A topographical representation.
1. Upper Respiratory tract.
(a) Lacrymal gland and Lacrymal duct.
Guarea-A capital remedy of dacryocystitis with obstruction of the lacrymal duct. Less known remedy, but very much used by Dr. Parteneau in 1x. It acts specially in dacryocystitis, acute, or chronic. Dr. Bernoville prescribes in granules, two granules once a day. Corresponding ground remedies are very often: Thuya, Lachesis, Lycopodium, Hepar sulphur (Suppurated dacryocystitis).
(b) Nasal mucous and cavum.
1. Acute coryza. Allium cepa, Euphrasia, Arsenic, Mercurius,
Pulsatilla-with sometimes Hepar sulphur form the small group of remedies of acute rhinitis.
Allium cepa-Irritating nasal flow with non-irritant lachrymation.
Euphrasia-Non -irritating nasal flow, irritating lacrymation. These two remedies may be alternated. They are also indicated in the catarrhal phase in the beginning of measles and in hay asthma where it should be used in the 30th, repeated every day, often simultaneously with 1000 in long intervals (Nebel).
Arsenicum album is opposit of Mercurius. Arsenic: acute coryza with catarrh directed towards the exterior with red nostrils; great irritation of the mucous membranes and even of the upper lip. Amelioration by hot applications. Mercurius: catarrh directed towards the interior, towards the pharynx, with possible erythematous angina. First stage of suppuration, the second stage is marked by Hepar sulphur and the third stage (chronic stage) by Silicea.
Pulsatilla-Used at the end of the end of the acute stage when the flow is yellow, non-irritating and sweet.
All these remedies play an important role not only in the acute stage of coryza but also in the treatment of sinusitis.
II Chronic Rhinitis.
Hydrastis and Kali bichromicum have almost similar indications: Thick yellow thready discharge. They may be used together because they reinforces the actions of each other. When the nasal discharge requires increasing, they are to be used in lower dilutions 3 and 6 for Hydrastis, 6 and 12 for Kali bichr. On the contrary when the stoppage of the discharge is necessary the 30th dilution is to be used. Let us insist on the symptom of Kali bichr: Thick, elastic, greenish yellow crusts, thrown out of the nose when the patient sneezes.
Kali muriaticum and Kali iodatum-They act in chronic non thready nasal discharge. Lump of mucous difficult to detach in Kali mur. with whitish discharge. Action on the Eustachian tube. In Kali iod the discharge is very fluid, like the white of an egg, colorless and very much abundant.
We know that the upper respiratory tract, particularly the cavum, forms a real cross-road between the different bonny stages of the face and between the digestive and the respiratory apparatuses, which explains the, existence, from physiopathological point of view, the naso hepatic syndromes, naso intestinal symptoms like that of naso urinary syndrome or naso genital syndromes. It is a capital rule in Homoeopathic Drainage to search what is the other pole of the organism: Which has the nasal pole for the toxinic equilibrium. The nose is undoubtedly an emonoctory of derivation, which is the most used by the human organism. Unfortunately we have not yet any sure rule by which we can envisage in a clear manner the syndrome in question. Perhaps one may think of the right passage of the cavum when the liver is the cause. The right nostril is particularly affected. We may think of the urinary and the genital apparatuses when the cavum and the nose are affected bilaterally. But this fact remains to be elucided.
The most important fact to note: when Lycopodium is the ground remedy (hepatic insufficiency), the elimination is marked through the right nostril. The second interesting point: In the pathogenesis of the remedies having elective actions on the liver, we note always the symptoms of pharyngitis (Chelidonium, Chionanthus, China and Myrica ). The third example is of the same nature: Some remedies like Argentum nitricum and Capsicum always respond to a balancing between the urinary and genital apparatus and the nasal mucous membranes, such as it is seen in some cases of acute rhinopharyngitis with albuminuria. We have already had the occasion to stress on the point that, that idea of elective action of medicines and their polarity of action dominate the importance of drainage and of canalisation. Dr. Rouy has begun a research in this sense. He has been able to show that in some cases, such part of the crystallin was related to such remedy which should orient the mind towards such lobe of the liver.
If we have to draw a chart of the remedies of diphtheria we will indicate:
Lachesis.- Elective action on the left tonsil.
