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Monday, October 1, 2012

Homeopathy For Cough

      ARTICLE PUBLISHED IN  CLEVERMAG IN AUG 2015 summer edition


COUGH is more common disease which every homeopath deals with day today some time its difficult to understand and treat it. Lets try to understand it

COUGH | Definition A sudden explosive expiration after deep inspiration and closure of the glottis.
       It is one of the physiological mechanisms for the protection of the lower respiratory tract against infection and invasion of foreign bodies. In disease it also has the function of expelling excessive secretions and exudates. Ciliary action of the bronchi also raise a thin sheet of mucus constantly towards the larynx. When it reaches the pharynx it is disposed off into the alimentary canal by un- conscious acts of swallowing. Pathological secretions are also removed in the fashion.
      Cough can be produced entirely voluntarily but it can be suppressed less voluntarily.
      Cough is produced by inflammatory, mechanical, chemical and thermal stimulation of the cough receptors.
       It could be a leading symptom in an acute illness of the respiratory tract or sometimes suggest-ing involvement of some other organ e.g. ear. It is found in chronic illnesses like chronic bronchitis, bronchiectasis, bronchial asthma, and sometimes in the affections of the heart, pericardium etc.
       The causes of cough are so numerous that they are difficult to classify. However, the following is, an attempt to classify the causes.

Causes of cough:    
  1. Pharynx and larynx
    1. Acute and chronic pharyngitis, including tonsillitis, uvulitis, elongated uvula etc.
    2. Tumours of the pharynx
    3. Acute and chronic laryngitis – specific and non- specific, including foreign bodies.
    4. Laryngeal edema
    5. New growths of larynx
  2. Affections of trachea and bronchi
    1. Acute tracheobronchitis including acute infections like measles, typhoid, pertussis etc.
    2. Chronic tracheobronchitis including the one due to smoking, exposure to irritant gases, foreign bodies, bronchiectasis etc.
    3. Pressure on trachea and bronchi from without e.g. Aneurysm of aorta, enlarged lymph nodes, Hodgkin’s disease, new growths etc.
    4. Cystic fibrosis
    5. Carcinoma and other tumours
  3. Causes in the lungs
    1. Acute infections like pneumonias
    2. Chronic infections like tuberculosis pulmonary suppuration, fibrosis, fungal infections and parasites (Hydatid cysts, amoebic abscess, Loeffler’s syndrome)
    3. Malignancy and other new growths
    4. Changes in the lungs due to heart diseases like pulmonary oedema, cor- pulmonale etc.
  1. Causes in the pleura
Infections like pleurisy, empyema, hydrothorax, pneumothorax, hydropneumothorax, pleural effusion etc.
  1. Causes in the mediastinum
Causing pressure symptoms or secondary invasion of infective process
  1. Enlarged lymphnodes e.g. Tuberculosis, Hodgkin’s disease, malignancy etc.
  2. Tumours e.g. Dermoids, teratoma, mediastinal goiter, thymomata, foreguf cyst etc.
  3. Due to heart disease, e.g. pulmonary oedema secondary to cardiac failure.
    1.      Outside the thorax
      1. Psychological – hysterical (Sydenham’s cough)
      2. Ear affections
      3. Subdiaphragmatic lesions like subphrenic and liver abscesses
  4.     Reflex cough
    1. Stomach
    2. Uterine etc.
  5.      Idiopathic
Homeopathy Management Of Cough:
          When a patient comes to the physician with cough he must try to make provisional diagnosis based on history and physical examination. This is important for the management as different conditions giving rise to cough differ from each other. Investigations may confirm the diagnosis later on. But, the physician is required to prescribe to relieve the patient. The following points should be noted in connection with cough.

