return every week. All stages are well marked. Chill generally in the forenoon, commencing in the breast; thirst before chill, and little and often. Debilitating night-sweats. Free perspiration is caused by every little exertion, especially on single parts.

  Shivering, with shuddering, or feverish trembling, commonly without thirst. Cold in the body, with congestion in the head, heat and redness of the face, and forehead hot. Shivering with headache, nausea, vertigo, congestion in the head, paleness of the face, cold in the hands and in the feet, and vomiting of mucus.

  General increase of heat, with veins swollen, without thirst.. Heat, with strong inclination to be uncovered, or shivering as soon as one is uncovered. After the heat, violent thirst.Shivering more violent after drinking.

  Heat, with dryness of the mouth, and of the lips, which are burning, redness of the face, headache, morbid hunger, delirium, pulse full and quick.

  Quotidian fever, or every two days, or tertian, commencing chiefly in the evening or in the afternoon, or in the morning, by shivering with trembling, followed by heat and nocturnal sweat. The attacks of fever are often preceded by sufferings, such as palpitation of the heart, sneezing, anguish, nausea, excessive thirst, headache, pressure colic

• GRINDELIA ROBUSTA : chronic malaria; gastric pains associated with splenic congestion 

• ALSTONIA SCHOLARIS :
  Malarial diseases, with diarrhea, dysentery, anemia, feeble digestion, are the general conditions suggesting this remedy. Characteristics are the gone sensation in stomach and sinking in abdomen, with debility. Atonic after exhausting fevers.

• CORNUS CIRCINATA : Chronic malaria, hepatitis, jaundice. Weakness in morning. intermittents with chill and sweat predominating. Diarrhea with profuse sweat and general physical and mental prostration . Great disposition to sleep ,countenance are sunken, yellow indicating of suffering and debility

• CIMEX LECTULARIUS : Tertian and quartan fever at any time of day or night. Before attack thirst with pain in bones of limbs several hours before chill. Chill with drowsiness and great joint pain. Chill in any part with shuddering as if cold water is pouring Heat without thirst but desire to drink in account of dryness Sour smelling sweat which relives Apyrexia with much thirst and can drink easily

• ABSINTHINUM : Chill and heat with sleep. Obstinate autumnal fever with swollen liver and spleen

• ELATERIUM: Intermittants suppressed by quinine Intermittents with cholera like attacks When chills suppressed urticaria appears. Chilliness with thirst Heat without thirst Copious sweat which relives Apyrexia with urticara which relives by rubbing

• EUCALYPTU : Sconstant tendency to chill and fever, patient being comparatively well for a week or two week and then relapsing, relapsing malaria in which spleen becomes affected early in disease. Vertigo in all stages. Sweat is offensive. Apyrexia with extreme muscular weakness and blunted sensation

• HELLEBORUS : Quartan type of fever. Chill spreads in arm with joint pain especially knee, Horrible convulsion with extreme coldness. Burning heat with internal coldness .Sticky sweat Continuous motion of arm except sleep .Quartan type of fever. Chill spreads in arm with joint pain especially knee, Horrible convulsion with extreme coldness .Burning heat with internal coldness. Sticky sweat.Continuous motion of arm except sleep

• HYOSCYAMU : Schill from feet up to back . Tertian or quarton fever at 11 AM chill, chill aggravates at night with short, dry cough .Heat runs along the spine .Hallucinations and febrile twitching ,insomnia and epileptic convulsion Sweat specifically on leg. Apyrexia with debility and illusion of vision

• STRAMONIUM : Quartidian and double quartidion fever without chill at noon and midnight .Chill with twitching of limbs. Heat of head with coldness of body .Sweat on forehead with good appetite and diarrhea

• OPIUM : Congestive chills especially in children and old people.In heat deep soporous sleep open mouth and twitching of limb, spasmodic contraction of facial muscle ending in hot profuse sweat .Heat and sweat intermingled. Apyrexia with cerebral congestion with stupor complete indifference

• VALARIANA : Chill is short with thirst begins in neck and run downwards with fainting. Heat long; lasting with headache and neuralgia of limb sweat profuse, esp.At night with violent thirst

• CHELIDONIUM : Chill begins on hands and feet , chills with nausea. Chill runs on back. Heat dry on face, without thirst. Heat from hands than spreads on body. Cheeks are dark red during heat Sweat during sleep towards morning.Apyrexia with liver complain, shooting towards back

• MENYANTHES : Intermittent fever, with coldness in abdomen.. Heat in evening, mostly on head with cold feet. Perspiration in evening as soon as he lies down, continuing all night.

