Frankly Developed Pneumonia



On seeing these patients you are immediately impressed by the fact that their respiration is seriously embarrassed. Their breathing is obviously difficult, and they say they cannot get enough air. Very early in the disease there are signs of the accessory respiratory mechanism coming into play, the chest wall is heaving a bit, the nose is flapping, and the patient is obviously having difficulty. In these earlier stages the difficulty is out of proportion to the actual physical signs to be found in the chest. Next you notice that the patient tends to be rather tremulous. The hands are a little shaky, the facial muscles are twitching, and there may also be irregular twitching of the alae nasi.

Always in these Phosphorus pneumonias there is a very trying, tormenting, irritating cough. And that cough is very often accompanied by a feeling of rawness, or burning in the chest.

In the earlier stages, I think, the Phosphorus tongue tends to be dry and reddish, and gives you the appearance of being a little swollen. But by the third or fourth day there is a certain amount of light, dry, white or whitish-yellow coating. These Phosphorus patients are always intensely thirsty, and their desire in pneumonia, as always, is for cold drinks. Phosphorus patients, no matter what their ailment, always want cold drinks, but in pneumonia, with their very dry mouth, they very often ask for something juicy or sour rather than plain cold water.

There is another point that sometimes helps you in the diagnosis of your Phosphorus pneumonias, and that is the position which patients find most comfortable. They want to be propped up, which is not surprising when you consider the feeling of oppression in the chest, but in addition to that you often see them with the chin tilted up and the head thrown well back, which they say very considerably helps their difficult breathing. That is a useful point, because it distinguishes Phosphorus from some of the other drugs which take up a position leaning forward with the elbows on the knees. There are not many drugs which adopt the Phosphorus attitude, and it always very suggestive when you see it.

Another point which ought to help you is that they are chilly patients; they feel the cold, and any draught of cold air is liable to excite an attack of coughing.

A further helpful point is that in their pneumonias, with their state of anxiety and distress, phosphorus patient very much dislike being left alone. They become scared if they are alone, and they feel very much more peaceful and comforted if they have someone about, particularly if they are in actual contact with them. It is not enough merely to sit by the bed of a Phosphorus patient, he wants you to hold his hand, and the actual physical contact gives him sense of great relief. There is one point I missed in both these drugs, and that is the character of the sputum. In the Phosphorus patient in the earlier stages there is a very tormenting, dry cough, with very little sputum indeed. By about the third day that sputum tends to increase, and there is a rather bright red streak through the mucous sputum. By the fourth day that red streak is becoming darker, and very soon afterwards the typical rusty sputum appears. In the Bryonia case the sputum is much darker in colour right from the beginning; even before it reaches the actual rusty stage of consolidation the blood in the sputum is darker than that of Phosphorus. And the sputum in Bryonia is, I think, more sticky, more difficult to expel, and rather tends to hang about the mouth. The phosphorus sputum is liable to be a little more watery, and although scanty it is easier to get up.

As regards the temperature and the pulse rate in Bryonia and Phosphorus there is awfully little to distinguish them. I think possibly the temperature tends to be a little higher in Phosphorus than it does in Bryonia, and possibly the pulse is a little fuller, but they both run a temperature round about 103 degree, and they both tend to have quite a full, strong pulse.

Veratrum viride.

The third of these frank pneumonia drugs is Veratrum viride, and here you have a very clear-cut picture indeed.

The onset is very similar to that in a Phosphorus case. It develops at much the same rate, but is not attended by the same degree of oppression of the chest. In Veratrum viride there is a very much more rapid rise of temperature, and there is apt to be a much higher fever, probably running up to 105 degree. There is a difference in the colour of the Veratrum viride patient and the Phosphorus patient. It is a little difficult to put into words, though if you could only see the two patients it would be quite easy to point out the difference. Although both are congested, and both have red faces, yet I think the Veratrum viride patient gives you the impression of being a little more livid than the Phosphorus one; I think that is the nearest one can get to it.

The Veratrum viride patient always complains of a feeling of intense pulsation, he feels as if his heart were simply pounding out through the chest wall. The pulse is full and bounding and with that you very often get the impression that the Veratrum viride patient’s face is rather bloated and swollen looking.

There is always marked excitement in these pneumonias. Very violent delirium may develop quite early, and the patients are liable to have all sorts of obsessions that they see faces and figures on the wall. It is always something terrifying that they see, and with that state of intense excitement, in Veratrum viride you will always find widely dilated pupils.

You will realize that this is almost word for word a repetition of the description of the picture you meet with in Belladonna, but it is impossible to confound the two. Belladonna has an intense flush and a burning dry skin; whereas Veratrum viride is livid and covered with beads of sweat.

In spite of the high temperature, and without any fall in temperature, there is always profuse perspiration in the Veratrum viride patients. I have seen them in pneumonia with a temperature of 105 degree, the sweat standing out in beads all over, and in spite of that profuse sweat there was no drop in temperature at all.

These Veratrum viride patients are always intensely thirsty, and very often with their thirst there is a feeling of slight nausea. There is one point, a clinical one, that I want to give you about their thirst. I have never come across it in any of the Materia Medicas, but clinically I have had it verified quite frequently, and that it is that the Veratrum viride patients often complain of every thing they takes tasting abominably sweet. For instance, I remember the first child I saw with a Veratrum viride pneumonia and one of his bitterest complaints was that everything he took, plain water, fruit drinks, anything in fact, tasted abominably sweet. We had an awful hunt to try and match it up with a drug, and finally it was on his general indications, not on his sweet taste, that he got his Veratrum viride, and he promptly cleared up. Since that time I have had the symptom verified at least half a dozen times. You do not always get it, but when you do it is a useful lead towards the possibility of Veratrum viride.

There is another point which is almost diagnostic of Veratrum viride when you meet it, and it concerns the tongue. You get two types of tongue in Veratrum viride. One has a thick, yellowish coating, and it is not uncommon. But the one that you look for, and hope for, is a tongue with a thick coating and a bright red streak down the centre. If you have a pneumonia with a high temperature, full bounding pulse, generalized sweat, thirst, and that red streak down the centre of the tongue, you need not bother your head any further; that is Veratrum viride, and will clear up on it every time. I remember one year we had six Veratrum viride pneumonias in the hospital during the winter; they all had Veratrum viride, and every one of them had their crisis the same night. So if you have these legs to stand on you are perfectly safe to push in Veratrum viride, and you will get your results every time.

There is one other point that I have had verified. You know the Bryonia patients have an aggravation from having to sit up, it makes them giddy and they very often resent having to move.

In Veratrum viride, also, there is an aggravation from sitting up, but it is different; the patients do not become giddy, but they complain that their vision becomes dim. I have verified that clinically on several occasions. You can tack on to that another Veratrum viride symptom-one which is not uncommon, I think, in the drugs with widely dilated pupils-and that is that you always find a certain amount of photophobia in the Veratrum viride patients.

The sputum in Veratrum viride comes in about midway between the Phosphorus and the Bryonia ones; it is not quite so bright as the Phosphorus and not quite so dusky as the Bryonia. It is a little difficult to expel, it is a little sticky, and there is always a certain amount of chest pain while coughing and trying to bring it up, but there is not the acute, stabbing pain of Bryonia, or the raw burning of Phosphorus.

Douglas Borland
Douglas Borland M.D. was a leading British homeopath in the early 1900s. In 1908, he studied with Kent in Chicago, and was known to be one of those from England who brought Kentian homeopathy back to his motherland.
He wrote a number of books: Children's Types, Digestive Drugs, Pneumonias
Douglas Borland died November 29, 1960.