Therapeutics of Acute Respiratory Tract Infections

INTRODUCTION

Acute respiratory tract infections are the most common illnesses in childhood, comprising as many as 50% of all illnesses in children less than 5 years old and 30% in children 5-12 years.

CAUSES

Over 200 different viruses have been isolated in patients with upper respiratory tract infections (URTI’s.)  The most common is Rhinovirus. Other viruses include: coronavirus, para-influenza virus, adenovirus, enterovirus and respiratory syncytial virus. 15% of acute pharyngitis cases are due to Streptococcus Pyogenes, group A streptococcus in streptococcal pharyngitis.

Influenza: A systemic illness.

Comments

The concept of ‘cause’ is wide and related to constitution, diathesis, sensitivity, susceptibility, immunity etc. in homeopathy.  The concept of infection is not local but general in homeopathy.  In other words, no illness is local; every illness is general and pertains to the patient as a whole

ACUTE UPPER RESPIRATORY TRACT INFECTIONS

Illnesses: Rhinitis, tonsillitis, pharyngitis, laryngitis, epiglottitis, sinusitis, tracheitis, otitis media etc.

ACUTE LOWER RESPIRATORY TRACT INFECTIONS

Organs: Lungs

Illnesses: Bronchitis, bronchiolitis, pneumonia, lung abscess, tuberculosis etc.

ARE ANTIBIOTICS NECESSARY?

Physicians are strongly encouraged today to decrease the prescribing of antibiotics to treat common upper respiratory tract infections because antibiotic usage does not significantly reduce recovery time for these viral illnesses.

Most studies show no difference in improvement of symptoms between those treated with antibiotics right away and those with delayed prescriptions. Most studies also show no difference in patient satisfaction, patient complications, symptoms between delayed and no antibiotics

It is to be noted that antibiotics don’t kill viruses and they have also no role to prevent the so-called secondary bacterial infections.

THE USE OF DECONGESTANTS

“There is insufficient data on the use of decongestants in children.”

Decongestants are not recommended for use in children under 12 years of age with the common cold. Oral decongestants are also contraindicated in patients with hypertension, coronary artery disease, and a history of bleeding strokes.

SYMPTOM COMPARISON BETWEEN ALLERGY AND URTI

SYMPTOMS	ALLERGY	URTI	INFLUENZA
Itchy, watery eyes	Common	Rare (conjunctivitis may occur with adenovirus)	Soreness behind eyes, sometimes conjunctivitis
Nasal discharge	Common	Common	Common
Nasal congestion	Common	Common	Sometimes
Sneezing	Very common	Very Common	Sometimes
Sore throat	Sometimes (postnasal drip)	Very common	Sometimes
Cough	Sometimes	Common (mild to moderate, hacking)	Common (dry cough, can be severe)
Headache	Uncommon	Sometimes (sinus pressure headache)	Common
Fever	Never	Rare in adults, possible in children	Very common (100-102°f (or higher in young children), lasting 3–4 days; may have chills)
Malaise	Sometimes	Sometimes	Very common
Fatigue, weakness	Sometimes	Sometimes	Very common, can last for weeks, extreme exhaustion early in course
Muscle pain	Never	Slight	Very common, often severe

THERAPEUTICS OF ACUTE RESPIRATORY TRACT INFECTIONS AGARICUS

Respiratory

• Spasmodic asthma, from muscular constriction or contracted blood vessels. Oppression or drawing in diaphragm.
• Cough: Spinogenic; nervous; spasmodic; dry, hacking; minute gun, in isolated attacks, or persistent. Worse: on falling into, or during first, or after sleep; motion; eating; > by effort of will. With headache. Sneezing at end of or alternating with, coughing.
• Expectoration: In balls, purulent, sometimes sans cough; “with weakness of chest, night sweats, as an intercurrent to Stann-i.”- Royal.

Relations

• is syphilitic Bell., syphilitic Rhus-t. and psoric Nux-v.
• is our homeopathic Penicillin.
• Midway between and Lach.
• , Am-c., Lach., Rhus-t. and Penic. – a group.
• Trios:
• Agar – Tub – Phos .
• Agar – Rhus-t – Phos
• Agar – Ars – Rhus-t
• Agar – Ars – Tu

Comments

• More for LRTI than for URTI. It is a remedy for chilly subjects and for ‘winter bronchitis’.
• Can be thought of when corona virus produces neurological symptoms and with coughing. But remember, Agar doesn’t have of taste and smell.

AILANTHUS GLANDULOSA

Nose

• Dry, itching and uneasy feeling; congested; secretion suppressed. Hay fever.
• Discharges: Thin, acrid. Copious, ichorous, bloody.
• > warm drinks.
• Rapid prostration. Advancing malignancy and stupor. Sepsis.

Throat

• Inflamed, oedematous, dusky red. Dry, rough, scrapping and choking. Pain on swallowing extending to ears. Hoarse croupy voice.
• Tonsils: Prominent; studded with many deep, angry looking ulcers, oozing a scanty, fetid discharge. Follicular tonsillitis, streptococcal infection, hemorrhagic diathesis.
• When the virus is attacking the throat.

Respiratory

• Cough: Dry, hacking, in violent paroxysms before retiring and retiring and on rising; painful; deep.
• Hawking up of mucus.
• Respiration: Heavy, hurried; oppressed.

Relations

• Similar: Am-c., Arn., Arum-t., Bapt., Bry., Echin., Gels., Hydr-ac., Hyos., Lach., Mur-ac., Nit-ac., Nux-v., Phos., Rhus., Stram.

Comments

• More for throat symptoms than for nasal complaints. Don’t forget this remedy when colds have descended and have caused follicular tonsillitis. Adynamia characterises this remedy.

ALLIUM CEPA

Nose

• Sneezing:< when entering the warm room.
• Coryza: copious, watery, bloody and extremely acrid discharge dropping from tip of the nose; with headache, bland lachrymation, heat, thirst, trembling of hands; < evening, warm room, > open air. Common colds going downward, progressing rapidly to laryngitis.
• Sensitive to odours of flowers and the skin of peaches. Polypus.

