POINTS

ARSENICUM ALBUM

HEPAR SULPH

KALI CARB

NATRUM SULPH

PHOSPHORUS

TUBERCULINUM

1) AETIOLOGY

(i) Asthma from suppressed itch.

(ii) Suitable for attacks occurring as consequence of suppressed catarrh.

(iii) Chill in water; eating ices.

(i) Cold, dry, winds.

(ii) Land wind (open fields).

(iii) Suppressed eruptions.

Catching Cold.

Every fresh cold brings on an attack of asthma.

(i) Strong odours, flowers.

(ii) Exposure to drenching rains, washing clothes.

Exposure to cold air.

2) COUGH &

    ASTHMA

(i) Dry cough.

(ii) Cough as if from Sulphur fumes.

(iii) Cough after drinking.

(iv) Apex of the right lung is more affected.

(i) Dry & hoarse cough.

(ii) Choking cough.

(iii) Croupy & rattling cough.

.

(i) Asthma: Wheezing.

(ii) Asthma: Bronchitis.

(iii) Asthma: Dry hard cough.

(iv) Base of the right lung is more affected.

(i) Asthma: Dyspnoea of damp weather.

(ii) Asthma: Humid asthma.

(iii) Asthma: in children.

(iv) Base of the left lung is more affected.

(i) Cough: From tickling in larynx.

(ii) Cough: Racking cough.

(iii) Cough: Nervous cough, aggravation from strong odours.

(iv) Larynx very painful: sore throat.

(v) Apex of the left lung is more affected.

(i) Suffocations.

(ii) Longs for cold air.

(iii) Catches cold easily.

(iv) Cough: Hard & hacking.

(v) Cough: Irritating.

(vi) Cough: Aggravation night.

(vii) Upper lobe of the left lung is more affected.

3) CHEST &

    EXPECTORA-   

    TION

(i) Scanty expectorations.

(ii) Frothy expectorations.

(iii) Putrid expectorations.

(i) Wheezy asthma.

(ii) Cough & breathing: Moist & mucusy.

(iii) Chest: Wheezing or purring sound in chest.

(iv) Weakness in chest.

(v) Splinter-like pain in chest.

(i) Chest: Stitching & cutting pain.

(ii) Chest: Coldness.

(iii) Chest: Sensitive.

(iv) Expectorations: Copious; Offensive; Cheesy.

(i) Chest: Must hold chest when coughing.

(ii) Chest: Pain, lower left.

(iii) Expectorations: Thick; ropy; greenish.

(i) Chest: Burning pains & heat; oppression.

(ii) Chest: Worse lying on left side.

(iii) Expectorations: Rusty; purulent.; bloody.

(i) Expectorations: Thick; easy; profuse.

(ii) Green foetid nasal discharge.

4) ASSOCIATED

    SYMPTOMS

(i) Exhaustion.

(ii) Chilly.

(iii) Burning pains.

(iv) Anguish with fear of death.

(v) Restlessness (Physical & Mental).

(i) Manifestations: Chilliness &  Hypersensitiveness.

(ii) Manifestations: Scrofulous.

(iii) Nose: Sore nostril.

(iv) Nose: Blocked, aggravation cold air.

(i) Constant Concomitant: Backache ; Sweat & Weakness.

(ii) Chilly.

(i) Constant desire to take deep long breath.

(ii) Nose: Hydrogenoid constitution.

(iii) Nose: Feels every change from dry to wet.

(i) Suitability: Tall, slender appearance.

(ii) Sudden  appearance of symptoms.

(iii) Susceptibility to external impressions.

(i) Very sensitive: mentally & physically.

(ii) Great exhaustion.

(iii) Nervous weakness.

(iv) When well selected medicine fails in a chilly,

POINTS

ARSENICUM ALBUM

HEPAR SULPH

KALI CARB

NATRUM SULPH

PHOSPHORUS

TUBERCULINUM

(vi) Suicidal.

