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Articles & News

Cough: A Repertorial Study

We read the repertories daily and come across numerous rubrics. The following article is based on those specific rubrics which can be observed clearly if known by the prescriber allowing the physicians to prescribe certain lesser used remedies more effectively.

Cough: A Repertorial Study
by Dr. Rajesh Shah, M.D.
Homeopathy Times, Vol.1, No.3, 1994

 

We read the repertories daily and come across numerous rubrics. The following article is based on those specific rubrics which can be observed clearly if known by the prescriber allowing the physicians to prescribe certain lesser used remedies more effectively. I manly deals with those reportorial expressions which have been repeatedly observed. Checked clinically and re-confirmed with results. If possible, the second part of this article may be published in the subsequent issue.

 

Cough is one of the most common symptoms that we come across in a homeopathy practice, posing quite of-ten a real predicament in selecting a correct remedy to combat it. It is easy to contract cough and it appears a minor aliment but it is not always that easy to find the correct remedy. A prolonged episode of bronchitis with tormenting cough often puzzles the member of all faculties of medicine.

In this article we shall discuss and concentrate only on the objective signs and symptoms which form the reliable and solid base of prescribing. This article comes from practice and experience. Not perform the text-bookish or theoretical jargon. The objective symptoms are either observed by the patient, the relation or the physician.

It is my personal experience several times that while talking continues for many hour, especially during a seminar, I develop a kind of irritating cough in the middle of a talk, which is quite embarrassing. The cough does not allow me to talk further for a few moments and compels me to drink a little water, which provides relief. It is also accompanied with an irritating (tickling) sensation in my throat. On experiencing this kind of cough often. I gathered the following totality and found a lesser used remedy called Cimicifuga (Actea Racemes), which was subsequently used later in over 12 cases successfully, It is now used in my practice as one of the common remedies for bronchitis and laryngitis, especially of allergic nature. It has been well said that if the mind knows, the eyes see. Familiar with the objective reportorial rubrics helps to select the remedy. Important cough totality of Cimicifuga.

Cough, Irritation in air passages, form Cough, tickling in larynx, from cough, dryness in air-passage, from Cough, dry spot in larynx, from Cough, Tickling,small spot in larynx, from Cough, Dry, talking on Cough, talking, with inability to speak
It has been well said that if the mind knows, the eyes see. Familiarity with the objective reportorial rubrics helps to select the remedy.

Besides the above important features the following symptomatology makes the complete totality of the remedy: Cough constant
Cough, hacking, dry, short, spasmodic, paroxysmal
Cough, 7 p.m.,7.30 pm.
Cough, evening, night
Cough, hands, must hold chest with both, while

The proving of Cimicifuga by Dr. Hills and Douglas (and others) on forty males and six women produce cough of above stated type, lasting for day and night almost for two weeks. My clinical experience confirms its role as a great laryngeal cough remedy.

While studying Cimicifuga, It remand me to mention Bufo Rana Another important respiratory remedy useful for similar complaints. The reader any go through my separate article on the topic published Homeopathic links.

Once a mother brought her child with violent, spasmodic cough of a many days duration, not responding to the usual allopathic medicines. She stated: every time the chilled cough he would hold his chest while coughing and he would also have watering of eyes with every bout of cough. This was observed and confirmed in the clinic, too further, she also added whenever the old grandma in the house coughs (she also had cough) funnily enough the little fellow would also wake up from sleep and start coughing! (Coughing is a common feature in a ward of whooping cough.)

The following totality has helped me a number of times to prescribe Arnica successfully, Arnica is great homeopathic antibiotic. So to say and has helped me indeed, many times to take care of infective bronchitis, with high grade fever.
Cough:
Dry, sharp, hacking constant Hands, Must hold chest with both wile Eyes, profuse lachrymatory with every bout of cough (Kunzil)Crying, agg
Talking agg
Noise, agg Sleep during waken form Sleep
Whooping
Other indication for Arnica are as follows:
Cough
Measles, after
day, morning, afternoon, night
Anger, Grief, mental Exertion
spirit, wine

After Repeated success with remedies such as the above and many more Underused remedies, do not we feel that how much narrow has been our applicability of the vital instrument that Dr. Hahnemann has best owed upon us?

Coming back to some more of objective symptoms while treating cough, it would be interesting to know about various positions which may aggravate or ameliorate cough. Carefully listening ears, accurate observation by the physician and the spontaneous and casual description by the patient or relatives may turn out to be key indicators in such prescribing.