Lycopodium-elective action on the right tonsil. Lachesis is very important.
With Arsenic, it is the remedy of serious infections in general, even gangrenous.
Mercurius cyanatus.-It is the most effective salts of mercury.
Mercurius proto-odatus-It has an affinity for the right tonsil and Mercurius bi-iodatus for the left.
We have still other important remedies such as Apis (Oedema of the uvula) and Kali bichromicum,. which we have already studied.
Some other remedies have action specially on the glottis. Hepar sulphur is classic. Dr. Bernoville says that it acts better in children having short neck, the head being pressed between the shoulders . They have tendency to spasm of the glottis. Apis is an important remedy of the oedema of the uvula. Then come Cantharis and Arsenic and in the case where the oedema of glottis is caused by bee sting, we must think of Ledum palustre and Calendula.
The most important and dominating remedy is Drosera, which is used in all sorts of laryngial phenomena in relation to a tubercular state. It should be given in rather high dilution 200, but rarely repeated with great care because its action is like that of Phosphorus and that of Tuberculines. On our schema we have drawn an arrow downwards vertically and we have indicated Sambucus, a remedy of laryngitis (stridulous) with Belladonna (in Sambucus the mucous falls in the throat which causes the spasm of the glottis). We have drawn an ascending arrow and we have indicated Bromium (of which the mucous has a tendency towards the exterior), a remedy of laryngo-trachitis and of Asthma ameliorating on the sea side. It is also a remedy extending to larynx and to the trachea. On the point of the sternal fork, the most important remedy is Rumex crispus, acting specially on the lower part of the larynx and trachea. The cough is caused by pressure above the fork, or while breathing cold air. It is better used in tubercular condition and to patients of oxygenoid constitution, who may have diarrhoea towards the morning like that of the Sulphur type.
Hyoscyamus has cough with congestion of the brain in horizontal position with the impression that the uvula is tickling on the posterior part of the pharynx. These troubles disappear in a vertical position. Hyoscyamus is a remedy of pharyngeal cough like that of Capsicum (sensation of burning with the menace of otitis) and Mentha piperita (the patient has the sensation of swallowing cold air, and cold air aggravates). It is equally a remedy of trachitis (aggravation at night in lying position) like that of Rumex crispus. Finally Hyoscyamus, Kali bich and Apis form the trio having elective action on the uvula.
With Bromium and Rumex we may compare Chlorum, Ammonium iodatum, Ammoniacum, which are the remedies of the secondary importance.
Sulphur is our important polychrest. It should not be neglected in laryngo-tracheal cough.
In recurrent cough, nervous cough of cardiac origin let us think of Naja and Spongia. We must not forget Digitalis (action on the heart).
Let us now consider a series of remedies having special action on the larynx.
Aconite, Spongia and Hepar sulphur, the classic trio of croupal cough. Aconite and Spongia have croupal cough at night. Hepar after midnight. Aconite has much anxiety Spongia has noisy cough, having sawing sound. We may use Aconite and Spongia 6 alternately every four hours and Hepar sulphur once in 24 hours. Use the 30th potency.
Arum triphyllum is specially indicated in the acute stage and even in grave stages of a secondary streptococcus infection. The patient has very much nasal voice, bi-tonal voice, and continually pricks his lips and tears the skin.
The remedies of chronic laryngitis are related to Carbo vegetabilis, Phosphorus and Causticum as ground remedies.
Phosphorus.-It is the remedy of congestive or inflammatory stages. Hoarseness in the evening, after overwork of the voice which causes congestion of the larynx. Phosphorus is the Bryonia of larynx.
Causticum is the remedy of paresis and of atony. Its hoarseness is worse in the morning; Causticum acts on the motility of the larynx. Causticum is the Rhus tox of the larynx.
We know that Causticum and Phosphorus are incompatible.
Carbo vegetabilis is an important remedy having elective action on the larynx. We should think of it in all cases of acute laryngitis or of chronic laryngitis specially when all other remedies have failed, or have caused the acute stage to enter into chronic stage. There is at the sametime atony and congestion. But the congestion. But the congestion is more passive than inflammatory. The patient has a sensation of heat or even burning in the larynx and trachea. Aphonia is often complete. There is the possibility of cyanosis and hyposphyxia.
