Since I’m sitting here coughing, and Shana is in the bedroom coughing, thanks to the “cougher” who sat next to us at the screening of “Deconstructing The White Album” last night, I thought we might as well do this month’s Tidbits on Coughing!
What remedies do we have for coughing?
How do you take a coughing case? We’ll do that later! Only homeopaths will be interested in that; right now, for the people out there who are coughing like we are, please see below:
The Most-Used Homeopathic Remedies for Coughing
We’ve had a lot of Antimonium tart cases in the Quiz lately so we should all be very familiar with it! When you think of Antimonium tart, think of “loose”, think of “rattling”, and think of “expectoration very difficult!” We call this “Difficult Cough”. In babies and children, they will be worse lying down and better carried. They may seem stuporous, lifeless with an overwhelming desire to sleep like Gelsemium. Better cold/outside air, worse warmth. They are irritable, complain-y and whiny. This is our drowning remedy, it’s our “swallowing wrong” remedy. Any time there’s fluid in the lungs and it needs to come out, give Antimonium tart.
This is our main remedy for pneumonia and bronchitis. I keep Phos. 200C by my bed and whenever I wake up with a distressing cough–which has only happened 2 or 3 times, but each time it was quite extreme–Phosphorus 200C stopped it in less than half an hour. For Phosphorus, think of dry cough, hoarse cough, tightness of the chest and oppression of the chest. Dry hacking cough. Can be painful. You may also observe the famous symptom: major thirst for ice cold drinks. Cough is worse from talking and laughing. Also, worse exertion and cold air. Better sitting and lying on the right side.
Bryonia is a remedy with very severe symptoms. A Bryonia case is going to involve a lot of sharp, stitching pain; so, here’s what you can expect from a Bryonia cough–a hard, dry cough that hurts the patient’s chest and his head. He may have to hold his chest or hold his head when he’s coughing. (Nux vomica holds his head too.) The least motion makes his cough worse, even breathing makes it worse, so he will try not to breathe deeply. He appears irritable because he does not want to talk to you. Talking involves taking a deep breath and he cannot do that without exciting a cough, which is painful; so, he may refuse to talk to you. He is very dry, mucus membranes dry, and so he’s very thirsty but will not want to sit up to drink, so, will ask for water only rarely but will drink the whole glass down when he does. Better rest, better firm pressure, better cool open air.
Another really important dry cough remedy. The cough can be barking, hollow, metallic or can sound like fabric ripping or a carpenter sawing through wood. Worse talking, better eating, better drinking, worse sweets. Can feel suffocating, as if breathing though a sponge. Gasping breathing. Fearful of suffocation. Worse warm room, worse lying down, worse wind, worse exertion; better warm food.
Switching over again to loose coughs, we have Pulsatilla! Let me clarify–loose in the day, dry at night. Evening aggravation. Thirstless. Wants to be propped up. Better for company. Desires butter, ice cream and creamy foods. Discharges are thick, yellow or green. Nose is stopped up. Child may be weepy and pathetic sounding. Better for sympathy and consolation. Better in outside open air and better for walking slowly. Worse warm, stuffy rooms.
One of our main whooping cough remedies. Violent fits of coughing, can hardly breathe! Cough is hard, painful, dry, barking and ends in gagging or vomiting. He may say there is a crumb or feather sensation in his throat. Worse lying, worse after midnight, worse cold drinks. Cough may result in nosebleed.
The thing with Ipecac is, almost any complaint that goes for Ipecac has nausea and vomiting; hence, the cough will have nausea or vomiting as a concomitant. You can confuse this remedy with Antimonium tart and Pulsatilla because like Pulsatilla, it is thirstless and better for open air, worse for warm stuffy rooms. Like Antimonium tart, it will have a loose, rattling cough with great difficulty to bring up mucus. The tongue is clean, no coating. There may be coughing up of bright red blood or nosebleed. Asthma remedy. Worse smell of food. Breathing is difficult. Very disgusted by everything, hard to please unlike Pulsatilla.
Dry or loose cough, can’t expectorate. Very cold, may be shivering. Any exposure to cold excites cough, must stay completely covered. Worse cold air, cold draft. Very sensitive to cold. Thick yellow mucus. Cough is worse from cold drinks. Weak with rattling in the chest. Very hypersensitive to pain, to touch of any part that’s painful. Suffocative attacks forces patient to sit up and bend head backwards. Worse after midnight.
Dry, incessant, violent, tickling cough. Tickle in throat. Rawness sensation in trachea. Worse from uncovering. Even just sticking the hand out of the covers excites a cough. Cough prevents sleep. Coughs as soon as his head hits the pillow. Mucus in throat. Worse inhaling cold air, so, he may pull the covers over his head.
How Do You Take A Coughing Case?