Last winter, lady accompanied by an old man suffering from chronic bronchitis and C.O.P.D came to me complaining Doctor, My husband’s tormenting cough neither allows him to sleep nor does it let me sleep in peace, perpetually in whole of winter. He keeps coughing at night, whenever he turns sides in bed. On account of cough, he has to get up from bed, and gets pain in chest on coughing. He cannot breathe enough and brings out so much of phlegm. This is not very uncommon description of an old lady talking about her asthmatic spouse. If you study the following rubrics closely. You may discover another rarely used remedy, and you might say, oh, Is that true that Kreosote could act for respiratory problems as well?

 

Cough, winter old people Bronchitis
Cough, bed in changing position
Cough, turning in bed
Cough, sit up must
Cough, sleep during
Cough, spasmodic
Cough, with infiltration in lower chest
Cough, spring
Cough, painful
Cough, must hold his chest
Purulent expectoration
Cough after influenza (Boericke)

 

Give Kreosote to such a patient and certainly the old lady will bless you. Remember also that Kreosote has marked acridity and it produces even gangrenous pathology in the lungs (Boericke).

Carefully listing ears, accurate observation by the physician and the spontaneous and casual description by the patients or relative may turn out to be key- indicators in such prescribing.

If the patient holds chest with his hands, think of Bryonia, Drosera, Phosphorus and sepia. All of the above three remedies (i.e. Cimicifuga, Arnica, Kreosote)do share this symptom.
If patient holds head while coughing remember Nux Vomica and Bryonia. If the patient holds larynx during shattering cough, think of Allium-cepa.
If the patient holds his abdomen while coughing, consider conium and phosphorus.

If the Patient holds the pit of the stomach on coughing, it is Drosera. Drosera is know for its most violent and loud cough also it would be worth nothing that Drosera is one of the few remedies for soundless cough.If a Nervous delicate Chile with violent measly cough has to hold himself in worldly think of Coffea.

Different position modifying cough may guide to the remedy For instance for cough aggravated on lying down in the evening the important remedied to be consider Pulsatilla, Ars-alb, Hyoscyamus, Drosera, Conium, Sepia etc.

Conium has some characteristic modalities.
Cough, lying down evening
Cough lying only when first lying down obliged to sit up and cough it out then can rest cough sit up must.
Innumerable times the above modalities have helped me to cure patient with prolongs bad cough.

Hyoscyamus is another such less commonly used remedy, but often of great help in treating acute bronchitis even in the absence of its universally know vulgar mental symptom. The main features are:
Cough, night lying while
Cough, hacking, lying while
Cough, first lying down on
Cough,
Lying head low
Cough
Measles after
Cough,
Sleep during wake up
Cough, old people, night

There are different position of aggravation in remedies, according e.g.: Lying on right side (Merc –sol, Stannum), left side (Phos. Sepia, Sulph) on abdomen back, face, kneeling, etc. please refer the repertory to have some exercise !

Different body movement that affect cough could help decide the selection walking aggravation the cough may suggest Ferrum, Calc (although walking relieves dyspnea in Ferrum)

Ignatia and Drosera have different relief in cough while walking. Walking fast and exertion aggravate cough Pulsatilla. A child playing an out door game and coughing thereby is often Pulsatilla. A dancer coughing while /after rehearsing for her dance may need Pulsatilla.

Rapid motion, manual labor and exertion provokes cough in Natrum-mur. Motion of the arms aggravates cough in Natrum-mur. Ferrum and Lycopodium laughing aggravates cough in phosphorus, china and Stannum met.

Excessive talking leading to cough is Collinsonia. Collinsonia is also remedy for singers hoarseness.
A Stannum old man may laugh loudly and cough to bring out profuse expectoration very easily, and may start talking again as it nothing has happened.

Iodum is a great lung remedy capable of curing. Tuberculosis. It has painful hoarseness with violent cough Iodum has a peculiar modality of an inability to lie down with cough, please read the exact rubic.Cough, lie down, could not, sat bent toward

Head movement upwards or looking up aggravates cough in Spongia and Bryonia. Head movement towards in cities cough in Causticum and relieves in Spongia. Raising arm, increase cough in Bryonia and Ferrum.

