Probably no fact is more fully established in medicine, in any school, than the beneficial action of Aconite action of **Aconite in pulmonary congestions. It is the remedy of remedies in the first stage of pneumonia, because it corresponds more closely to the symptoms usually found in that stage. It should not, however, be used in this or any disease in the first or any stage unless the symptoms call for it.
The symptoms are these: High fever preceded by a distinct chill; the pulse is full, hard and tense; a history of exposure may also be taken into consideration; dry, cold winds. The skin is hot and dry, without moisture upon it; ***there is a hard, dry, teasing and painful cough; there may be some expectoration present, if so it is watery, serous and frothy, may be blood tinged, but not thick. Thick expectoration indicates that exudation is commencing, and then **Aconite is no longer the remedy. There is pain also with **Aconite, which is poorly borne. With these symptoms there is great restlessness, tossing about, anxiety and perhaps fear;of death. It will strengthen confidence in remedies to see **Aconite act in these cases. **Veratrum viride in some is similar to **Aconite in some particulars, but it is easily distinguished; there is a full rapid pulse and a great deal of arterial excitement; the eyes are glistening and there is a red streak down through the centre of the tongue. It is, perhaps more often indicated at the commencement of a pneumonia than is **Aconite.
A great indication for Aconite in pulmonary congestions is **suddenness;of onset, and especially so if it occurs in young and plethoric persons who are full of life and vigor; for it is per-eminently in such patients that congestions, when appearing at all, appear suddenly. **Gelsemium lacks the suddenness;of **Aconite. Here apathy is marked, and the two drugs need never be confounded.
Ferrum phosphoricum. [Ferr-p]
This, like **Aconite, is a remedy for the first stage before exudation takes place, and,, like **Aconite, if there be any expectoration it is thin, watery and blood streaked. It is a useful remedy for violent congestions of the lungs, whether appearing at the onset of the diseases or during its course, which would show that the inflammatory action was extending; it thus corresponds to what are termed secondary pneumonias, especially in the aged and debilitated. There is high fever, oppressed and hurried breathing, and bloody expectoration, very little thirst; there are extensive rales, and perhaps less of that extreme restlessness and anxiety that characterizes **Aconite. This remedy, with **kali muriaticum, forms the Schuesslerian treatment of this disease.
This remedy is one both for the first and second stage of pneumonia, especially for the croupous form. It has high fever and restlessness like Aconite, and there is a tendency to rapid extension of the hepatization. There is a decided cough and great difficulty in breathing, as if the chest would not expand; the sputum is blood streaked. **Iodine may also be a remedy in the later stages when resolution does not progress, the lung breaking down with hectic and suppurative symptoms.
Dr. Kafka, our celebrated German confrere, prescribed drop doses of **Iodine in the 1st, 2nd or 3rd dilution every hour or so as soon as physical signs of pneumonia showed themselves, and claimed that it would arrest the process of hepatization within twenty-four hours. He considered that **Aconite was entirely unnecessary in the treatment of pneumonia. It is also favorably spoken of by Prof. T. F. Allen.
Veratrum viride. [Verat-v]
In violent congestions about the chest preceding pneumonia **Veratrum viride may be the remedy, and thus it is seem that its use is more in the beginning of the disease, and especially where there is great arterial excitement, dyspnoea, chest oppression and stomach symptoms of nausea and vomiting; the engorgement is profound, and here it greatly resembles **Sanguinaria; but it differs from that drug, in that it is of;little use after hepatization has taken place. There is high fever, violent action of the heart, the pulse is full, hard and rapid, and the tongue has a red streak down the center; this latter symptom is a characteristic keynote of the drug. The air cells at the bottom of the lobes are filling up with frothy mucus. the pulse will indicate, it being full and hard. Hard, quick and small indicates **Aconite. Strike out anxiety and alarm and insert an ugly delirium with a deeply flushed, bloated face and headache and you have **veratrum viride. One must beware not to encourage cardiac depression with this remedy.
is the remedy for pneumonia; it furnishes a better pathological picture of the disease than any other, and it comes in after *Aconite, Ferrum phosphoricum and **Veratrum viride. The fever continues, but the skin is not as hot and the patient not as restless as in **Aconite. the cough of **Bryonia is looser and more moist than that of **Aconite, and there are usually sharp stitching pleuritic pains, the cough of **Bryonia is also hard and dry at times and the sputum is scanty and rust colored, so typical of pneumonia. There may be circumscribed redness of the cheeks, slight delirium and apathy; the tongue will most likely be dry, l and the patient will want to keep perfectly quiet. It is a right-sided remedy and attacks the parenchyma of the lung, and is perhaps more strongly indicated in the croupous form of pneumonia. The patient dreads to cough and holds his breath to prevent it on account of the pain it causes; it seems as though the chest walls would fly to pieces. The pains in the chest, besides being worse by motion and breathing, are relieved by lying on the right or painful side, be cause this lessens the motions;of that side. Coughs which hurt distant parts of the body call for **Bryonia. **Phosphorus most commonly follows **Bryonia in pneumonia, and is complementary. In pneumonias complicated by pleurisy **Bryonia is the remedy, **par excellence. Halbert believes that **Cantharis relieves the painful features of the early development of the exudate better than any other remedy, a hint which comes from Dr.Jousset, who used the remedy extensively.
Kali muriaticum. [Kali-m]
Since the advent of Schuesslerism this has been a favorite remedy with some physicians, and not without a good ground for its favoritism. Clinical experience has proved that this drug in alternation with **Ferrum phosphoricum constitutes a treatment of pneumonia which has been very successful in many hands.