• CHININUM : SULPHA dose of Chinin sulph in high potency sometimes arouses suppressed malaria, and brings back the paroxysm. Aside from its undoubted influence over malaria, it is indicated homeopathically whenever there is marked periodicity .Chill daily at 3 pm. Anticipating chills. Thirst in all stages. Delirium during heat. Increasing fever and prostration, with profuse night sweats. Profuse sweat amel. but exhausts. Clear apyrexia. Typical malaria. Subnormal temperature

• CEDRON : Periodicity is the most marked characteristic of this drug. Its particularly useful in tropical or in damp, warm, marshy countries. It has been found curative in malarial affections,especially neuralgia.Regular paroxysms of fever, coming at same hour, commencing every day 6 p.m. by chills in back and limbs, or cold feet and hands. Hot stage: dryness; heaviness of head; redness of face; burning heat in hands; pulse full and accelerated; thirst, with desire for warm drinks. Profuse perspiration.─During sweat: coldness and heat, and heat and coldness irregularly, intermingle.─Bluish-red face; forearm to elbow and hands and feet cold; sweat beneath axilla and on chest. Quotidian or tertian fever with marked regularity.

• EUPATORIUM : Fever with nausea from sight and smell of food.Periodicity is well marked . twice a week at 7 to 9 AM .Chill is began from shoulder spread to extremity. Can not drink during chill because It causes shuddering. Bruised feeling as if broken all .Perspiration relives all complain except headache

• ARSENI : CHigh temperature. Periodicity marked with adynamia. Septic fevers. Intermittent. Paroxysms incomplete, with marked exhaustion. Chills irregular, shaking; craves hot drinks during chill; dyspnea during chill. Heat as of hot water in veins; or they burn like lines of fire. High fever, hectic fever. Sweat, with great thirst, dyspnea or exhaustion. Sweat cold.

• ARANEA : DIADEMABefore chill: cutting cramp in stomach; vomiting; backache. Cold all the time, cannot get warm; chilly as if bones made of ice even in summer; during rain. Chilliness after being in water. Chill with clock-like regularity; as clock strikes four daily. Thirst, fever and sweat may be absent. Chill every other day at precisely the same hour. During chill: pains in head, stomach, knees. Afterwards: vomiting. During heat: headache (but less violent than during chill), with drowsiness. After heat: vomiting and prostration; lies as if dead; stinging in eye. Sweat absent; sweat without thirst or sweat with thirst.

• NATRUM : MURChill between 9 and 11 am. Heat; violent thirst, increases with fever. Fever-blisters. Coldness of the body, and continued chilliness very marked. Hydrćmia in chronic malarial states with weakness, constipation, loss of appetite, etc. Sweats on every exertion

• Conclusion : Homoeopathic Medicine can be useful in treatment of Malaria during fever as well as in its complication. Homeopathic Treatment can be useful in decrease the mortality in malaria and better management of the Cases of Malaria

References

1. Sandhya A Kamath, Siddharth N Shah, Milind Y Nadkar, Vikram Londhey, Ghan Shyam Pangtey,, Falguni Parikh, Anupam Paralash, Trupti Trivedi, Nihar p Mehta, Yash Pal Munjal, API TEXTBOOK OF MEDIVINE, Edition 11 Volume 1
2. William Boericke, MD, Pocket Manual Of Homoeopathic Materia Medica and Repertory
3. John Henry Clarke,, MD, A Dictionary of Practical Materia Medica
4. Samuel Lilienthal, Homoeopathic Therapeutics, The Classical Therapeutic Hints
5. H.C.Allen, Therapeutics of Intermittent Fever
6. B.K. Sarkar, Hanemann’s Organon of Medicine 5th edition
7. World Health Organization ,Malaria,https//www.who.int >malaria