Respiratory

• Cough: Hacking, incessant, tickling, < on inspiring cold air. Oppressed breathing from pressure in the middle of chest; < evening.
• Larynx: Acute laryngitis and great hoarseness and pain in the coughing as if the “lining” of the larynx would be torn out, or as if the larynx would split, and sudden lachrymation. Throbbing and contracted sensation.
• Chest: Cold extending to bronchi, with profuse secretion of mucus, coughing and much rattling.
• Relations: when All-c. drives catarrh to the chest, think of Phos.

ALLIUM – CEPA	ARUM TRYPHILINUM
Side: Left2to right	Side: Left3
<: warm room, evening, odors of flowers and peaches	<:  cold winds, northwestern winds, lying down
> open air	> warmth2
Discharge: Profuse, watery, acrid	Discharge: Profuse, watery, acrid, thick, yellow, crusts
Obstruction less marked	Obstruction more marked
Sensation: Crawling, tingling, itching	Sensation: Feeling of heat in face and head
No picking of nose	Constant picking at nose until it bleeds.

ALLIUM CEPA	EUPHRASIA
Nasal discharge: Acrid, profuse, fluent	Nasal discharge: Bland, profuse, fluent
Coryza with bland lachrymation	Coryza with acrid lachrymation and aversion to light
Coryza without obstruction	Coryza with obstruction of nose
Colds descending down to laryngitis	Not descending down
Tickling in larynx with hoarseness and sensation as if larynx is split or torn;	Tickling in larynx causing cough, followed by tensive pressure beneath the sternum
Chills alternating with heat	Chills predominate, < forenoon
Incessant, hacking, cough < evening	Whooping type of cough < day time
Expectoration: Lumpy mucoid	Expectoration: Easy, copious, mucus
< evening, warm room, smell of flowers, wet feet, damp weather; > open air	< morning/daytime; > night, lying down
Thirst: Increased	Thirst: Not significant

 Comments

• Don’t limit its use only for sneezing bouts; this remedy is also for laryngitis and bronchitis.

AMMONIUM CARB

Nose

• A chief remedy for obstruction of nose. Snuffles of children.
• Sneezing, morning in bed. Allergic to dust. Epistaxis on washing face in morning.

Respiratory

• Cough: Dry; nightly; 3 a.m.; hollow; with salivation (Am-m), hypostatic congestion of lungs; pneumonia, coughs; post-midnight. Hemoptysis.
• Dyspnea < during sleep, > in cool air (Carb-v.).
• Emphysema: Oppression/short breath (with palpitation) at every exertion. Increasing difficulty in breathing, wakes around 3-4 a.m. (Kali-c.), with sneezing etc.
• Fungus infections, toxemic, atonic bronchitis.
• Good palliative in the last stages of consumption

Comments

• This is a deep-acting remedy from simple coryza to a wide range of complications. Think of this remedy when the infection has caused myocardial ischemia, heart failure or multi-organ failure.

AMMONIUM MURIATICUM

Nose

• Free acrid, hot watery discharge corroding the lip; closing one nostril.
• Sneezing: Arousing from sleep; with shooting pain in nape of the neck à Rhino-sinusitis.
• Loss of smell. Obstructed, stuffy feeling; constant and availing efforts to blow it out.

Respiratory

• Cough: Dry, hacking, scraping cough; < lying down on back or right side; at night preventing sleep; loose in afternoon and profuse expectoration and rattling of mucus. Cough very fatiguing.

Comment

• All mucus secretions are increased and retained.
• Don’t forget this remedy in frontal and maxillary sinusitis. Profuse catarrh and irritability accompany the symptoms.

ARGENTUM NITRICUM

Nose

• Coryza and stupefying headache over the eyes; has to lie down; sneezing; sickly look.
• Allergic rhinitis.

Respiratory

• Colds settle in larynx; voice untime or hoarse; aphonia (from overuse).
• Cough: Sporadic dry hacking mild (or teasing) coughs, < in warm room, evening, laughing (), talking; > lying (Mang.); short rattling, by day. Winter chest colds.
• Expectoration: Easy, bland, like boiled starch, grey, gelatinous. Weakness of chest (Stann).

Relations

• : Arg-n. is restless, active, tense, hurried, impatient, impulsive while Gels. is slow, sluggish, dull, and doesn’t want to be disturbed.
• is connected to Arg-n. through Gels, which is acute of both Bapt. and Arg-n. Bapt. – Arg-n.- Gels. a trio.
• Nux-v.: (unlike Arg-n.) starts from nerves and then goes to mucous membranes. Both have anxiety but Nux-v. is more irritable, ambitious and abusive.
• Ran-b. is a remarkable blend of Bry., Arg-n. and Kali-c.

Comments

• When colds have settled in larynx, don’t forget this remedy. Hoarseness with cough < in warm room are chief indications. Kali-s. (it has < from warm room and evening) follows well after Arg-n. when the infection has gone down in chest and has caused bronchitis.

ARSENIC ALBUM

Nose

• Sneezing: Frequent; violent; morning, waking on; without relief, without coryza.
• Discharges: Thin, watery, excoriating. Nose feels stopped up. Hay fever and coryza; < open air; > indoors. Nose colds descend to chest. Right-sided coryza.

Respiratory

• Unable to lie down; fear suffocation. Air-passages constricted.
• Cough:< after midnight, lying on back; on going into cold air; alternating dry and loose; dry at night > sitting up, < drinking; excited by smoking.
• Expectoration: Scanty, frothy, like beaten white of egg.

Comments

• Invaluable remedy of wide dimensions. It has all four miasmatic activities and the process may be active of the dominant miasm at a given time. A simple attack of cold may cause a violent attack of asthma.
• Remember three points for : It is not necessary that 1. Every patient should be restless 2. There must be < night³. There must thirst for SQSI (note that Ars. has thirst for a large quantity for 3 marks and that too often for 1 mark).

ARSENIC IODATUM

Nose

• Obstinate catarrhs, first dripping, then collecting, finally snuffly.
• Unrelenting sneezing; burning (and in throat); pain over root of nose and frontal sinuses; pungent irritation in nose and eyes; soreness; hunger.
• Post-nasal catarrh; green; redness of upper lip ().

