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.
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:
- Pharynx and larynx
- Acute and chronic pharyngitis, including tonsillitis, uvulitis, elongated uvula etc.
- Tumours of the pharynx
- Acute and chronic laryngitis – specific and non- specific, including foreign bodies.
- Laryngeal edema
- New growths of larynx
- Affections of trachea and bronchi
- Acute tracheobronchitis including acute infections like measles, typhoid, pertussis etc.
- Chronic tracheobronchitis including the one due to smoking, exposure to irritant gases, foreign bodies, bronchiectasis etc.
- Pressure on trachea and bronchi from without e.g. Aneurysm of aorta, enlarged lymph nodes, Hodgkin’s disease, new growths etc.
- Cystic fibrosis
- Carcinoma and other tumours
- Causes in the lungs
- Acute infections like pneumonias
- Chronic infections like tuberculosis pulmonary suppuration, fibrosis, fungal infections and parasites (Hydatid cysts, amoebic abscess, Loeffler’s syndrome)
- Malignancy and other new growths
- Changes in the lungs due to heart diseases like pulmonary oedema, cor- pulmonale etc.
- Causes in the pleura
- Causes in the mediastinum
- Enlarged lymphnodes e.g. Tuberculosis, Hodgkin’s disease, malignancy etc.
- Tumours e.g. Dermoids, teratoma, mediastinal goiter, thymomata, foreguf cyst etc.
- Due to heart disease, e.g. pulmonary oedema secondary to cardiac failure.
- Outside the thorax
- Psychological – hysterical (Sydenham’s cough)
- Ear affections
- Subdiaphragmatic lesions like subphrenic and liver abscesses
- Outside the thorax
- Reflex cough
- Uterine etc.
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
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
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),
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
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
- Asthmatic Ant-t, ars, cina, cupr, dros, ip, nux-v, etc.
- Barking Acon, bell, dros, hep, spong, stram, etc.
- Barrel – deep and hollow as if coughing in a barrel Med.
- Choking Alum, coc-c, ip, etc.
- Constant Alum, caust, chin, lyc, rumx, spong, puls,
- Convulsive Ambr, bell, carb-v, chel, hyos, osm, phos, rumx, ther, etc.
- Croupy Acon, hep, iod, kali-bi, lach, phos, samb, spong, stram, brom, etc.
- Deep Dros, stann, verat, etc.
- Deep sounding stram, kali-bi, verb, etc.
- Dry Acon, alum, ars, ars-I, bell, brom, bry,
iod, kali-c, lach, mang, nat-a, nat-m, nux-
v, petr, ph-ac, phos, puls, rumx, spong, sulph, tub, etc.
- Exhausting Ars, bell, caust, sep, stann, etc.
- Explosive Caps, etc.
- Forcible phos, etc.
- Gagging cina, etc.
- Hacking Alum, ars, lach, nat-a, nat-m, phos, sang,
- Hard Bell, kali-c, phos, stann, etc.
- Hawking Eug, coc-c, lach, phyt, etc.
- Hissing Ant-t, caust, etc.
- Hoarse Acon, all-c, bell, brom, carb-v, caust,
- Hollow Bell, caust, spong, verat, etc.
- Hysterical From, gets, ign, etc,
- Loose Ars, puls, coc-c, con, phos, sep, etc.
- Metallic kali-bi, etc.
- Minute guns Cor-r, etc.
- Nervous Caps, dros, hep, hyos, ign, etc.
- Noiseless Calad, dros.
- Noisy Bell, kali-m, stict, etc.
- Panting Dulc, etc.
- Paroxysmal Bell, carb-v, cina, coc-c, cupr, dros, hep,
stann, tarent, verat, etc.
- Persistent Bell, cupr, etc.
- Racking Agar, bell, bry, carb-v, caust, coc-c, ign,
- Rattling Ant-t, caust, ip, kali-s, sep, etc.
- Resonant kali-bi, etc.
- Retching Carb-v, chin, dros, hep, kreos, nat-m, puls,
- Sharp Arn,. Calc-s, staph, etc.
- Short Acon, coff, ign, rhus-t, sep, stann, etc.
- Shaking (Refer Racking)
- Shrill Ant-t, sol-t-ae, stram, etc.
- Sibilant Spong, etc.
- Sneezing ends in Agar, arg-n, bell, squil, sulph, etc.
