In this lecture Dr. Bernoville concludes his study of the medicines of moist cough taken up in the 4th lecture. He recalls at first in a general way if it is necessary to deal with the therapeutic of the respiratory system from the angle of derivation and of canalisation more than the drainage properly called. In the study of the remedies of humid cough we have to deal with remedies of direct drainage on the respiratory mucous, of expectorants, of medicines fluidifying the bronchial secretion such as Antimonium tartaricum, Kali bichromicum, Hydrastis, etc…
In the last lecture we have already studied two groups of medicines of humid cough. The Antimony group of which the most important is Antimonium tartaricum characterised by abundant expectoration easy or difficult to throw up and by its depressive action on the circulation and on the heart; and the kali group characterised by a fundamental symptom: Physical and muscular weakness.
To-day we will study the Salts of Ammonia, the Heavy metals (tin, mercury and silver) the salts of Calcium, Baryum and Aluminium and then the vegetable group.
Salts of Ammonia They are characterised by weakness, hypothymic tendency, need to use smelling salts. The subject are fat, with hypotension, weakness of oscillometric amplitude, whose heart is weak and the general condition is failing. They have humid cough. The expectoration would be easy to throw up without the weakness of bronchial contraction. In old persons one should think of the Ammonium salts, when there is a cardio renal trouble with great weakness proceeding towards uremia.
Ammonium carbonicum. Cough accompanied by weakness, oppression or nasal voice. Great sensitiveness to inspired air. Ammonium carbonicum is related from this point of view to Rumex crispus. It is an interesting remedy of chronic emphysematous bronchitis of ripe age and of old persons of whose the general condition and renal functions are deficient. It is a remedy of derivation of lungs towards the kidney and of which the association with Coccus cacti 3x (Polarity: lungs-kidney) is often helpful.
Ammonium muriaticum acts on the upper respiratory tract. The subject suffers from catarrh of the throat. Thick, abundant secretion difficult to detach. Thus it is related to Antimonium iodatum and Antimonium sulphuricum, Antimonium phosphoricum. Well studied by Dr. Le Tellier. Congestive tendency of the lungs very marked because of the radical phosphorus. Arthritic subjects sufferings from catarrhs; gouty or rheumatic patients (Polarity is very clear: Locomotor system and respiratory system).
Antimonium iodatum. Chronic bronchitis of rickety children proceeding towards tuberculosis. Dr. Barishac says that it is a good remedy of diabetes.
Antimonium causticum. Difficult respiration, aphonia, burning sensation in the throat, incessant cough with accumulation of mucous. Spasms of the glottis. Uvula covered with thick white mucous.
Ammonium bromatum. Dry and spasmodic cough specially at night with tickling in the larynx and thick mucous. Chronic catarrh of orators.
Ammoniocum. Chronic bronchitis of old persons who are sensitive to cold having much accumulation of mucous in the respiratory tract but little expectoration.
In summary we may say that. In all salts of Ammonia the cough is humid, the subject is weak and failing with a tendency to passive congestion of the lungs.
Heavy metals: Salts of tin.
The most important of this group is :
Stannum metallicum. An excellent remedy, well studied by Charge and afterwards by Le Tellier: Constant oppression, worse at night, Extremely abundant expectoration, sweetish, sweet or fad. Great sensation of weakness in the chest. This is the dominant symptom. General traumatic sensation of the walls of the chest. Sometimes with constrictive sensation (Cactus).
Stannum is an important remedy of ulcero-caseous tuberculosis.
It is a delicate remedy. Dr. Bernoville finds it very inconstant.
Stannum iodatum. It is more preferable than the former, indicated in bronchial catarrh and in tuberculosis. It is a very good remedy.
Salts of Mercury Mercurium solubilis. It has a more important action on the cavum, on pharynx, on bronchuses. Its action is not so important on the mucous membranes of the lungs. However, it may be indicated in acute bronchitis, pulmonary congestion with muco- purulent expectoration and with the possibility to develop into gangrene or abscess of the lungs (Mercurius is used in the first stage of suppuration before Hepar).
Aggravation at night, by the heat of the bed. No amelioration by sweat. symptoms of mouth, larynx and pharynx are classic. Abundant expectoration, yellowish or whitish with metallic taste. Cannot hack up when lying on the right side.
Mercurius corrosivus. It had marked action on the mouth and gums. Small ulcerations of the mucous membranes.