Respiratory

• Catarrhal laryngitis; hoarseness; spasmodic croup.
• Air hunger; asthma in psoric or phthisical persons; < 11 p.m. to 2 a.m.; < when first lying down, must sit up. Bronchitis; loose coarse rales.
• Cough: Hacking; winter; chronic.
• Sputa: Heavy, purulent, yellow-green, (may be) stringy.
• Acute catarrhal pneumonia; delayed or slow resolution; abscess; caseous degeneration, fibrosis; with valvular disease, esp. mitral. ‘Flu broncho-pneumonia. Pleurisy; exudative, tubercular.

ARSENIC ALBUM	ARSENIC – IODUM
Side: Right	Side: Right
Sneezing without relief	Persistent but unsatisfactory sneezing. Coryza < by sneezing.
Discharge: Fluent, bloody, burning2, copious3, crust2, thick3, viscid1, excoriating3, hot2, mucous3, yellow2, yellowish-green2	Discharge: Thin2, fluent2,  excoriating3 when acute; thick3 yellowish3/greenish2, purulent2when chronic
< cold air2, open air2, after mid night3, drinking liquids3lying on back3> warmth3	< dry cold air2, warm south winds; > open air3
Colds descend to chest	Acute coryza getting chronic
Suffocative/ asthmatic cough; shortness of breath/ dyspnea3	Suffocating2, hacking cough1; shortness of breath/ dyspnea2
Expectoration: scanty2, forthy3, like beaten egg white	Expectoration: mostly absent or yellow- greenish2, foul2

 Comments

• Chilliness of Arsenic ion predominates over the Iod (an exception to the warm-bloodedness of all iodides), but Ars-i.is more catarrhal, has more glandular involvement and is indicative of a later(suppurating) stage. (Ref. Absolute Materia Medica). Evolution is simple: maintains its features but the discharge becomes thick, green and post-nasal in Ars-i.

BROMIUM

Nose

• Sneezing: Violent. Allergy to dust. Nasal obstruction after sneezing.
• Coryza: With corrosive soreness of nose, and upper lip. Stoppage of right nostril; later the left. Pressure at root of nose. Tickling, smarting, as from cobweb. Fan-like motion of alae nasi (Lyc.). Long continued obstinate coryza.

Throat

• Throat: Rawness with hoarseness. Swelling of mucus membranes of fauces and pharynx.
• Tonsils: Pain < evening, swallowing (fluids < than solids). Tonsils swollen, deep red, with network of dilated vessels, covered with mucus. Left-sided tonsillitis.
• Larynx: Colds start in larynx, go upward and downward. Scarping and rawness in larynx, provoking cough as if the pit of throat is pressed against the trachea. Voice hoarse: cannot speak clearly; loss of voice.

Respiratory

• Cough: Spasmodic, suffocative; croupy (Hep.); rattling of mucus in the larynx. Every inspiration provokes cough; < dust, exertion.
• Dyspnoea; can’t inspire deep enough; as if breathing through a sponge. Suffocative fits; starts up with chocked or croupy or wheezing cough.

Comments

• is a halogen and hence, glandular and with coryza, one should expect tonsillitis. Ars. and Brom. run parallel in the initial phase but the evolution of glandular involvement, hoarseness and spasmodic cough and warm thermal state differentiates Brom. from Ars. Brom. is usually without fever (unlike Iod.).

CARBO-VEGETABILIS

• Sneezing: Ineffectual efforts to sneeze; from irritation in larynx; < blowing nose; with pain in abdomen. Descending colds.
• Coryza and cough esp. in moist, warm weather. Can’t stand suppression of discharges; > free discharge from the nose.
• Larynx: Hoarseness < evening, morning, continued talking; long-lasting.
• Cough: Caused by itching in larynx; spasmodic; gagging and vomiting of mucus; with burning in chest as from glowing coals; < evening, open air, after eating and talking. Cold breath; must be fanned.
• Expectoration: Thick, sticky, yellow and profuse, salty, mucus yellow-green.
• Pneumonia late stage (abscess, gangrene), with affections of right heart; in emphysematous persons; suppurative stage; cold and sweaty, blush face, spasmodic cough, offensive expectoration, bad spots in the lungs and bronchial tubes. Old badly treated or neglected cases, bronchitis remaining, hepatization does not clear up; feeble pulse, complete giving out of the vital forces, collapse (pneumo-typhus). Lung degeneration. Oedema of the lung.
• Destructive lung diseases. COPD. Empyema. Lung abscess etc.

Relations

• Carb-v. is the Kali-c. of blood and Lyc. of arteries.
• Collateral: Psor.
• Counterparts: Ant-t., Dig.
• : exhausted. Carb-v.: adynamic. Echin.: fired. Bapt: prostated. Cur: weak

Comments

• Carb-v. is close-up of Am-c. It is for devitalized state. Air-hunger, coldness of extremities, flatulence and fetor accompany the symptoms. It is also used for post-influenzal complications like bronchitis, aphonia, myocardial weakness and above all, delayed convalescence. The patient is so weak that he has no capacity to talk or to cough. Remember, Carb-v. contains Kali-c.

CORALLUM RUBRUM

Nose

• Coryza:< odours of smoke, onions etc. Post-nasal catarrh; causing frequent hawking. Dry coryza: Nose stopped up and ulcerated. Violent fluent catarrh of odourless mucus, looking like melted tallow and leaving a greasy stain on linen. Inspired air feels cold (Cist.).

Respiratory

• Cough: Whooping; spasmodic, esp. when the attack comes on with a very rapid cough, and the attacks follow so closely as to almost run into each other. Often preceded by sensation of smothering, followed by exhaustion; with expectoration of blood; barking; with redness of face; < eating.

Comments

• The proving has yielded much coryza, even ulceration in nostrils and epistaxis. It resembles Dros., but has wet cough while Cor–r. has dry cough. Red coral contains calcium carbonate and iron oxide.

EUCALYPTUS GLOBULUS

Highlights

• Catarrhal, grippy congestions; leading to hemorrhages, toxaemia; with malaise and exhaustion ab initio ( like ), a stiff, weary aching throughout body;  a tense,  full  feeling  as  if  a  coryza,  influenza,  epistaxis, diarrhoea, menses  or sweat were about to appear; followed by actual hemorrhages. Typifies a congestive-catarrhal miasmatic influenza. Most of its conditions are febrile.
• Toxaemia: Toxic conditions (malaria etc.) esp. of the congestive variety. Quinine cachexia. Intestinal (, Carb-ac.).