(vii) Cannot bear smell or sight of food.

(v) Nose: Discharge smells like old cheese.

(iv) Nose: Worse rainy, damp weather.

(iv) Aphonia with rawness, aggravation evening.

impatient, discontented constitution

5) MODALITIES

Aggravation:

(i) Midday, midnight.

(ii) Wet weather.

(iii) Sea shore.

Ameliorations:

(i) > by leaning forward in bed.

(ii) Walking around.

(iii) Head elevated.

(i) Asthma: Worse dry, cold air.

(ii) Asthma: Better in damp.

(iii) Amelioration: Bending (head) backwards; warmth.

Aggravation:

(i) Worse lying left side.

(ii) Around 3 a.m. (2-4 a.m.).

(iii) Cold weather.

Ameliorations:

(i) Leaning forward.

(ii) Rocking.

(iii) Warm climate.

Aggravation:

(i) Nose: Worse rainy, damp weather.

(ii) Nose: Feels every change from dry to wet.

(iii) Chest: Rattling, aggravation 4-5 a.m.

Amelioration:

Dry weather; sitting up.

Aggravations:

Lying on left side, exertion (physical and mental), weather changes, wet weather.

Ameliorations: Rubbing.

Aggravations:

Morning (purulent expectoration).

Ameliorations:

Open air.

6) PRESCRIBING

    TIPS

Associated symptoms: (i) Exhaustion.

(ii) Chilly.

(iii) Restlessness (Physical & Mental).

Modalities:

(i) Aggravation: Midday, midnight.

(ii) Ameliorations: > by leaning forward in bed.

Cough & Asthma: Choking cough.

Chest & Expectoration:

Wheezing asthma.

Associated symptoms:

(i) Manifestations: Chilliness & Hypersensitiveness.

Modalities:

(i) Asthma: Worse dry, cold air.

(ii) Asthma: Better in damp.

Associated symptoms:

i) Constant Concomitant: Sweat.; Backache & Weakness.

Modalities:

(i) Aggravation: Around 3 a.m. (2-4 a.m.).

(ii) Ameliorations: Rocking.

Aetiology: Every fresh cold brings on an attack of asthma.

Cough & Asthma:

(i) Asthma: Dyspnoea of damp weather.

(ii) Asthma in children

Chest & Expectoration:

Chest: Must hold chest when coughing.

Associated symptoms:

(i) Nose: Feels every change from dry to wet.

(ii) Nose: Worse rainy, damp weather.

Modalities:

(i) Nose: Worse rainy, damp weather.

(ii) Nose: Feels every change from dry to wet.

(iii) Chest: Rattling, aggravation 4-5 a.m.

Cough & Asthma:

Cough: Nervous cough, aggravation by strong odours.

Chest & Expectoration:

(i) Chest: Worse lying on left side.

(ii) Expectorations: Bloody.

Associated symptoms:

Suitability: Susceptibility to external impressions.

Cough & Asthma:

(i) Longs for cold air.

(ii) Catches cold easily.

Associated symptoms:

When well selected medicine fails in a chilly, impatient discontented constitution.

POINTS

ARALIA RACEMOSA

BLATTA OCCIDENTALIS

CASSIA SOPHERA

ERIODICTYON

POTHOS FOETIDUS

SOLIDAGO VIRGA

1) ASTHMATIC

    MANIFESTA-

    TIONS

(i) Asthma with wheezinbg.

(ii) Inspiration is difficult.

(iii) Right lung: affected.

(iv) A f.b. (foreign- body) sensation.

(v) Wheezing in throat. Constriction in chest and throat with a sensation of foreign body in the throat.

(vi) Inspiration is difficult than expiration.

(i) Doctrine of Signature: Cockroach lives in cracks and crevices; in damp shady places, therefore it is a wonderful medicine for Asthma for people who live or work in damp basements, cellars, etc.; damp dwelling. Aggravation from damp and rainy weather.