Well, first of all, you have to ask your patient, “What does your cough sound like?” And you have to give him examples, because otherwise, your patient will give you unimaginative answers. Do you honestly think your patient is going to say, “It sounds like a saw going through a pine board”? But that’s a very important description for us, as only Spongia has it! And you know where to find it? It’s in the Coughing chapter under “Sibilant”. Yeah, I know, don’t ask.
What are some of the coughing sounds listed in our Repertory?
- Metallic sounding
- Paroxysmal (coughing fit)
- Whooping cough
- Difficult (hard to raise phlegm)
- Machine-gun cough–it’s under “Minute, guns, short hacking cough, like”. (Don’t ask!) See also “Series, coughs in a”.
Now, we need to ask about the all-important “Sensation” the patient may be experiencing when he’s coughing, let’s list a few of them here:
- Burning–burning in chest, trachea, throat, etc.
- Constriction–in throat, chest, etc.
- Crawling sensation–in chest, throat, etc.
- Down of a feather, see also “feather”
- Dryness–of chest, throat, etc.
- Foreign body sensation–in throat, etc. See also “Crumb” & “Lump”.
- Formication (like insects crawling)
- Fullness sensation in chest
- Hair sensation
- Icy cold air in air passages
- Itching in chest
- Itching in Larynx
- Lump in throat
- Rawness in larynx
- Roughness–cough leads to a roughness sensation in throat, etc.
- Scratching sensation–in throat, chest, etc.
- Smoke sensation in trachea
- Smothering sensation
- Sticking sensation–in throat, etc.
- Swollen sensation in throat
- Tickling–in chest, larynx, etc.
- Oppression (of the chest)
Location! You’d be surprised but some people will say, “It feels like the cough is coming from my stomach.” So, here are a few locations where the cough may be coming from:
Modalities, the all-important modalities! (The things that make the patient better or worse.) Oh yeah, they are really important!
- Coughing agg. The more you cough, the more you cough. (I had that once! That’s Ignatia!)
- Acids agg. I assume that means orange juice, etc.
- A certain time aggravates: Look up Daytime, Forenoon, Afternoon, Morning, Evening and Night. Check the subrubrics for the exact time if needed.
- Air agg. Look at the subrubrics–cold air, dry air, open air, etc.
- Anger agg.
- Ascending stairs agg.
- Autumn agg.
- Bathing: better or worse? Hot or cold? (see also Generals: bathing)
- Bed, on becoming warm in bed agg.
- Belching amel.
- Bending, forward or backward, agg. or amel.
- Breathing agg.
- Cold–temperature, drinks, food, wind, milk, etc. either agg. or amel.
- Heated, on becoming
- Holding, holds chest with his hands amel.
- Hunger agg.
- Ice cream
- Inspiration (breathing)
- Laughing agg.
- Lying (down)
- Periodic. This means the cough comes at a predictable time or day. For example, if your cough comes every night at 1 am, go to “Night, 1am”
- Pressure agg.
- Rising, on
- Room, in
- Sit up, must
- Spicy food agg.
- Storm, thunder storm, agg.
- Sun agg.
- Sweetmeats agg. I guess that means sweets. Think of Spongia for that.
- Tea, hot, agg.
- Touched, being, agg.
- Uncovering, undressing agg.
- Walking agg. or amel.
- Warm agg. or amel.–warm food, warm room, etc.
- Wet, getting wet
- Wind, coughing in the
- Bright, shiny objects
- Spoken to, being spoken to agg.
- Cellars–cellar air/damp cellars
Concomitants! That means, “What else is going on besides the cough?” This is how I found Shana’s remedy, because she complained that her eyes were running, and I already knew her nose was running because she was sniffing, so I gave her Allium cepa and it really brought her out of the worst of it. What are some of the concomitants listed in the Coughing chapter?
- Coryza (that means runny nose, another way of saying “the common cold”)
- Heart complaints–some people have what’s known as “cardiac cough”.
- Mental symptoms, like fear from coughing, fear that they might not be able to stop, which could be Aconite.
What Are You Doing?
In my Acute Case Questionnaire, which you can find on my website, one of the questions I ask is, “What are you doing?” I then give examples because otherwise, the answer you’ll get is “Nothing”! But what the patient is “doing” is often a big clue to the remedy! For example, Shana was grasping her throat on coughing, another symptom that goes for Allium cepa! And this is a very unusual cough remedy! I’ve never heard of giving Allium cepa for coughs! But all the usual cough remedies were failing! Spongia, Phosphorus, Rumex, you name it…one failure after another until she finally said her eyes were running; so, you see, the Concomitant…so important! But anyway, yes, ask your patient “What are you doing?” Here are some examples from the Coughing chapter.
- They may be changing position in bed, tossing back and forth. The rubric is “Coughing: bed”; not “Coughing: restless”, as you might expect!