Nose

• Sneezing (Lob-s.); < morning. Respiratory ‘flu. A prophylactic(traditional use).
• Acute damp weather coryza; acrid, watery, or (when ripe) fetid, purulent or stuffy; with tense feeling.
• Sinusitis frontal or ethmoidal (Aur-m., Kali-i.). Hay fever-asthma; allergic to dust.
• Influenza: Catarrhal. Sporadic. Sore throat.

Respiratory

• Catarrhal bronchial asthma of anemic, debilitated or aged persons. Bronchorrhea and bronchiectasis; senile (Seneg.). Irritative cough (renal reflex). Whooping cough of rachitic children.
• Phthisis: After malaria; with catarrhal crises of throat, stomach, lungs; with profuse sweats. A good restorative here.

Relations

• Nearest analogues: Ars., Bapt., Echi., Ter.
• Counterpart: Mur-ac.
• Intensified: Ter.
• is asthenic, convulsive and less toxaemic Eucal.; it is a Eucal. with pronounced malignancy and paralysis.
• Nux-v. + Rhus-t. = Eucal.

Comment

• Said to be preventive of influenza. Who can forget Nilgiri used for colds since ages? It is known for its use either as an essential oil or leaf tea for its ability to relieve congestion and ease breathing in colds. It is a stimulating expectorant.

FERRUM IODATUM

Nose

• Sneezing, nightly.
• Catarrh (morning fluent or obstructed); with heat (and restlessness); sometimes sweet-smelling urine. Pain at root of nose, extending to occiput. Scrofulosis; nose swollen.
• Discharges: Acrid, watery, thick, greenish, yellow, purulent; crusts. Epistaxis; from coughing. Descending colds.
• ‘‘A great remedy to finish acute colds, viral infection colds and influenzas. It is a reabsorbent as other iodides”- Bellokossy.

Respiratory

• Laryngeal catarrh, with hoarseness. Asthma. Cough. Expectoration copious, greenish, viscid, offensive, bloody, < mornings. Unresolved pneumonia.
• Phthisis: Catarrhal; mercurial; suppurative; in the last stage. (for acute infections during phthisis, Ferr-p.).

Comments

• Ferrum’s sensitivity and allergic diathesis make it an IMP group in allergic disorders. Redness of affected part may be the entry point. More for LRTI and in warm-blooded patients.

FERRUM PHOSPHORICUM

Nose

• First stage of colds in the head. Predisposition to take colds. Epistaxis; bright red blood; in children.
• Throat: Fauces red, inflamed. Ulcerated sore throat. Tonsils red and swollen. Eustachian tube inflamed. Sore throat of singers. Sub-acute laryngitis with fauces inflamed and red.

Respiratory

• Cough: short, painful tickling cough. Croupy, hard, dry cough and sore chest; > at night; < morning and evening.
• Expectoration: Pure blood in pneumonia.

Comments

• One of the causations is checked perspiration on a warm summer’s day. Midway between and Bell. Timely administration of Ferr-p. in high potency may abort pneumonia.

GELSEMIUM

Nose

• Coryza with violent sneezing and acrid water; with coldness in the extremities, < morning; with fever from afternoon till morning, hot head and congested face, going down into the throat-tonsils, heaviness in the extremities, fullness at root; with muscular weakness, lethargy, sleepiness.
• Chills running up and down back, hugs the fire.
• Tonsillitis: Pain from throat into ear; painful spot deep in tonsil; rapid progress (Dewey).
• Cough: Dry with sore chest and fluent coryza, < in spring.

Comments

• When the system has become indolent and the patient has appearance of intense heaviness of eyelids and thirstlessness, think of this remedy.

HEPAR SULPHURICUM

Action

• On respiratory mucous membranes, producing croupous catarrhal inflammation; profuse secretion.

Nose

• Sneezing: Every time he goes into cold, dry wind and running from nose later, thick, offensive discharge.
• Stopped up every time he goes out into cold air. Hay fever. Ripened colds and old catarrh. Inflammation of the nostrils, swelling and pain like a boil.
• Sense of smell extremely sensitive; lost.

Throat

• swallowing; sensation of a plug or a fish bone or a splinter; extending to ears on yawning. Quinsy and impending suppuration. Stitches in throat extending to ear when swallowing; on turning the head. Hawking up of mucus. Chronic tonsillitis; and hardness of hearing. Pressive and constrictive sensation in throat. Fear of constriction, suffocation.

Discharges

• Profuse; foul; like old cheese; sour: stools, body, sweat etc. Sweats easily and profusely. Infected sinus and pus formation.
• Abscess, threatening; much thick pus. Inflammation ending in suppuration.

Respiratory

• Cough: dry, hoarse cough; excited whenever any part of the body gets cold or uncovered, or from eating (or drinking) anything cold; crying, talking, walking. Croup and loose, choking; barking, < cold drinks or in morning; hacking as from a feather.
• Expectoration: Weakness and much rattling in the chest; can’t expectorate; tightens up in cold air; thick, yellow. Recurrent bronchitis, from every cold.
• Note: The cough of is never a dry one; (opposite Cor-r.); it has a slight loose edge; the expectoration is slight and there is little fever.

HEPAR SULPH	MERC SOL
Affinity: Respiratory mucous membrane	Affinity: Glands more than mucus membrane
Tendency to catarrhal inflammation with profuse secretions and suppuration	Tendency to ulceration more than Hep-sul
Discharges: Profuse3, fluent, yellow thick, mucopurulent3, offensive3 like old cheese, sour3	Discharges: Profuse3, fluent, acrid3 bloody3, thin, offfensive3, thick2, yellow-greenish3
< from change of weather3, cold air3	< at night3, from damp weather, heat3
Sneezing with coryza; < cold, dry wind	Much sneezing without coryza; < sunshine
Colds get ripened	Cold ascending upward or attack eyes.
Ulcerative tonsillitis with intense sphincter like pain in throat	Ulcerative tonsillitis with smarting, burning pain in throat
Tonsillitis with mucus2	Tonsillitis with much salivation3
Deep, rough, barking, chocking, croupy cough with profuse expectoration	Short, chocking, cough with scanty expectoration
Not specific	Cough in 2 paroxysms
Expectoration: Loose; but can’t expectorate	Expectoration: Loose in daytime, dry at night
Cough with weakness3 and much rattling	Cough with pressive pain in head and chest, and shortness of breath.