Rinsing mouth and brushing teeth aggravates cough in Coccus cacti A person coughing more in the morning while brushing teeth and gagging with anguish while rising the mouth, near the wash - basin strongly think of Coccus cacti read:
Cough, rinsing the mouths Cough, brushing teeth Stomach, gagging, coughing on stomach, gagging, expectoration, during.

If I separately bring to your notice the contradictory symptom in Coccus-cacti, it will be remembered better i.e. Cough, paroxysmal rinsing the mouth with cold water, amel

As describe in the text, Coccus cacti has regulate paroxysm of violent tickling. Racking cough ending in vomiting or raising much clear ropy mucus hanging from mouth if you observe such a patient once. You will start prescribing this beautiful remedy much more often. Even your patient will describe it in a graphic manner. Coccus cacti has an other time modality i.e. cough <11.30 pm. I have yet to see such a patient.

When your ask your patient to open his mouth wide open to examine his fauces with torch, and if the patient starts coughing you wait for a while and repeat your act. If he again gets the same cough, take that as a peculiar symptom. Many times this very indication has helped me to find the correct remedy if you are not patient enough to find out the exact rubric yourself in the repertory, you find failures many a times in treating day to day cases of cough. Read the following rubric and find out on your on important remedy tip from the repertory!

Cough putting out the tongue, from Cough, stretching out the throat Cough stretching out the arms.

When you observe the paroxysm of cough makes your patient bend double. It is not Colocynth but Agaricus or Theridion. Agaricus is another wonderful gift to the sufferers of cough.

A paroxysmal bout of cough ending in sneezing is a characteristic of Agaricus and Squilla. Often the patient does not realize the peculiarity of but the minutely observing physician shall not miss anything the peculiar symptom during the case interview while your patient coughs.

Cough leading to vomiting may suggest Alumina i.e. Ant Tart Cough with eructation may lead to think of Pulsatilla. When patient or attending nurse in the ward says that he coughs and coughs and then vomits all the food consumed only then he gets relief in the cough. it is likely that he may need a lesser used remedy like Mezerium. Look at the following rubrics which are a little difficult to spot in the repertory.

Cough, violent uninterrupted, until relived by vomiting: Mez
Cough, constant vomiting, amel
Cough, eating until he vomits.

Again if the spasmodic cough ends in to expectorating sputa look at the following identical rubric to know the remedy, cough hard spells not ceasing until the masses of the offensive sputa are raised: Carb-veg.

We shall not go in to the defining the types of cough such as hacking, shattering, paroxysmal etc.

When mother tells you that child coughs at night then think of the following possibilities. Cyclamen Bacillinum, Arnica, Chamomilla, Nit-ac in my experience the first three remedies have been confirmed for this valuable indication.

Ignatia is another interesting cough remedy often underrated respiratory remedy I have seen it more often indicated in non hysterical individuals suffering from cough it also has hysterical cough. The peculiarity of Ignatia cough is that as the patient starts coughing the cough increases. Ignatia cough is typically hollow which can be better-imagined and observed then described in words. Have a look at the following characteristics in your repertory

Cough
Hollow morning walking on violent constant day and night increases more as he coughs more.

Inversely it will be interesting to note that in Antim-crud the cough becomes weaker and weaker on coughing. Look at the following rubrics
Cough
Paroxysmal attacks the first the strongest following once weaker and weaker. It reminds me of Corallium-rubrum which has a credit of treating difficult cases of cough which almost runs in to each other (Boericke) it is a remedy for very rapid bouts of cough often looks like a barking cough. Besides the definite time modalities could be observed which may help in the selection of the remedy.

When you observe a child rubbing his face and eyes with hands during cough you should think of Causticum, Pulsatilla and Squilla, is a great cough remedy in my day to day practice.
A child waking up frightened from cough or springing up in bed with clinging may call for a common remedy like Antim-tart to a rare remedy like Kali-brom if you resort to the repertory in an unbiased manner, it gives plenty of opportunities for making your practice much more rewarding and interesting.

The contents of the entire article has been of course compiled from the repertories, but I am confident that every sincere student of homeopathy will agree that time tested practice based teaching material is useful.

Needless to say that reportorial article such as this type, especially centered around the objective signs in relation to a specific symptom such as cough can never be claimed complete. It is more of the space limit what compels us to stop here. The reader is welcome to go further, study and apply.

Reference:
Kunzil's Repertorial Generate
Allens Encyclopedia of Pure Materia Medica

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