Carbo veg. is related to Arnica and Selenium which are its complementary.
In the laryngitis of influenza, laryngial cough, catarrhal laryngitis with incessant cough, it is always better not to wait for the search of a simillimum. It is better to use the more sure remedies alternately. As for example we may prescribe Drosera 200, one dose, followed every hour by Sambucus 6, Rumex 6, and Spongia 6. We will thus have a good and rapid result.
Cuprum metallicum is an important antispasmodic remedy, specially used in whooping cough or in whooping -cough like cough with possible cyanosis and laryngial suffocation (like Carbo vegetabilis). Amelioration by drinking cold water (like Causticum).
Coralium rubrum is the opposit of Cuprum. The child becomes red during the fit of whooping cough. Really speaking Cuprum acts also very well, even if the child becomes red during the fit.
Let us recall here some of the principal remedies of whooping cough: Belladonna, Ipeca, Drosera, Coccus, cacti, Mephitis, Arnica, Cina and the nosode Pertussin.
These are the principal remedies having an elective action on the larynx and trachea. Let us now consider the remedies having a local elective action on the bronchi, the lungs and the pleura.
Lower Respiratory system.
1. Pleurisy and pleuritis.
Seven remedies are of the first importance: Sulphur iodatum, which is the most important of all. Its satellite is Arsenicum iodatum; then the trio of pleurisy : Bryonia, Ranunculus bulbosus, Asclepias tuberosa; finally the duo of the exudation: Cantharis and Apis, to which we may add Kali carbonicum.
Sulphur iodum is indicated in pleuritis for avoiding pleurisy. In course of pleurisy, to check symphysis, and finally when there is symphysis. It is also indicated in Cortico-pleuritis. Sulphur iodum, acts rather on the left lung, while Phosphorus triodatus acts rather on the right.
Arsenicum iodum has the same indications as that of Sulphur iod. It is an excellent remedy in general, in oxygenoid tuberculars patient, more or less menaced by pulmonary bacillosis. Has special action on the right lung.
Bryonia is the most important of the three remedies of pleuritis. Pains ameliorated by rest, aggravated by movement. Right sided.
Ranunculus bulbosus: Pleurodynia aggravated by humidity. Left laterality. Marked action in rheumatic and alcoholic patients in relation to Lachesis and Sulphur.
Asclepia tuberosa; Tubercular condition. Acts specially on the left base.
Cantharis and Apis are the remedies of exudation. Cantharis being the most important.
Kali carb is a remineralising remedy. Should be applied at the end of pleurisy.
One point merits special mention here. Opposition between Sulphur iodatum and Phosphorus. Phosphorus triodatus is more indicated in tubercular patients having central pulmonary lesions of caseous type, while Sulphur iodatum responds to peripheric fibro-caseous or fibrous lesions.
Finally let us not forget the remarkable decongestive action of Sepia on the left apex. Sepia is an important remedy but the most misunderstood remedy of tuberculosis and of congestion of the left apex. When one treats a recalcitrant tuberculous patient, when it does not react to medicines and seem to evolve towards an evolutive phase, with a left apical localisation, we must think of Sepia, even in the absence of the general symptoms of the remedy.
Pulmonary and bronchial affections.
Lycopodium and Chelidonium act on the right base purely topographically, affecting the whole inferior portion of the hemithorax (right ) (right lobe of the liver, pleural cul-de-sac, base of the right lung). It is opposed to Sulphur, Natrum sulphuricum, Antimonium sulphuricum auratum acting specially on left base in asthma.
Bryonia is indicated from the pulmonary point of view. It acts specially on the right lung.
Antimonium tartaricum acts on the two lungs, like Ipeca. Antimonium is one of the most faithful remedy of expectoration. Elective action on the bronchial mucous and on the bronchial alveoles. Has also action on the heart. Ipeca acts on the contrary through the medium of the vagus on the diaphragm and on the bronchial mucous., It acts very well on the respiratory spasms and bronchial mucous. But it may cause congestion if it is given very often or in very high dilutions.
Ethyl sulphuricum discoloratum is the remedy of the acute oedema of the lungs. Satellite of Phosphorus and of Sulphur.