 Comments

• Sensitivity, pain, redness and tickling in larynx indicate Mentally Hep. patients are difficult and have critical and discontented look.

HIPPOZENIUM

Nose

• Descending catarrh beginning in nose (Hydr.).
• Acute/chronic rhinitis; secretion acrid, offensive, tough, greenish.

Respiratory

• Pharynx ecchymosed. Papules and ulceration in frontal sinus and pharynx. Frontal sinusitis. Catarrhal laryngitis.
• Respiration at first partially impeded, later absolute dyspnea, noisy, short, irregular breathing.
• Asthma, bronchial; senile. Chronic bronchitis. Bronchiectasis. Whooping cough. Pneumonia. Lung abscess. Neglected bronchitis or pleurisy; sub-pleural ecchymosis.
• Phthisis: Catarrhal; as a palliative, abates recurring inflammations (like Ferr-p.).

Comments

• Checks the liability to catarrhal affections. More useful in thin, emaciated subjects. A deep acting nosode of glanders.

KALI BICHROMICUM

Nose

• Sneezing: Violent; < morning; with lachrymation of right eye.
• Great dryness of the nose, and feeling of pressure in nasal bones. Coryza and obstruction of nose. Pressure and pain at root of nose and sticking pain in nose. Ulceration of septum; round ulcer. Fetid smell (from retention of discharge in nose).
• Discharges: Thick; greenish-yellow; croupy; acrid. Tough, elastic plugs from nose; leave a raw surface.
• Inflammation extends to frontal sinuses. Dropping from posterior nares.

Respiratory

• Cough: Bronchitis; cough > lying down and warmth; < morning on waking; after eating; deep inspiration.

Comments

• ‘Kali-bi. influenzas are generally definitely chilly’ (Borland). Indicated for 2^nd and 3^rd stage of inflammation and more for LRTI. Morning < is very imp. Great liability to take cold in open air. Kali-bi is adherent in mental make-up and in discharges. Kali-bi. develops pathology (esp. of sinusitis) out of accumulation (adherence) of stress from business and family issues. It is more adherent and stickier than Kali-s.

KALI-MURIATICUM

Nose

• Second stage of inflammation.
• Discharges: White, thick, cheesy. Stuffy cold. Hawking of mucus from posterior nares. Adherent crust in vault of pharynx (Kali-bi.).
• Throat: Follicular tonsillitis. Tonsils inflamed; enlarged so much, can hardly breathe; swallowing painful. Grayish patches or spots in the throat and tonsils.

Ears

• Acute or chronic catarrh of middle ear; threatened mastoid. Effusion about auricle. Obstruction of eustachian tube; retraction of drum. Deafness with earache. Noises in ears. Pain in ear < cold air.

Respiratory

• Cough: Loud, noisy stomach coughs; short, acute, spasmodic, like whooping.
• Expectoration: Thick, sticky, white; flies from the mouth. Rattling sounds of air passing through thick, tenacious mucus in the bronchi; difficult to cough up.

Comments

• When throat is the target and throat is with white deposits, use Kali-m.

KALI SULPH     

Nose

• Nose obstructed; discharge from PN. Engorgement of the naso-pharyngeal mucous membrane; mouth breathing, snoring, wheezing, etc., remaining after removal of adenoids.
• Discharges: Profuse; earlier thin yellow, watery, later thick, ripened, deep yellow or greenish pus; slimy, serous or degenerated secretion; brownish (ears).
• Third stage of inflammation.

Respiratory

• Tendency to itis: Laryngitis, pharyngitis, bronchitis, bronchiolitis, asthma, pneumonia, whooping cough etc.; with yellow, slimy or watery; easily expelled.
• Cough: < evening, lying, hot atmosphere, > cold air and drinks; post-grippal; hard coarse like croup; mucus slips back and is generally swallowed, in children.
• Ratting of mucus in chest (Ant-t.); during sleep; with or without cough premature mucous rales in chest (i. e. rales which appear before other symptoms).
• Relations
• Kali-bi. is more adherent and sticky than Kali-s.
• Acutes: Hep., Kali-c., Kalm., Puls., Rhus-t.

Comments

• Kali-s. is a blend of and Puls. and is a cross between Puls. and Sulph. It is one of the chief remedies for bronchitis in warm-blooded subjects.

KALI IODATUM

Nose

• Sneezing: Morning, on rising; paroxysmal, violent, frequent, prolonged. Allergic conditions, with coryza, sinusitis, (angio-neurotic) edema, hay asthma.
• Inflammatory catarrh, involving eyes, face, frontal and maxillary sinuses, root of nose, mouth and chest.
• Crawling, tingling, burning in congested nose.
• Discharges: (Earlier) copious, watery, acrid; (later) greenish, cool, viscid, bland. Also, dry, stuffy colds (‘cold in the head’).
• Hay fever. Influenza. Ozena, with perforated or ulcerated septum.

Respiratory

• Spasmodic croup, of scrofulous children. Aphonia: nightly, with dyspnea; with head or chest pains.
• Larynx: Catarrhal inflammation, with edema, choking spells.
• Dyspnea, edema pulmonum and emphysema. After midnight wakes with symptoms like strangling or hyperventilating, dry lips, oppression (2 am).

Comments

• It is more a remedy of sinusitis, esp. ethmoidal as the proving has yielded ‘tightness (and fullness) at the root of nose.’ Note the characteristic symptom, ‘takes cold from every damp day.’ Remember, Kali-i. is a deep-acting syphilitic remedy and you may be dealing with malignancy. Kali-i. is a pathological museum as a strong potassium combines with a strong halogen to develop several pathologies.

BRYONIA	KALI-CARB
Fluid, thin, light coloured discharge	Thick, yellowish, fetid discharge
< motion3, open air3; > rest3, pressure, lying on abdomen	< midnight to 5 am; > open air, head bent forward on knees, motion
Epistaxis in morning on rising, instead of menses	Epistaxis on washing face in morning
Loss of smell3	—
Cough: Dry3, hacking with stitches in chest, painful3	Cough: Dry3, hard, asthmatic3 with wheezing3
Expectoration: Rust coloured, tough, falls like lumps of jelly; but generally, less	Expectoration: Salty, thick, tenacious, lumpy of small round balls come flying from mouth without effort

 LOBELIA SYPHILITICA

Nose

• Sensitive to cold air. Dull aching over root of nose; in frontal sinus. Constant sneezing. Dry, stuffy colds; later thick discharge from post-nasal (Hydr.). Colds descend. Hay fever. Influenza. Internal nose is painfully sensitive to cold air.

