Cough – Predominantly dry, but in pneumonia sputa tough and hard to separate, falling in a jelly – like lump, light in color, or of a soft brick shade.
Cough aggravated by – worse motion; eating or drinking; coming from cold air into warm room; on breathing deeply.
Ameliorated by – worse perfect quiet; pressing hand upon chest, lying on painful side. Concomitants – Stitches in chest; pain in head as if it would burst, pain and soreness in chest, must support it with hand when coughing. Constant disposition to expand the chest or sigh deeply. Short breath worse on motion; pleuritic stitches worse on motion and inspiration; effusions into the pleural cavity; stitching pains in region of heart; generally worse on motion. In acute inflammations of the respiratory organs Bryonia is not so often indicated in the first or congestive stage as Aconite, Belladonna or Ferrum phos., but rather in the second stage when effusion, hepatization or the products of inflammation are appearing. Then it becomes the prime remedy if the symptoms characterizing the drug appear. In coughs which persist after the inflammatory stage is past, or in which this state was not very pronounced, it is still one of our best remedies. Cough worse by coming from cold air into warm room is characteristic ( Nat. carb. ) and the soreness of the chest also ( Causticum, Eupat. perf. and Nat. sul. ). Stitches in chest finds a remedy not only in Bryonia, but in Kali carb. and Squills. The Kali carb. stitches occur any time and are not necessarily worse on motion like those of Bryonia. In a general way the thirst, dry mouth and lips and dry, hard constipation, as well as worse of all symptoms on motion are all corroboratory for Bryonia.
Bryonia is very often indicated after the remedies for the stage of engorgement have done all they can. It is especially in cases of pleuro – pneumonia that it is most useful. The fever still continues being only partially controlled by the former treatment, the breathing is short, expiration shorter than inspiration, the patient wants to lie perfectly still on the painful side, as the least motion aggravates all the symptoms; there is great thirst for large draughts of water, with corresponding dryness of mouth, and lips, which are dry and cracked, or parched (only exceptionally there is no thirst), the expectoration is generally tenacious and sometimes falls in round jelly – like lumps of a yellow or soft brick shade. It is the stage of the exudation, or the second stage of the inflammatory process, and if given in nick of time, in not too low a potency, say, 12th to 200th, will often finish the case, promoting absorption and all. If it does not complete the case, but has well started it toward cure, no remedy follows it so well (generally) as Sulphur, which will often do the rest and prevent chronic conditions following. The pains of Bryonia are characteristically Stitching pains, which, occurring as they do in serous membranes, show that the pleura is involved.
Bryonia may follow Aconite or Nux vomica, if notwithstanding these remedies the nose remains dry and obstructed, and the headache over the root of the nose persists and is greatly aggravated on motion. The lips are parched and dry, and there is much thirst. If the first stage is passed and the fluent coryza has set in another class of remedies comes in, such as –
Bryonia alba stands about midway between Eupatorium and Gelsemium. Like them it is better when quiet and greatly aggravated on motion, the face turns pale on rising and he faints or is nauseated, and stitching pain in various parts are prominent. It must come early into the case if there are the stitching pains in the pleura.
If we are called in too late and the stage of effusion has begun or the Aconite does not remove all the trouble the next remedy is generally Bryonia when the sharp stitching pain continues and the thirst and fever also; the pain and suffering is aggravated on the least motion, and the patient feels better lying on the painful side; the tongue is coated white. No remedy acts more positively on the serous membranes and it may finish the case, even to promote the effusion, which Aconite could not do. Pleuritis.
Jahr wrote in his Practice – ” if the cough is quite dry I give to women Bryonia and Nux vomica to men, according to circumstances.” Ah! that last ” according to circumstances ” is the saving clause. Jahr was a master and knew better than to rest his case on a few routine remedies. No more can we. Bryonia is one of the first remedies if, as the exciting cause of an incipient tuberculosis in a patient predisposed thereto, a Pneumonia, especially a pleuro – pneumonia, has been suffered.
And it is on what are called pathological as well as symptomatological indications that we may, or must, base our choice. The hepatized lung does not clear of the exudate, or the pleuritic effusion has been imperfectly absorbed, or not at all.
Many forms of Phthisis commence in this way. If the proper remedial treatment is applied early we will not have these plastic exudates to deal with; but many times we are called too late to do so. So we must do the best we can at the later stages.
The cough remains and may be still dry and painful, causing the patient to hold the chest with the hands. It hurts the head to cough, and is always or nearly so, worse on motion, or coming in out of cold air into a warm room, or after eating, causing retching and vomiting. Stitching pains in chest are more pronounced during the acute pneumonia or pleuritis, but may still continue in a greater or less degree. The appetite is poor, but there is often much thirst for large quantities at long intervals, and the lips are dry and parched and sometimes cracked. This shows a lingering internal fever. Other symptoms and a number of them may be present for this so well known remedy. A knowledge of the pathogenesis of the drug will disclose them. The aggravations are worse on motion; exertion; A.M.; hot weather; rising up from lying (gets faint); going from cold into warm room. Ameliorated by lying on the painful side; pressure, rest; perfect quiet; cold and eating cold things.
Still elevated temperature, great thirst, mouth dry and lips parched, short respiration, dry, hard cough, which hurts the head and chest, splitting headache, and all symptoms greatly aggravated on the least motion, wants to lie perfectly still. It is especially indicated if the trouble extends downward, threatening the lungs and pleura. Acute bronchitis.