i) Acute or Chronic
Acute – laryngitis, tracheobronchitis, pneumonia, lung abscess,
              uvulitis, epiglottitis etc.
Chronic – chronic bronchitis, cystic fibrosis, bronchiectasis, pulmonary tuberculosis, chronic ob- structive lung
                  diseases, pulmonary malignancy etc.
ii) Productive or non- productive (dry)
Productive –Brochiectasis, lung-abscess, pulmonary tuberculosis,
                      chronic obstructive pulmonary diseases, pulmonary
                      oedema etc.
Non- productive – Irritation of the external auditory meatus,
                               whooping cough, foreign body in the bronchus
                              (early stage), mediastinal tumours, carcinoma
                              larynx, neoplasm of bronchus, psychological etc.
N.B.  Female patients are inclined to swallow sputum and will not
         expectorate as Male patients do. This tendency may lead to
         incorrect conclusion in a female patient that cough is irritative
         and non- productive.
iii)      Onset of Cough
           when an upper respiratory tract infection does not respond to the
           regular treatment; think of pulmonary tuberculosis and bronchogenic.
          Cough appearing for the first time in a middle aged man think of
          bronchogenic carcinoma.
iv)              Time
a)     Morning –smoker’s cough, chronic bronchitis, chronic sinusitis, early pulmonary tuberculosis etc.
(Alum, ars, bry, calc, chin, euph, kali-a, kali-bi, kali-c, mosch, nux-v, phos, puls, rumx, squil, sulph, etc.)
b)    First lying down at night or appearing at some change of posture – Bronchiectasis, lung abscess
(Lying<: data-blogger-escaped-apis="apis" data-blogger-escaped-caust="caust" data-blogger-escaped-con="con" data-blogger-escaped-etc="etc" data-blogger-escaped-hyos="hyos" data-blogger-escaped-kreos="kreos" data-blogger-escaped-nbsp="nbsp" data-blogger-escaped-p="p" data-blogger-escaped-puls="puls" data-blogger-escaped-rumx="rumx" data-blogger-escaped-sang="sang"> (First lying down on < : Ars., dros, con, caps, puls, sabad, etc)
c)     Early night – pulmonary tuberculosis
d)    When lying down (Balme’s cough) – pharygitis, elongated uvula
e)     At the end of dyspnoea  - bronchial asthma
(Ant-t, ars, cina, cupr, ip, nux-v, etc.)
f)      Wakes the patient up from sleep – Left ventricular failure or cough of cardiac origin
(carb-v, lach, laur, spong, kali-c, naja, etc.)
g)     If related to meals – hiatus hernia, trachea-oesophageal fistula, oesophageal diverticulum
(Eating < : kali-bi, nux-v, anac, sep, thuj, carb-v, etc)
v)                 Character of Cough
       (N.B. please listen to the accompanying cough- cassette.)
Barking Cough        -  Epigiottal involvement, hysteria and nervousness
Brassy Cough          -  Tracheal involvement, mediastinal tumours,
                                     aneurysm of aorta
Hoarse Cough         -   Aneurysm of aorta (Aneurysmal cough),
                                      laryngeal affection
Dog cough or Compression cough- Due to compression of bronchi-
                                     sounds like a dog coughing
Dry hacking cough-  Chronic pharyngitis and tracheitis, neurosis
Short suppressed cough- pleurisy, pneumonia
Paroxysmal cough- Whooping cough
                                 Minute-gun cough – (paroxysms close together in
                                 whooping cough), Carcinoma, bronchial spasm
Presence of whoop – Whooping cough
vi)               Sputum
      Discussed separately
vii)           Associated  features
e.g. Fainting, COPD
    viii)  Cough is a distressing symptom and a patient expects fast relief. When a patient consults a physician for the first time, the physician will have to find out the indicated medicine as early as possible. Besides the general symptoms the physician should cover symptoms connected with cough. They may be
a)      Character of cough
b)     Modalities of cough
c)      Associated symptoms or concomitants

The character of cough and concomitants are described hereunder with some important medicines. Most of these remedies are discussed elsewhere in this book under a different heading e.g. pneumonia, pleurisy etc. besides the important medicines which are listed here, there may be other remedies which are not mentioned here. The reader is requested to refer to repertories and books of materia medica if required, to study the other remedies and the modalities.