Respiratory

• Tickling and tension in larynx. Morning hoarseness, gastric reflex.
• Dry, hacking cough; dyspeptic; with pain in chest.
• Oppression in lower chest as if air could not reach there.

Comments

• This remedy gives a perfect picture of (sneezing) influenza, involving the posterior nares, palate, and fauces. A lot of synalgias point to this neglected remedy. The cause may be grief.

NAJA

Nose

• Severe coryza; congested, hot and tender; thin discharge and sneezing; later, descending into larynx, with asthmatic breathing (> in erect position), suffocative spells < sleep, lying.

Respiratory

• Catarrh of larynx. Laryngismus stridulus from spinal irritation. Asthma; hay; cardiac (Laur.). Respiration failing, gasping, stertor, puffing; asphyxia during sleep; > sitting erect, sneezing.
• Cough: Dry, hacking; short; cardiac (Spong.); of laryngeal or pulmonary phthisis; > lying on right side.
• Expectoration: Viscid, white; blood spitting (non-coagulable).

Comments

• Naja is a chilly Lach. Due to venom, you may get blood tinge in the expectoration. Feeling of suffocation is marked.

NATRUM ARS

Nose

• Stuffy colds < night, morning, open air; alternately dry and flowing.
• Rhino-sinusitis; pressing pain over root of nose.
• Discharges: Mostly PN; watery or thick yellowish, tough, bloody crusts, purulent, offensive; has to hawk up. Violent sneezing. < cold, dust, smoke. Hay fever. Influenza (Lob-s.).

Respiratory

• Dyspnoea from (coal) dust, smoke, with oppression along sternum, about epigastrium or behind sternum; chest feels clogged, full or stuffed and oppressed; all > urination.
• Roughness in bronchi; causes hemming, with (dry) racking cough (< mornings), difficult sputum.
• Expectoration: Grayish, (slate-colored), greenish; or bluish black, offensive, purulent.
• Bronchitis; in growing children.

Comments

• A chilly Natrum that combines the features of Natrum and Arsenicum. At a larger scale, Nat-ars. is a cocktail of , Nat-m., Sep. and Thyr. This remedy has tendency to take colds and it is an anti-pollutant remedy (like Beryl. or Sulphurous-acid).

NATRUM MUR 

Nose

• Tendency to take cold; after emotional upset; begins with bouts of sneezing < in early morning; must cover head, else obstruction at night; with loss of smell (Arundo) and taste.
• Watery, fluent discharge. Sinusitis. Numb one side. Hay fever, < in summer.
• Polypus

Comments

• A pronounced psycho-somatic component. The pent-up emotions find their way through weeping from the nose.

NUX-VOMICA

Nose

• Sneezing: Violent, abortive; from intense crawling in nostrils. < in dry cold weather, in warm room, > open air; ineffectual; bed in, morning.
• Coryza: Fluent in daytime and in open air; stuffed up at night and outdoors or alternates between nostrils. Stuffy colds, snuffles, oversensitive to strong odours.

Respiratory

• Throat: Tickling in end of eustachian tube; sore throat.
• Cough: Tight dry hacking; bloody expectoration; with bursting headache; caused by adherence of mucus in trachea, < morning, on rising. Dry cough after midnight; > warm drinks.

Comments

• Loss of sleep, sedentary habits, junk food, and travel contribute to recurrent colds. Tickling in larynx, chilliness and thirstlessness are prominent concomitants.

PENICILLINUM

Nose

• Coryza: Fluent, watery; after drinking cold drinks or sleeping in cold damp air; begins with a tickling sensation; with lachrymation; during daytime; intermittent; with fever after eating stale food in morning; after loss of sleep; < throughout winter, after suppressed eczema; with fever in rainy season, when eczema was also worse.
• Severe sneezing, in morning on waking or moving about and evening in bed. Thick, yellow, trailing discharge.
• Right frontal sinusitis.

Respiratory

• Throat affected after cold or frozen things (like Tub.). Cold begins in throat and rise into nose (Lac-c.) or go down to chest.
• Tonsils: Hypertrophied; red, inflamed, abscess, fever, aching, restlessness; > warm drinks.
• Cough: Sympathetic with cold or lingering on after the running of nose has stopped or is suppressed. Whooping cough with lachrymation, coryza, salivation, red face; < 2-5 pm, 4 pm, after suppressed leucorrhoea, gonorrhea (cp. Med.).

Relations

• is subacute of Bry. and Nux-v. (which is intensified Bry.).
• When Rhus-t. is indicated but does not work well think of Penic.

Comments

• A remedy of suppressed discharges. A Sycotic remedy. “Like other remedies of fungi origin it causes sycosis or chronic reticulo-endotheliosis” (proliferation of RE cells associated with their function of lipoid storage). Hydrogenoid (). Low resistance power. Takes cold easily.

PULSATILLA

Nose

• Sneezing: Constant, violent, > in open air; but coryza more fluent in open air (All-c.).
• Coryza: < evening; (in morning, yellow mucus); with loss of smell and taste (chronic) and sneezing; stopped on lying or in room; pressing pain at root of nose; allergic to dust. Ripe cold; greenish yellow thick discharge and hoarse cough. Ozaena.
• Cough: Loose in morning, dry in evening and night; must sit up. Variable; after pneumonia; after meals. Whooping cough; with suffocative attacks; desires open air; with itching in chest. Barking. Croupy.
• Expectoration: Copious, bland, thick, slimy, greenish; variable; bitter, salty, sour or sweet; taste of old catarrh; putrid; greasy.

Comments

• The gentleness of expression is seen even in acute infections. The child plays but craves for the company. > in open air is a keynote symptom. It is best suited to ripened cold rather than initial stage.