(ii) Asthma with bronchitis, especially indicated after Arsenic when this is insufficient.

(iii) Acts best in stout, or corpulent persons. Seems to act better in patients who have a tendency to obesity.

(i) Skin disease (like dandruff, eczema, itching, ringworm etc.) are associated with bronchial troubles.

(ii) More the cough (in asthmatic

patients) and the more it is a painful and distressing cough, the better it is indicated.

(i) Bronchitis followed by tubercular chough.

(ii) Profuse nocturnal sweat and spasm > by expectoration.

(iii) Cough after influenza.

(iv) Past history of

recurrent pneumonia, recurrent bronchitis -> lung vitality weak à Easily catches cold à Asthma.

(i) For asthmatic complaints, which are caused and  made worse from inhaling any dust.

(ii) Difficult, troublesome respiration;

oppression with perspiration. Anguish with oppression.

(iv) Allergic broncho-spasm from dust; fur; dog fur/ hairs etc.

(i) Periodical asthma with nightly dysuria.

(ii) Asthmatic symptoms with kidney complaints.

2) EXPECTORA-

    TION

Expectoration is salty and hot.

Much pus like mucus.

Asthmatic symptoms with rattling of mucus in the throat but not much expulsion.

Lots of mucus à Rattling.

Not much mucus. Allergic wheeze.

Expectoration:-

(a) Profuse (b) Blood tinged.

3) MODALITIES

(i) Agg. At 2 A.M.

(ii) Lying agg.

(iii) < after lying,.

Aggravation: Damp, wet rainy weather; change of weather.

(i) Aggravates during rainy and winter seasion.

(ii) < later part of the evening and past and mid-night, towards early morning.

(iii) Better by sitting up.

Aggravation: Afternoon.

Amelioration: From expectoration.

Aggravation:

(i) From dust.

(ii) Asthmatic symptoms are better by passing stool.

Amelioration:

> open air.

4) PRESCRIBING

    TIPS

Asthmatic manifestation:  Wheezing in throat. Constriction in chest and throat with a sensation of foreign body in the throat.

Expectoration:

Expectoration is salty and hot.

Modalities: < after lying, < 2 A.M.

Asthmatic manifestation:

Wonderful medicine for Asthma for people who lives or works in damp basements, cellars, etc. damp dwelling. Aggravation from damp and rainy weather. Sycotic asthma.

Expectoration:

Much pus like mucus.

Asthmatic manifestation:

(i) Skin disease is associated with bronchial troubles.

(ii) More the cough (in asthmatic patients) and more it is a painful and distressing cough, better it is indicated.

Modalities:

(i) Aggravates during rainy and winter season.

(ii) < later part of the evening and past and mid-night, towards early morning.

Asthmatic manifestation:

(i) Profuse nocturnal sweat and spasm > by expectoration.

(ii) Past history of recurrent pneumonia, recurrent bronchitis -> lung vitality weak à Easily catches cold à Asthma.

Asthmatic manifestation:

For asthmatic complaints, which are caused by and are made worse from inhaling any dust.

Modalities:

Asthmatic symptoms are better by passing stool. Tuberculat asthma.

5) POTENCY OF

    CHOICE

Q, 6C, 1M.

(i) Q, 30C, 1M.

(ii) After the spasm for the remaining cough use higher, stop with improvement.

(i) Q., 30C, 1M.

(ii) Cassia sophera is antidoted by smoking or chewing tobacco, so patients should avoid them during medication.

Q, 30C.

Q (during acute attack), 30C, 1M (Constitutional for Allergic Broncho-spasm).

(i) Q, 30C.

(ii) 15 drop doses promotes expectoration in bronchitis and bronchial asthma, in old people.

Cases with clear picture (Clarity of symptoms to make it complete e.g. with sensation, modalities, etc.)

