Clinical Cases

The Importance of Aetiology in a Case of Persistent Cough

Written by Daniela Karsten

Daniela Karsten presents the case of a cough that had lasted 48 years, finally yielding to a remedy based on etiology.

The significance of aetiology or causation as part of the homeopathic totality is well recognised. In his, “Lectures on Homeopathic Philosophy”, Kent differentiates allopathy from homeopathy with reference to the importance given to the cause of disease. In Lecture 1, entitled “The Sick”, Kent observes that in allopathy, “the microscopic pathological results of the disease are noted and considered to be the beginning and ending, i.e. the result without anything prior to them…..But Homoeopathy perceives that there is something prior to these results”.  He concludes that, “only in this way can we trace cause and effect in a series from beginning to end, and back again from the end to the beginning.”

The following case offers a clear window onto the importance of the aetiology, and its’ potential for attaining the “highest ideal of a cure”: That is “rapid, gentle and permanent restoration of health”.

My patient, a 78 year old female, of slight build and neat appearance, had been coughing persistently and paroxysmally for 48 years. The cough had started suddenly after the birth of her second daughter, and was characterised by the patient as “hard”. The cough was worse on getting up at 6-6.30am, at night lying down, and was also worse for warmth and anxiety – when a nervous cough would develop. The cough was further characterised by lack of expectoration, a sensation of something in the throat, and was accompanied by a runny nose, with mostly clear discharge. Most winters a catarrhal cough may be added to the mix. Her family history included her mother’s continual cough and her father’s death from TB. However, her own personal health history was largely clear, and apart from the irritating cough, the patient was generally in good health, and un-medicated.

It was while recording her pregnancies and childbirth experiences that I stumbled on a piece of hidden personal history that was key to the case. It emerged that between the birth of her two daughters, she had given birth to a son, who had died two weeks later from a heart condition. Her second daughter was born fourteen months later, and in her words, “I didn’t dwell on it.” It was shortly after this, that the cough developed.

The patient’s personality further revealed a high level of retention and reserve. Phrases such as “just got on with it”, and “whatever went on you kept it to yourself”, added weight to the picture. The patient was economical with her information, and explained that she found it uncomfortable to express her emotions, and if upset, would cry privately, not enjoying consolation. She would avoid quarrels, choosing to “put the issue to one side,” disinclined to say what she really thinks. With a strong sense of values and duty, she did, however lack confidence.  As she put it, “not confident to do anything outstanding.” She was family oriented, and avoided new people or situations where possible. She enjoyed handicrafts.

Her generalities included a chilly temperature with an aversion to warmth, a love of salt along with thirst, preferring warm drinks. The miasmatic weighting was slightly towards tubercular, with psora and sycosis in the background, and only traces of syphilitic.

I prescribed a multi-miasmatic remedy, Nat Mur 200c, followed by 1M, on the basis of aetiology: Ill effects of Silent Grief, and a supporting totality.

At the first follow-up six weeks later, the night time cough had reduced to three to four nights out of seven, and was looser and more productive. As a consequence, the sensation of a blockage in the throat had also reduced, and her breathing had improved. The nervous cough had also shown signs of improvement, with the patient able to enjoy a meal without coughing. It was also noted by her daughter that her mother’s previous anxiety about having sweets with her to ameliorate the cough, was also lessened. Her wellbeing was good, but the morning “coughing fits” were still there. The patient was boosted with a sac lac prescription. Six weeks later the patient reported a sixty percent improvement with “hardly any nights coughing” and only occasional coughing during the day. Her daughter confirmed the change saying that she had not noticed the cough much. The patient was still expectorating, and there was some greenish nasal discharge. She was now rarely coughing in social situations, and rarely needed the sweets for alleviation. She was feeling more confident to go out and reported feeling less tired. The patient was boosted with sac lac.

The next appointment was eight weeks later, where 100% improvement was reported. The patient was no longer coughing at all, her wellbeing was recorded at optimum (10/10), and most interestingly she had found a new level of confidence, undertaking new social activities, making new friends and taking the initiative! The patient kindly wrote a testimonial:

“I decided I would give it a go though I was sceptical at first, thinking nothing else had worked so far. Initially the cough remained the same, but gradually with the second treatment it started to improve. By the third set of treatments in April 2012, I was pleased to find that I no longer had a cough!!”

Two years later the patient enjoys good health and is not sufficiently troubled by any symptoms to warrant a return visit.

© Daniela Karsten, September 2013

About the author

Daniela Karsten

I discovered homeopathy while looking for a safe and drug-free approach to treatment for chronic eczema and common childhood illnesses, for myself and my family. It has long been my treatment of choice, and I have been using homeopathic remedies successfully for over 15 years. I graduated from a four year course of study and training at Allen College. Always looking to improve for the benefit of my patients, I undertake regular professional development. In 2013 I did post-graduate study and clinical practice in the slums of Calcutta, India. As a mother and former Montessori teacher, I have a strong interest in children's health. I have contributed to a professional nanny agency's newsletter and website, and write regular articles on family health issues for Salad Days Magazine. I am also proud to be a "selected practitioner" for Cambridge University Hospital Trust, which includes Addenbrooke's Hospital and the Rosie Maternity Unit.


  • As decided by the Dr.Danela Kerstan, Nat mur has done the wonder in this case, where a patient suffered persistant courgh years toghether. It is really unbelievable and this medicine has cured many dieseases.

  • DEAR DR,

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