Relations

RANUNCULUS BULB

Nose

• Rhinitis; smarting in nose, eyes, fauces (Ars.); tingling-crawling in nostrils, > in open air; a feverish coldness; tenacious mucus “running down in torrents”, < eating, reading, studying, the “old man’s pearl” (Thuj.).
• Discharges: (Acrid) thick, ropy, albuminous, < morning.
• Colds after spoiling stomach, after ice-cream, sweetsops, cold exposure or bath, with chills and shuddering in chest, < at every change of weather; epistaxis. Hay fever (Wye.).

Relations

• A remarkable blend of Bry., Arg-n. and Kali-c.
• Is a close-up of Bry., Nux-v.
• Ran-b. is psoric Rhus-t.

Comments

• Chest pains accompany several complaints. Respiratory complaints in alcoholics. Breathing easier when going uphill or along the uneven road that on the level. A person is neurotic.

RAPHANUS

Nose

• Incipient cold (from cold exposure).
• ‘Cold in the head’: bursting-aching in head, pain at or above root of nose, in turbinate bones < after tobacco), in fauces, chest (also in ‘chest colds’), frequent sneezing, hot breath, feverish feeling, dripping (left).
• Obstructed; snuffles.

Respiratory

• Voice hoarse (< evening); muffled, weak.
• Dyspnea; > noon, < evening; from incarcerated flatulence. Strangulation on beginning to drink or eat. Hot breath.
• Cough: From tickling larynx. Endless coughing in a vain attempt to raise sputum from depth.
• Expectoration: tenacious white mucus; round balls; rarely, easy also.

Comments

• is basically a hysterical remedy and you may get a hysterical cough. Incarcerated flatulence often accompanies the symptoms.

RUMEX

Action

• Irritation: Gastro-intestinal (GI), upper respiratory tract (URT), skin.
• Mucous membranes: Secretions decreased causing stickiness and burning but sensitivity (tickling) more. Yet not passing into an inflammatory condition of ulcerative or suppurative type (unlike Sil.).
• Discharges: Profuse; thin, watery, later tenacious.

Nose

• Tendency to colds; colds with diarrhoea in phthisis. Great desire to pick nose (Arum-t.). Violent and rapid sneezing attack; watery copious flowing; later viscid. Dryness in posterior nares (Stict.). Yellow discharge from post-nasal. Hay fever (cp. Lob-s., Sabad.).
• Tongue: coated; white; yellow (Chel.); yellowish-brown, or reddish-brown.
• Hawks up much tenacious mucus.

Respiratory

• Aphonia; catarrhal; in cold air.
• Cough: violent (but out of proportion to degree of organic affection), incessant, dry, tickling, teasing, fatiguing (cp. Caust., Fago.). Hoarse barking cough of children (cp. Dros., Stict.). Early stage of whopping cough.
• With: cold hands; spurting of urine (Caust., Puls., Squil.); eructations.
• Worse: morning on waking; on first lying down (evening) (cp. Con.); breathing cold air (Spong.); talking; eating (Calc.); lying on (or turning to) left side (Phos.); from smoke.

Relations

• Compare: (both are chilly, > wrapping, oversensitive, have profuse discharges; but Hep. is destructive, suppurative, has sour and offensive discharges, chapped skin; Rumx cognate to Calc., while Hep. is cognate to Sil.).
• All-c. (Both are neuralgic and have violent sneezing bouts, but All-c. Has coryza < warm air/ room. > warmth; All-c has excoriating nasal catarrh with bland lachrymation, Rumx. has bland coryza without lachrymation.
• Contains calcium phosphate, chrysophanic acid, organic iron, potassium, and sulphur (and represents them in its action)
• Nux-v. and Rhus-t. partially relieve a Rumx case. Cough, as well as skin symptoms, may be compared with the Kalis Caust. Cough < in early pregnancy and may cause miscarriage. Obese, chilly and oedema above eyes point towards Rumx.

SPONGIA TOASTA

Nose

• Fluent coryza, with stoppage of nose. Dryness; chronic, dry nasal catarrh. Nostrils wide open; fan-like motion.

Throat

• Sore throat; < after eating sweet things. Tickling causes cough. Clears throat constantly. Throat symptoms > lying on back.

Respiratory

• Great dryness of all air passage. Feeling of a plug in larynx.
• Cough: >after eating or drinking, esp. warm drinks; hollow; barking; crowing; sawing; or tight; croupy; wakes him; followed by burning in chest and throat; < cold drinks, excitement, sweets, cold milk; > eating or drinking, esp. warm things. Bronchial catarrh and wheezing, asthmatic cough < cold air; profuse expectoration and suffocation; > lying with head low and in a hot room.
• Awakes suddenly after midnight with pain and suffocation; is flushed, hot, and frightened to death (Acon.).

Comments

• The differences between And Spong.: Dros. has cough during sleep but he doesn’t wake up while Spong. wakes up with bouts of cough. Dros. has more prolonged and incessant cough; cough seems to come from abdomen in Dros. while it comes from laryngeal irritation in Spong. Dros. cough is prolonged and incessant and is associated with retching or vomiting. Spong. cough is hollow; barking; crowing; sawing or croupy and usually associated with suffocation. Dros. cough < warmth; Spong. cough < cold air.

SQUILLA MARITIMA

Nose

• Coryza: Fluent; acrid, < morning, with sneezing and lachrymation. Sneezing < night; during cough.

Respiratory

• Cough: Short, dry; stubborn, dry, rattling; disturbs sleep; ends in gagging; < morning and evening. Violent, exhausting; provoked by taking a deep breath, cold drinks, exertion, change from warm to cold air; of measles.
• Expectoration: Profuse, salty, slimy; with involuntary spurting of urine.
• Dyspnea and stitches in chest and painful contraction of abdominal muscles.
• Broncho-pneumonia.

Comments

• Although this remedy is called as a slow acting remedy, my experience suggests that it acts fast when corresponded. Inclination to sit and doesn’t want to move. Compare with All-c., Ant-t.and

STANNUM METALLICUM

Nose

• Obstinate acute coryza; influenza and cough. Over sensitiveness to smell.

Respiratory

• Cough: Violent, dry < in evening until midnight; excited by laughing, singing, talking; < lying on right side; fatiguing; paroxysmal.
• Expectoration: Copious, green, sweetish; saltish; sour, salty; putrid; bright yellow pus or balls of mucus.
• Respiration: Short, oppressive; stitches in left side when breathing and lying on same side.