Phosphorus is here an important remedy of pulmonary congestions, of bronchopneumonia and of pneumonia, action electively on the parenchyma, of the lungs, specially on the right side.
Silicea is opposed to Phosphorus. It acts on the interstitial pulmonary tissues, on the pulmonary elasticity. It is a remedy of suppuration, and a remedy of emphysema as well (metabolical trouble of silicate on the lungs). In persons suffering from emphysema one will often give Phosphorus and Silicea alternately in high dilutions. Phosphorus during congestive phases. Silicea for giving more elasticity.
We will not speak here again about different antispasmodic remedies such as Cuprum, Ipeca, Hydrocyanic acid etc., which we have already studied. We will speak only about those that have elective action. Phellandrium: pain which crosses the right apex; Myrtus communis on the right apex; Illicium, pain specially on the third rib of the right side of and of the corresponding cartilage; Chelidonium: spontaneous pain, one or two centimetres below the lower angle of the right shoulder blade. Chenopod glauci aphs has similar pain on the left shoulder blade.
And let us now conclude our study by some general consideration about the important ground remedies of the respiratory apparatus. We may say that there exists an axis formed by four important remedies (Schema II): Sulphur, Phosphorus, Arsenic and Carbo vegetabilis.
Sulphur is used specially in congestive stages, but the remedy has a centrifugal action. It is used at the end of the acute stage.
Phosphorus is also a remedy of congestive states, but as the action of the remedy is centripetal it should be manipulated rightly.
Arsenic is indicated when the patient has lost his vitality.
Carbo vegetabilis is used when there is a greater loss of the vital force.
Often the respiratory troubles evolves according to these four remedies, i.e. to say one may check the gravest (Carbo veg) and less grave (Sulphur).
On each side of our schema we may indicate: Lachesis, the great remedy of hyposphyxic conditions, Ignatia, Cimicifuga, Cuprum are the remedies of spasms. On the left of our table and on the top: Lycopodium, pneumonia of children with fanning of the nostrils: Nux vomica its complementary: Thuya and Natrum sulphuricum, remedies of hydrogenoid constitution and of sycosis. opposed to psoric conditions of all the other remedies of the chart; Sepia, a remedy of the respiratory system, though it is less important, yet it should not be neglected; it is related to Nux vomica and Thuya. Causticum, a remedy of aphonia, laryngial paresis, is related to Thuya and Natrum Sulphuricum.
Psorinum is very important in pulmonary affections specially chronic and responds to chronic Sulphur aggravated while evolving towards Carbo veg and Opium (uremia).
Silicea and Phosphorus are opposed to each other, Silicea is related to Natrum muriaticum which follows Natrum Sulphuricum. Between Sulphur and Iodium is placed Sulphur iodatum, which is very important in tuberculinics. The adolescent Natrum muriaticum which evolves towards Silicea, may have pulmonary lesions of serious functional troubles which may evolve towards Sepia or Lachesis. The patients of Sepia and Lachesis are often chronic Natrum muriaticum or chronic Pulsatilla. Natrum muriaticum has also important relations with Calcarea carbonica and with its complementary Hepar sulphur, a remedy of suppurations (pulmonary), which may later on evolve towards Silicea. We may still indicate some satellites of these polychrests Opium and Morphinum, remedies of uremic coma Around Opium: Cuprum arsenicosum (spasms), Ammonium carbonicum Carbolic acid, Helleborus.
Carbolic acid, Helleborus, Opium and Morphinum are the four remedies of Cheyne-Stocks respiration.
Between Phosphorus and Carbo veg: Cuprum and Veratrum album. Let us also think of the trio of vegotonia: Ipeca, Hydrocyanic acid, Lobelia inflata.
Silicea has some relations with Baryta carbonicum in pulmonary sclerosis.
Pulsatilla is an important drainer of Phosphorus, Sulphur and Lycopodium.
Rhus toxicodendron, the drainer of Thuya and Natrum Sulphuricum.
We find also the three important remedies of the drainage of Dr. Nebel’s tuberculinics: Pulsatilla, drainer of Marmoreck; Rhus tox, drainer of T. R. and Denys; Nux vomica, dainer of T.K. Some times T.R. and the hydrogenoid conditions are drained by Nux vomica and Ipeca.
Sulphur’s important satellite in acute cases: Aconite.