- Spasmodic Agar, ambr, bell, bry, carb-v, chin, cina,
lach, nux-v, puls, rumx, sep, spong, etc.
- Splitting Aur.
- Stertorous Cact, etc.
- Sudden Squil, agar, euphr, ip, sep, etc.
- Suffocative Alum, carb-v, chin, cina, cupr, dros, hep,
- Two coughs in succession Merc, puls, etc
- Toneless Calad, cina, carb-b, dros, etc.
- Tormenting Ars, bell, caust, dros, ip, etc.
- Trumpet tones Verb.
- Tube, sounds as if he Osm.
- Uncontrollable mag-p
- Violent Agar, bell, carb-v, caust, coc-c, con,
mez, ph-ac, phos, puls, sep, squil, stann, etc.
- Whispering sound Carb-b.
- Whistling Hep, laur, sang, spong, etc.
- Whoop in inspiration with
bronchi and great mental
- Whooping Carb-v, dirc, dros, kali-s, etc.
- Yawning Arn, asaf, cina, mur-ac, nux-v, puls,
Cough with concomitants
- Chickenpox, after Ant-c.
- Loss of consciousness, with Cadm, cina, cupr, etc.
- Convulsions, with Bell, cham, cina, cupr, dros, hyos,
- Dentition, during Calc, calc-p, cham, cina, hyos,
- Elongated uvula Alum, bapt, brom, hyos, merc-i-r,
- Gastric Bor, card-m, ferr, ip, kali-ar, lob,
- Suppressed gonorrhea after Benz-ac, med, sel, thuj, etc.
- Gout, before an attack of Led.
- Haemorrhoids, after the Berb, euphr, sulph, etc.
- Heartburn, from Carb-s.
- Violent hunger, with Nux-v, sul-ac.
- After labour kali-c.
- During lactation Ferr.
- After lifting heavy weight Ambr.
- Manual labour, from Led, nat-m, etc.
- After measles Dros, puls, etc.
- Pregnancy, during Caust, con, nux-m, etc.
- During remittent fever Podo
- Following scarlatina Ant-c, con, hyos, etc.
- Alternating with sciatica
- Splenic troubles, from Card-m, squil.
- Students of Nux-v.
- Sympathetic Lach, naja, etc.
- After vaccination Thuj.
- During variola Plat
- With sensation of worms
- With pain in anus when
- Aneurysm of aorta Spong
- With aphonia Am-caust, phos, rumx, seneg,
- With arthritic pain, worse cold ph-ac.
- With ascarides
- With bitter taste in mouth Nux-v.
- With cataleptic spasm cupr.
- After abuse of china Arn, ferr, etc.
- With chlorosis Plb.
- With cholera infantum Ars.
- Cough in comatose state Benz-ac.
- With constipation Bry, nat-c, podo, sep, etc.
- Child angry and cross
- With cyanosis verat.
- Depression, after cough Iod, sep, etc.
- Dizziness, with cough Ant-t.
- Staggers, after coughing Led.
- Before eczema Led
- Emaciation, with cough Chel, lyc, merc-c, nit-ac, ol-j,
- After an epileptic attack
- Cough better when
- With bloodshot eyes Arn.
- Fainting precedes cough kali-c.
- Faints between paroxysms Ant-t.
- Faintness, during cough Coff, lach, op, etc.
- Foot-sweat, with Lac-ac.
- Swelling of gums All-c.
- With heart affections Ars, cact, lach, laur, mosch,
- Hiccough, during cough Ang, tab.
- Cough from infiltration of
- After suppressed itch Psor.
- Lachrymation, during Euphr, etc.
- With blueness of lips cupr-ac.
- Mania, with cough verat.
- Melancholy, with cough Petr.
- Spasmodic cough of phthisical
- Enlarged tonsils, with Phyt.
- Trembling, after cough Cupr.
- Tremors, with cough Phos.
- Involuntary dribbling of urine Ant-c, caps, caust, kreos, while coughing nat-m, phos, ph-ac, puls,
- Pain in uterus on coughing Bell.
- Uterine affections with cough Plat.
- with whooping cough spong Weeping.
- With worm symptoms
- Cough with zona caust.
- Spasmodic jerking of head
While coughing Ther.
- Uninterrupted, until relieved
1 Phatak material medica and repertory
2 Dr Prakash Vakil text book on respiratory system
Dr Ajay Yadav