Comments

• Debility is marked esp. in chest, while going downstairs than upstairs. Talking causes very weak feeling in throat and chest. Stann is more for LRTIs and for strong pathologies like bronchiectasis, TB, abscess, cancer, COPD etc.

STICTA PULMONARIA

Nose

• Atrophic rhinitis (Calc-f.). Constant need to blow the nose, but no discharge. Dry scabs, esp. In evening and night.
• Hay fever; incessant sneezing (Sabad.); fullness in the forehead and root of nose.

Respiratory

• Coryza dries up so rapidly that it can’t be discharged. Tingling in the right side of nose; loss of smell. Feeling of fullness at the root of nose (Nux-v.).
• Cough: Dry, hacking, < during night; inspiration; lying down; with splitting headache. Loose cough in the morning. Cough after measles ().

STICTA PULMONARIA	COCCUS CACTI
Dryness of nose: Painful; secretions dry up so rapidly that it can’t be discharged	Dryness of nose: Not painful; with increased secretion of mucus
Sneezing: Almost incessant	Sneezing: Violent and frequent
Soreness < from slightest cold	Soreness < in warmth, esp. In bed
Tickling in larynx: Hawking cough, but no expectoration	Tickling in larynx: Hawking cough, with expectoration of mucus
Coughing without vomiting	Coughing ends in vomiting
Dry cough entirely	Cough initially dry, then expectoration: Whitish, yellow, tough, stringy
Cough short, noisy, racking, barking, like whooping	violent, tickling, racking cough
< after taking  cold, at every inspiration3	< warm room, when lying, waking on

Comments

The Doctrine of Signatures amply demonstrates the use of this remedy in respiratory tract infections. Sir J. E. Smith says, “Every part of the plant is mucilaginous, but its reputation for coughs arose not from this circumstance, but from the speckled appearance of the leaves, resembling the lungs”.

It has recently been found that the lungwort lichens contain antibiotic chemicals that are effective against the kind of bacteria that cause tuberculosis and many other chest infections.

Fever < august. If rheumatic symptoms accompany, think of this remedy. Stict. is more close to Phos. and Kali-c.

SABADILLA

Nose

• Sneezing: Persistent, spasmodic, violent or abortive, shaking the whole body, < odor of flowers, even thinking thereof.
• Very dry nose. Every cold settle in nose, in throat.
• Coryza: With severe frontal pains, redness of eyes and lachrymation (without lachrymation, ), sub-acute, with pyrexia intervening constant sneezing.
• Nose stuffed; rawness, burning, discharge at first thin, later thick (yellowish-greenish), > inhaling hot air; burning-stinging, complete obstruction, watery discharge, itching and tingling in nose, nose swollen, eyes watery; stopped left nostril day and right night.
• Prolonged cases of coryza that do not yield to ordinary remedies.
• Hay fever or rose cold.

ARUM TRIPHYLIUM	SABADILLA
Sneezing < night	Persistent, violent, abortive, spasmodic sneezing
Fluent coryza < afternoon.	Coryza < odour of flowers, even thinking of flowers aggravates coryza
Dry cough; patient cringes under it, it hurts so.	Asthmatic cough <anger, lying down
Tonsillitis: Left side	Tonsillitis: Left to right

 Comments

• Remember the relation between flower and ; it is a spring remedy. Catarrhal sinusitis; left, complemented by Merc-i-r. If a patient has erroneous notions about himself and difficult to handle, think of Sabad. Two grand characters should always be kept in mind: general > open air and < at the same hour each day.

SENEGA

Nose

• Coryza, commencing with a feeling as if red pepper were in nostrils and air passages, followed by a distressing cough.
• Sneezes so violently and often that head grows heavy and dizzy followed by thin watery mucus.

Respiratory

• Catarrh of larynx, stinging pain; vocal cords partially paralyzed, voice unsteady, husky, hoarse, thorax feels too narrow (stricture), < suddenly when reading aloud, after coition.
• Old asthmatics; with congestive attacks; wheezing; breathing and cough < motion. Asthenic bronchitis of old people with chronic interstitial nephritis or chronic emphysema.
• Cough: < evening, night, in warm room, lying on (left) side. Hacking, incessant, choking-strangling, shaking the whole frame; ends in sneezing; whooping cough. Post-influenzal cough. With spurting of urine.
• Expectoration: Difficult, thick, copious, ropy, gluey, blood-tinged, albuminous, clear mucus, like white of an egg, may even slip back.
• Pneumonia: Catarrhal; pleuro-pneumonia; right or right to left pain; Pleurisy. Edema of lungs. Emphysema. Hydrothorax.

Relations

• Is in an earlier stage.
• “Seneg. is a cross between Bry. and Rhus-t.

BRYONIA	SENEGA
> rest	< rest
Onset: Insidious	Onset – rapid
Right sided	Left sided
Warm-blooded more	Comparatively less warm
Dry cough more marked	Usually wet cough
Sputum: Scanty	Sputum: Profuse
Accentuates more on joints	Accentuates more on eyes
Tendency to constipation	Tendency to diarrhea

Comments

• More for lower respiratory tract infections. Sub-acute catarrhal paretic states in respiratory organs. It is a cross between and Phos. and between Bry. and Rhus-t. It is for strong pathologies in the lungs. Anxiety, with cough is a strong concomitant.

**********

REFERENCES

• Tarkas P.I., Kulkarni Ajit. Absolute Homeopathic Materia Medica, Volume 1. B. Jain Publishers, New Delhi, 2019
• Kulkarni Ajit. Homoeopathic Posology, tailoring the dose to the patient. Soham Prakashan, Satara, 2005
• Kulkarni Ajit, Homeopathy through Harmony and Totality, Volume I, B. Jain Publishers, New Delhi, 2020
• Tyler, Margaret. Pointers to common remedies. B. Jain Publishers; New Delhi
• Borland DM. Pneumonias. B. Jain Publishers; 2004
• Bhanja, K.C. The Homoeopathic Prescriber. National Homoeo Laboratory; Kolkata
• Bhanja, K.C. Masterkey to Homoeo. Materia Medica. National Homoeo Laboratory; Kolkata
• Vermeulen Frans, Concordant Materia Medica. Emryss bv Publishers, 1997
• Complete Repertory, Roger Van Zandvoort
• Radar Opus, Homeopathic software