  Character of cough – indication for a remedy

  1. Asthmatic                         Ant-t, ars, cina, cupr, dros, ip, nux-v, etc.
  2. Barking                             Acon, bell, dros, hep, spong, stram, etc.
  3. Barrel – deep and hollow  as if coughing in a barrel   Med.
  1. Choking                             Alum, coc-c, ip, etc.
  2. Constant                    Alum, caust, chin, lyc, rumx, spong, puls,
                                                 rhus-t, etc.
  1. Convulsive         Ambr, bell, carb-v, chel, hyos, osm, phos, rumx, ther, etc.
  1. Croupy                 Acon, hep, iod, kali-bi, lach, phos, samb, spong, stram, brom, etc.
  1. Deep                                    Dros, stann, verat, etc.
  2. Deep sounding                    stram, kali-bi, verb, etc.
  3. Dry                                     Acon, alum, ars, ars-I, bell, brom, bry,  
                                                calc, calc-s, carb-an, chin, dros, hyos, ign,     
                                                iod, kali-c, lach, mang, nat-a, nat-m, nux-
                                               v, petr, ph-ac, phos, puls, rumx, spong, sulph, tub, etc.
  1. Exhausting                          Ars, bell, caust, sep, stann, etc.
  2. Explosive                            Caps, etc.
  3. Forcible                               phos, etc.
  4. Gagging                               cina, etc.
  5. Hacking                               Alum, ars, lach, nat-a, nat-m, phos, sang,
                                                       sep, tub, etc.
  1. Hard                                     Bell, kali-c, phos, stann, etc.
  2. Hawking                              Eug, coc-c, lach, phyt, etc.
  3. Hissing                                 Ant-t, caust, etc.
  4. Hoarse                                 Acon, all-c, bell, brom, carb-v, caust,  
                                                  dros, hep, kali-bi, stann, etc.
  1. Hollow                                 Bell, caust, spong, verat, etc.
  2. Hysterical                             From, gets, ign, etc,
  3. Loose                                   Ars, puls, coc-c, con, phos, sep, etc.
  4. Metallic                                kali-bi, etc.
  5. Minute guns                         Cor-r, etc.
  6. Nervous                                Caps, dros, hep, hyos, ign, etc.
  7. Noiseless                          Calad, dros.
  8. Noisy                               Bell, kali-m, stict, etc.
  9. Panting                             Dulc, etc.
  10. Paroxysmal                      Bell, carb-v, cina, coc-c, cupr, dros, hep,  
                                              hyos, ip, meph, nux-v, puls, rumx, sep,
                                              stann, tarent, verat, etc.
  1. Persistent                          Bell, cupr, etc.
  2. Racking                            Agar, bell, bry, carb-v, caust, coc-c, ign,
                                                  kali-c, merc, nux-v, phos, puls, stann, sulph, etc.
  1. Rattling                             Ant-t, caust, ip, kali-s, sep, etc.
  2. Resonant                           kali-bi, etc.
  3. Retching                           Carb-v, chin, dros, hep, kreos, nat-m, puls,
                                                    sulph, etc.
  1. Sharp                                 Arn,. Calc-s, staph, etc.
  2. Short                                  Acon, coff, ign, rhus-t, sep, stann, etc.
  3. Shaking                              (Refer Racking)
  4. Shrill                                  Ant-t, sol-t-ae, stram, etc.
  5. Sibilant                               Spong, etc.
  6. Sneezing ends in                Agar, arg-n, bell, squil, sulph, etc.
  7. Spasmodic                          Agar, ambr, bell, bry, carb-v, chin, cina,
                                                     cocc, cor-r, cupr, dros, hyos, I, kali-br,
                                                    lach, nux-v, puls, rumx, sep, spong, etc.
  1. Splitting                               Aur.
  2. Stertorous                             Cact, etc.
  3. Sudden                                 Squil, agar, euphr, ip, sep, etc.
  4. Suffocative                           Alum, carb-v, chin, cina, cupr, dros, hep,   
                                                   hyos, ip, nux-v, samb, sulph, etc.
  1. Two coughs in succession     Merc, puls, etc  
Three coughs in succession   Carb-v, cupr, etc.
  1. Toneless                            Calad, cina, carb-b, dros, etc.
  2. Tormenting                        Ars, bell, caust, dros, ip, etc.
  3. Trumpet tones                    Verb.
  4. Tube, sounds as if he          Osm.
Coughed in a
  1. Uncontrollable                     mag-p
  2. Violent                                 Agar, bell, carb-v, caust, coc-c, con,   
                                                 cupr, dros, hep, hyos, ign, ip, kali-c, lach,
                                        mez, ph-ac, phos, puls, sep, squil, stann, etc.
  1. Whispering sound                Carb-b.
  2. Whistling                             Hep, laur, sang, spong, etc.
  3. Whoop in inspiration with
Choking at the bifurcation of
bronchi and great mental
distress                                    Syph
  1. Whooping                               Carb-v, dirc, dros, kali-s, etc.
  2. Yawning                                 Arn, asaf, cina, mur-ac, nux-v, puls,
                                                     staph, etc.