Silver Salts They are rather indicated in laryngial manifestations than in pulmonary phenomena.
Argentum metallicum. Nasal voice, aphonia with some times easy expectoration with sensation of sternal or sub-sternal ulceration. Aphonia after having talked or laughed. Great weakness of the chest.
Argentum nitricum. It acts more deeply. Acute or chronic nasal voice, cough is often provoked by high pitch of voice palpitation aggravated by lying down on the right side. Aggravation in a hot room at night (mercuries).
Salt of Gold
It is curious that the salts of gold are so much used in Allopathy while it is almost disdained in Homeopathy in the pulmonary affections. However if one considers their pathogenesis it will be at once found that there are some respiratory symptoms in Aurum metallicum, Aurum muriaticum and in Aurum muriaticum natronatrum.
In Allopathy they are used to change the bacillary lesions into sclerosis. The results are good but sometimes great intoxication with renal and cutaneous troubles are seen. According to Dr. Bernoville it would be interesting to make more use of these salts in Homeopathy specially in pulmonary affections. We know already the very beautiful action of Aurum muriaticum natronatrum 6x in arteriosclerosis and in fibromes. Let us try this remedy in certain cases of emphysema with chronic bronchitis of old persons. Let us try it according to the law of similars to the antipodes of caseosis in the pulmonary affection with very marked fibrosis. The salts of Gold are interesting to use homoeopathically in bronchitic manifestation of the lungs of syphilitics.
Salts of Calcium
Here they are of secondary importance: Calcarea carbonica, and Calcarea phosphorica are the essential remedies of morbid temperament.
As functional remedies of drainage let us note: Calcarea silicata. It is related to Hepar and is used specially in weak emaciated patients, hypersensitive to cold with yellowish green expectoration and having a tendency to psoric eruptions.
Calcarea sulphurica. It is related to Hepar and is used in dilatation of the bronchuses and abscess of the lungs. Purulent expectoration.
Calcarea iodata. Pneumonia or tuberculosis with hectic fever. Purulent, greenish, abundant expectoration. Chronic cough with swelling of glands.
Salts of Baryum
Baryta carbonica. Morphologically it is an interesting remedy. Man-like woman having a muscular face. This aspect is related to the troubles of pituitary gland. The patient has often arterial hypertension with vascular sclerosis, a chronic bronchitis or asthma. Baryta carbonica is to be given in the 30th or in higher dilutions.
Cartier very well understood the value of Baryum salts in sclerosis and arteriosclerosis. In reality its action is very slow. It seems to be more interesting in localised sclerosis in persons whose heart is dilated and has maximum arterial tension.
Salts of Aluminium Alumen (30 or higher) is indicated in old persons having asthma intricated with bronchitis with copious expectoration in the morning. Weak subjects having the tendency to paralysis. It is also a remedy of schirrus cancer.
Alumina. A remedy of old singers who suffer from chronic bronchitis whose voice has become husky and who are forced to expectorate after singing.
At first a group of seven remedies of which the first three are of the first importance:
They are Balsamum peruvianum, Phellandrinum and: Allium sativum. They are specially used in chronic bronchitis and in tuberculosis.
Balsamum peruvianum. Profuse, purulent, thick expectoration. The patient fills up the spitoon, he is very depressed, has night-sweats and scanty urine. Tuberculosis with cavity chronic bronchitis with dilatation of bronchuses. Possibility of pulmonary gangrene.
Balsamum tolutanum. Similar indications.
Phellandrinum. Much more interesting than the preceding two. It is one of the best medicines of the respiratory system. Profuse putrid and sweetish expectoration. Same indications as that of Balsamum peruvianum but has more marked action. Phellandrinum deodorises some expectorations of chronic gangrene of lungs. A particular symptom of this remedy Pain of the sternum of the right thorax irradiating to the back through the right lung. Phellandrinum responds to all affections of the lungs acute or chronic when there exists in the expectoration numerous bacteria of secondary infections.
Phellandrinum forms with Balsamum peruvianum, Hepar sulphur and Pyrogenium a group of medicines of the greatest importance in association with microbes.
Myosotis and Myrtus communis. These two are not so faithful. May be indicated in tuberculosis and chronic bronchitis. They have almost the same symptoms: Night sweats, pain in the left lung, aggravation by cough and great sensitiveness to pressure and percussion. Muco-purulent expectoration. The two remedies may be alternated.