The symptoms calling for **Kali muriaticum as laid down by Schuessler are very meager, it is given simply because there is a fibrinous exudation in the lung substance. There is a white, viscid expectoration and the tongue is coated white. It is better suited to the second stage, for when the third stage appears with its thick, yellowish expectoration it is replaced by **Kali sulphuricum in the biochemic nomenclature.
is “the great mogul of lobar pneumonia.” It should be remembered that **Phosphorus is not, like **Bryonia, the remedy when the lungs are completely hepatized, although it is one of the few drugs which have been known to produce hepatization. When bronchial symptoms are present it is the remedy, and cerebral symptoms during pneumonia often yield better to **Phosphorus than to **Belladonna. There is cough;with pain under sternum, as if something were torn loose; there is pressure across the upper part of the chest and constriction of the larynx; there is pressure across the upper part of the chest and constriction of the larynx; there are mucous rales, labored breathing, sputa yellowish mucus, with blood streaks therein, or rustcolored, as under **Bryonia. After **Phosphorus, Hepar sulphur. naturally follows as the exudate begins to soften; it is the remedy of the third stage, the fever is;of a low character.
**Tuberculinum. Arnulphy says that in lobular pneumonia this remedy surpasses **Phosphorus or Antimonium tartaricum, and competent observers are convinced that it has an important place in the treatment of pneumonia; some using it in very case intercurrently; doses varying from 6x to 30x.
When typhoid symptoms occur in the course of pneumonia then **Phosphorus will come in beautifully. **Phosphorus follows **Bryonia well, being complementary to it. There is also a sensation as if the chest were full of blood, which causes an oppression;of breathing, a symptom met with commonly enough in pneumonia. Hughes maintains that **Phosphorus should be given in preference to almost any medicine in acute chest affections in young children.
Lilienthal says **Phosphorus is our great tonic to the heart and lungs.
**Hyoscyamus. Dr. Nash considers this remedy one;of the best in typhoid pneumonia, meaning that it is more frequently indicated than any other.
When **Sanguinaria is indicated in pneumonia there will be fever, burning and fullness in the upper chest, a dry cough, sharp, sticking pains more on the right side, dyspnoea, and the expectoration is rust- colored, here resembling **Phosphorus. It has circumscribed redness and burning heat of the cheeks, especially in the afternoon. The hands and feet are either very hot or very cold, the heart is weak and irregular, there is great engorgement of the lungs and the congestion is very intense, here resembling **Veratrum viride but the arterial excitement is more marked under veratrum viride. **Sanguinaria has imperfect resolution and purulent expectoration, as in **Sulphur but it is more offensive, even becoming so to the patient himself.
Bilious pneumonia is, perhaps more often indicative of **Chelidonium than of any other remedy. there are stitching pains under the right scapula, loose rattling cough and difficult expectoration, oppression;of chest, as under **Antimonium tartaricum, and fan-like motions of the alae nasi, as under **Lycopodium.
**Mercurius is quite similar in bilious pneumonia; the stools will decide, those of **Mercurius being slimy and accompanied by tenesmus; the expectoration is also apt to be blood- streaked. With **chelidonium there is an excess of secretion in the tubes, which;is similar to **Antimonium tartaricum, and an inability to raise the same. It has been greatly praised in catarrhal pneumonia of young children where there is plentiful secretion and inability to raise it. The right lung is more often affected in cases calling for **chelidonium.
Antimonium tartaricum. [Ant-t]
This drug is especially indicated in pneumonia and pleuro- pneumonia at the stage of resolution. There are fine moist rales heard all over the hepatized portion of the lungs; these are different from the **Ipecac rales; they are ***fine, while those of **Ipecac are ***coarse. With ***Antimonium tartaricum there is great oppression of breathing, worse towards morning, compelling the patient to sit up to breath. There are also sharp, stitching pains and high fever, as under **Bryonia, and it, perhaps, more closely corresponds to the catarrhal form than it does to the croupous. Bilious symptoms, if present, do not contra-indicate, as there are many of these in its pathogenesis. There is one peculiar symptom, the patient feels sure that the next cough will raise the mucus, but it does not. When there is deficient reaction, as in the aged or in very young children, this remedy is particularly indicated.
Kali carbonicum [Kali-c]
Is, perhaps, more similar to **Bryonia than any drug in the symptom of sharp, stitching pains in the chest. These are worse by motion, but, unlike **Bryonia they come whether the patient moves or not, and are more in the lower part of the right lung. In pneumonia with intense dyspnoea and a great deal of mucus on the chest, which, like in all of the **Kalis, is raised with difficulty, wheezing and whistling breathing, **Kali carbonicum is the remedy, especially if the cough be tormenting. It comes in with benefit ofttimes where **Antimonium tartaricum and **Ipecac have failed to raise the expectoration.
**Kali bichromicum may be indicated by its well-known tough, stringy expectoration.
Is a remedy to be used in any stage of pneumonia. It will prevent, if given in the beginning, if the symptoms indicate it. It will prevent hepatization and cause imperfect and slow resolution to react. When the case has a typhoid tendency and the lung tends to break down, where there are rales, muco- purulent expectoration slow speech, dry tongue and symptoms of hectic, **Sulphur is the remedy. Weakness and faintness are characteristic symptoms. Dr. G. J. Jones says a dyspnoea occurring at night between 12 and 2 causing the patient to sit up in bed is a valuable symptom. Its field is especially in neglected pneumonias in psoric constitutions, with tendency to develop into tuberculosis.
In purulent expectoration **Sanguinaria is the better remedy, especially where it is offensive even to the patient himself. If the lung be hepatized, the patient at night restless and feverish, ulceration threatened, and there is no tendency to recuperation then one may depend upon **Sulphur.
**Lycopodium is also; a most useful remedy in delayed or partial resolution. There is a tightness across the chest, aching over lungs, general weakness. Hughes says it is the best remedy where the case threatens to run into acute phthisis.