                                    Cough with concomitants
  1. Chickenpox, after                     Ant-c.
  2. Loss of consciousness, with     Cadm, cina, cupr, etc.
  3. Convulsions, with                     Bell, cham, cina, cupr, dros, hyos,
                                                                    meph, stram, etc.
  1. Dentition, during                       Calc, calc-p, cham, cina, hyos,
                                                        keros, podo, rhus-t, etc.
  1. Elongated uvula                         Alum, bapt, brom, hyos, merc-i-r,
                                                         nat-m, etc.
  1. Gastric                                        Bor, card-m, ferr, ip, kali-ar, lob,
                                                         nux-v, etc.
  1. Suppressed gonorrhea after        Benz-ac, med, sel, thuj, etc.
  2. Gout, before an attack of            Led.
  3. Haemorrhoids, after the              Berb, euphr, sulph, etc.
appearance of
  1. Heartburn, from                          Carb-s.
  2. Violent hunger, with                   Nux-v, sul-ac.
  3. After labour                                 kali-c.
  4. During lactation                           Ferr.
  5. After lifting heavy weight           Ambr.
  6. Manual labour, from                    Led, nat-m, etc.
  7. After measles                               Dros, puls, etc.
  8. Pregnancy, during                        Caust, con, nux-m, etc.
  9. During remittent fever                  Podo
  10. Following scarlatina                     Ant-c, con, hyos, etc.
  11. Alternating with sciatica            
In summer                                      Staph
  1. Splenic troubles, from                   Card-m, squil.
  2. Students of                                    Nux-v.
  3. Sympathetic                                   Lach, naja, etc.
  4. After vaccination                           Thuj.
  5. During variola                                Plat
After variola                                 Calc.
  1. With sensation of worms
Crawling up in throat                   Zinc.
  1. With pain in anus when
Coughing                                      Lach.
  1. Aneurysm of aorta                        Spong
  2. With aphonia                                Am-caust, phos, rumx, seneg,
                                                            spong, etc.
  1. With arthritic pain, worse cold      ph-ac.
  2. With ascarides
(Loeffler’s syndrome)                    Mag-s.
  1. With bitter taste in mouth               Nux-v.
  2. With cataleptic spasm                     cupr.
  3. After abuse of china                       Arn, ferr, etc.
  4. With chlorosis                                Plb.
  5. With cholera infantum                   Ars.
  6. Cough in comatose state                Benz-ac.
  7. With constipation                           Bry, nat-c, podo, sep, etc.
  8. Child angry and cross
before cough                                   Asar
  1. With cyanosis                                 verat.
  2. Depression, after cough                  Iod, sep, etc.
Depression, with cough                  Mag-arct, psor.
  1. Dizziness, with cough                    Ant-t.
  2. Staggers, after coughing                 Led.
  3. Before eczema                                Led
  4. Emaciation, with cough                 Chel, lyc, merc-c, nit-ac, ol-j,   
                                                            puls, stict, etc.
  1. After an epileptic attack
(which is during menses)                Atro-s, Tep.
  1. Cough better when
eruptions  appear                             Tep.
  1. With bloodshot eyes                       Arn.
  2. Fainting precedes cough                 kali-c.
  3. Faints between paroxysms             Ant-t.
  4. Faintness, during cough                 Coff, lach, op, etc.
  5. Foot-sweat, with                             Lac-ac.
  6. Swelling of gums                            All-c.
  7. With heart affections                     Ars, cact, lach, laur, mosch,
                                                            naja, etc.
  1. Hiccough, during cough               Ang, tab.
  2. Cough from infiltration of
Lower chest                                    Kreos.
  1. After suppressed itch                       Psor.
  2. Lachrymation, during                      Euphr, etc.
Coughing
  1. With blueness of lips                        cupr-ac.
  2. Mania, with cough                             verat.
  3. Melancholy, with cough                     Petr.
  4. Spasmodic cough of phthisical
Girls                                                     Meph.
  1. Enlarged tonsils, with                           Phyt.
  2. Trembling, after cough                         Cupr.
  3. Tremors, with cough                             Phos.
  4. Involuntary dribbling of urine               Ant-c, caps, caust, kreos, while coughing                                       nat-m, phos, ph-ac, puls,   
                                                                  rumx, sep, squil, verat, etc.
  1. Pain in uterus on coughing                          Bell.
  2. Uterine affections with cough                      Plat.
  3. with whooping cough spong Weeping.
  4. With worm symptoms
(Loeffler’s Syndrome)                                 Cina, dol, mag-c, spig.
  1. Cough with zona                                          caust.
  2. Spasmodic   jerking of head
Forward and knees upwards
While coughing                                            Ther.
  1. Uninterrupted, until relieved
By vomiting                                                   Mez.

Reference from
1 Phatak material medica and repertory
2 Dr Prakash Vakil text book on respiratory system

Dr Ajay Yadav