Cases with scarcity of symptoms (suppression or masking of sensations, modalities etc. by strong and off prolonged effect of drugs)

Constitutional Prescribing with the use of Homoeopathic Organopathic Broncho-dilators (to gradually wean off the inhalers, etc.)

As there may be symptoms, but not good symptoms to characterise the patient and frame a good totality for selecting a constitutional medicine, its better not to prescribe a constitutional medicine on a few vague/common symptoms. But there is scope of employing Homoeopathic Organopathic medicines. This Organopathic medicine will not only help to withdraw the allopathic drugs but also in my experience will clear-up the suppression and bring more symptoms to the surface.

To stimulate

the vital organs

Gradually withdraw

the drugs

Re-assess after 50% - 60% of the withdrawl of drugs

Try constitutional medicine

Withdraw in order

1 – Ventolin

2 – Inhaled Steroids

3 – Oral Steroids

Aim for 10% less in 6 months; long weaning off period; takes time.

If on a constitutional remedy, but inhaler dependent, use tincture to help decrease dependency.

Use constitutional remedy first, this will cover all the symptoms anyway, tincture will assist as organopathic.  Need to withdraw steroids finally, Homoeopathy won’t work and make any permanent results, if steroid dependent.

Tincture - once 50% of allopathic remedy withdrawn, go to 6c, once 80% withdrawn, go to 30c but only if tincture is similimum.

MONTH 1

MONTHS 2-6

MONTHS 7-12

MONTHS 13-18

MONTHS 19-24

Allopathic Treatment

Using:

Ventolin (Reliever) 2 puffs when required.

Steroid Inhaler

(Preventative) 2 puffs twice a day

Oral Steroids – assumed being taken as a one off course.

If not needed, to be gradually reduced. (10% less in 6 months)

Continue all inhalers and steroids as usual.

Reduce (50%),balance with homoeopathic Rx

Ventolin (Reliever) 1 puff when required. Need to monitor frequency – use SOS tincture X

 4 hourly or when necessary.

Steroid Inhaler (Preventative) try to reduce to 2 puffs once a day over the period.

Oral Steroids – usually weaned off over a few weeks and then stopped.  Aim to reduce frequency of use.

Reduce (75%)

Ventolin – can patient now do without?

Use SOS tincture when required only, not on a regular basis.

Steroid Inhaler – reduce to 1 puff once a day, Months 7-9, 1 puff every other day Months 10-12.

Oral steroids – should have ceased.

Reduce (100%)

Use SOS tincture only if and when required

Steroid Inhaler – can patient now do without?

(Bear in mind this takes 2 weeks to build up in the body)

Reduce (100%)

Use SOS tincture only if and when required.

Ventolin Inhaler should have ceased.

Steroid Inhaler should have ceased.

Asthma under control barring exciting cause e.g. colds, virus.

Homoeopathic Treatment

Take Constitutional remedy e.g. Calc Carb 30 – (potency according to patients vitality).

Start indicated Homoeopathic Tinture 8 hourly to bolster the lungs e.g. Eriodictyon.  Use tincture as SOS as well, if necessary.

Continue to take Constitutional Remedy, increase potency if necessary or change remedy depending on symptoms.

Continue use of tincture as SOS and reduce dose to once a day, if possible.

Use SOS tincture as and when required.

Continue Constitutional treatment – deal with any acutes as they arise.  Need to get more symptoms, may need to open up case with nosode if stuck.

Continue Constitutional treatment.

Continue Constitutional treatment.

Patient may well have ongoing Homoeopathic treatment for some years - takes 25-40% of the time they have been ill.

MONTH 1

MONTHS 2-6

MONTHS 7-12

MONTHS 13-18

MONTHS 19-24

Notes

May need to use LMs if patient is unwell or cannot handle aggravations.

As time goes on – may need to change tincture as asthma symptoms may change.

May be incurable case, may only be able to palliate or reduce allopathic medicine.