- Bending. They may be forced to bend double or bend their head forward or backward, or bending forward or backward may make them worse.
- Closing the eyes. Hepar sulph. is in bold, and the only remedy listed, for “Closing eyes at night excites cough”.
- Fears to cough. Some people may be making a concerted effort not to cough because of how painful it is. You’d have to think of Bryonia right away, but, Phosphorus too.
- Grasping Larynx at every [cough]–this is what Shana was doing. Allium cepa is the only remedy–though there is a subrubric “Grasping throat”, and I’m hard-pressed to tell the difference between the two, frankly!
- “Hands, holding” and all the subrubrics. What this rubric means is that the hands are holding one part of the body or another while coughing; for instance, holding the abdomen, holding the chest, holding the head, holding the larynx–again, only Allium cepa listed for that.
- Hold and Holds. Same as “Hands” above, patient holds himself while coughing due to pain.
- Holding very still, lying still, not moving. The rubric is “Coughing: motion agg.” It means least motion brings on the cough.
- Moving. Some people are better moving, worse sitting still. The rubric is “Coughing: motion amel.”
- Sitting up. The rubric is, “Coughing: sit up, must”. See also, “Coughing: sitting, while” and all the subrubrics regarding sitting bent, sitting erect, sitting long and sitting still.
- Sleep. Cough during sleep, and all the subrubrics including on going to sleep, cough prevents sleep, wakes from sleep, disturbs sleep, after waking up, and so on.
- Standing agg.
- Talking–in the sense that he may not be able to talk because of the cough.
- Uncovering–in the sense that because uncovering makes him worse, he dares not uncover! Hepar, Rumex, Rhus tox and Silica are main ones.
Finally, etiology! The way we express etiology in the Repertory is by saying, “Ailments from __________”. There is nothing more important than the etiology. Etiology is right at the top of our “Hierarchy of Symptoms”. Etiology overrules symptomatology (overrules the totality of symptoms) For example, Coughing from blunt trauma–Arnica. Coughing from acute grief–Ignatia, and so on.
Most homeopaths have a lot of trouble with this. They add etiology into the repertorization along with all the other symptoms. They don’t see that all the other symptoms disappear in its shadow.
The reason we have a Hierarchy of Symptoms is because the symptom at the highest level over-shadows all the rest of them. Let’s say we don’t have an etiology in our case, but, we do have a “Peculiar”, like Shana did (grasps larynx with each cough). Then, in that case, the Peculiar would over-shadow all the symptoms that come below it–not take equal weight with them! People should read my article “Acute Vs. Chronic Remedies, The Hierarchy of Symptoms, and the Kitchen Sink”–oh yeah, that’s a great title!
You see, this explains why when homeopaths take a case, they’re always trying to find the “Essence”–the mental picture–because the mental/emotionals are right at or near the top of the Hierarchy! They over-shadow everything that comes beneath them, they make everything else virtually irrelevant!
I’ll give you an example, speaking of coughs. About 20 years ago, I had an Ignatia cough, which means that every cough leads to the next cough, which can inevitably lead to fear that you will never be able to stop coughing! When this happened to me, I would take Aconite and the cough would stop! Now, is Aconite a “cough remedy”? No! But it was the “mental” part of the case!!!! You see? It made everything else disappear!
This is why no one ever repertorizes an Arnica case! Isn’t that right? Who repertorizes an Arnica case? You get injured, you get Arnica! Am I right? “Ailments from blunt trauma”–Arnica! Boom! Case closed! Blunt trauma is the etiology. Etiology is at the top of the Hierarchy. Therefore, it overrules everything else in the case! Now you think about that while I take the potatoes out of the oven!
OK, I’m back. Now, here are some of the etiologies from the Coughing chapter:
- Ascending stairs
- Cellar air (see also Damp room)
- Cold temperatures
- Dryness of air passages
- Fluids, loss of
- Heated, on becoming
- Injuries, after
- Wet, getting wet
Now, listen, if the cough is a concomitant to some disease the patient has, like Measles, go to your Measles rubric. Ask yourself, “Which of these measles remedies most closely resembles the patient?” 80% of the time, the remedy you need is in that rubric. For measles, the main two remedies are Pulsatilla and Euphrasia. They’re “bold/underlined”, or a “4” as we call it.
Now, you know, I can’t cover everything here, there are other chapters of the Repertory you may have to visit, like Generals, Nose, Breathing, and so on; and you’ll need to get the color, odor and consistency of any discharges the patient has. Go to Generals: mucus.
OK, I gotta make my salad now. My cough is much better, thank you. I’ve been taking Allium cepa.
Elaine Lewis, D.Hom., C.Hom.
Elaine takes online cases! Write to her at LEWRA@aol.com
Visit her website: elaineLewis.hpathy.com