Ilicum. Spontaneous pain of the third right rib near the union of the right cartilage of the second intercostal space of the right side in tuberculosis patient or patient suffering from bronchitis.
Myrtus chikan. Same indication like that of Myrtus communis but the expectoration is more difficult to detach.
Allium sativum. A very important remedy. Hypotension Asthenia Emaciation, Humid rales, cough in the morning with expectoration difficult to detatch, sometimes foetid; sensitiveness at cold. Allium sativa deodorises cough like phellandrinum.
It is useful in the 30 and 200 or M in pretuberculous or tuberculous states at the beginning for increasing the weight and to raise the arterial tension.
The second group is composed of remedies which are interesting for their action not only on the respiratory apparatus but also on the urinary apparatus.
The most interesting are kreosotum, Eucalyptus, Copaiva, Cubeba, Cupressus, Ichthioleum and Syphilinum.
Syphilinum is interesting in catarrh, cystitis and in profuse, clear, frothy and glairy expectoration.
Cupressus. Catarrh of the Eustachian tube. A very inconstant remedy.
Copaiva. Catarrh caused by cold with burning sensation and greenish, purulent expectoration. At the same time it has an action on the skin with herpes. Action on the colon and the rectum, recto-colitis. Action on the blunder, cystitis. It is an interesting remedy of old urinary subject who have bronchial catarrh.
Cubeba. Catarrh of the nose and of the throat. Foetid expectoration.
In all the cases where these remedies may be used one may note some curious phenomena of metastasis. The patient drained by Copaiva and Cubeba begins to expectorate but at the same time his kidney and the bladder symptoms are ameliorated. Thus one understands the primordial importance of the elective action of the remedies in the drainage and canalisation. More important are Kreosote and Eucalyptus.
Eucalyptus acts on the upper respiratory tract and also on the urinary organs. It is classical in influenza.
Kreosotum. At a time Kreosote was an important remedy of Allopathy particularly in the treatment of tuberculosis. Kreosote has in fact a very toxic and violent effect causing ulceration of the mucous membranes. Used in Homoeopathy in homoeopathic doses, not in pulmonary tuberculosis, it is useful in chronic bronchitis and pulmonary gangrene. It is capable of giving good results. It acts also better when it is used homoeopathically in cancer of the lungs conjointly with Chrysis, Sedum acre and Onkolysin of Dr. Nebel.
Ichthyolum. Less important. May be used in lower dilutions in tuberculosis and chronic bronchitis.
The third group is composed of very important remedies.
Squilla marina. It acts at the same time on broncho- pneumonia of children and acute bronchitis of old persons. I has also an action on chronic bronchitis of old persons. The patient sneezes while coughing. The cough and sneezing alternate or seen together. The expectoration is viscous and salty (the patient passes a few drops of urine while coughing like Pulsatilla and Causticum). It has a secondary action on the spleen like Grindelia.
Sticta pulmonalis. Bronchitis with influenza, spasmodic coryza, hay fever. Has action on the locomotor system. Rheumatism.
Senega. An important remedy. It has a marvellous action on chronic bronchitis of old persons, has abundant rales in the bases and the patient is often suffering from chronic interstitial nephritis. It acts also well on acute congestion on the ground of a chronic bronchitis. Dr. Nebel uses it in high dilutions.
Sanguinaria. Acute or chronic congestion of the bases with influenza.
Pulsatilla, Hydrastis and Kali bichromicum. These three remedies fluidity the expectoration in lower dilutions. One may use Kali bichromicum and Hydrastis alternately with good results.
The fourth group is composed of three remedies of asthma intricated with bronchitis specially of old persons:
We know Ipeca is aggravated by humid and hot weather: Acts on the spasm in medium dilutions or in high dilutions (centripetal action and checks expectoration). In lower dilutions 1x or 3x provokes expectoration.
Grindelia. Satellite of Lachesis, has abundant expectoration with oppression, asthma ameliorated by expectoration. The patient has, like Lachesis the impression of being suffocated while in sleep. It has often arterial hypertension and digestive troubles, Nausea and vomiting. In Grindelia the same paresis of the vagus as that of Lobelia inflata, Laurocerasus, Ipeca, Hydrocyanic acid and Veratrum album is seen.
Eriodictyon. It helps the expectoration in asthmatics when other remedies have failed.
Finally, the fifth group is composed of remedies which, really speaking, has little action on the respiratory system, should not be neglected.
Chelidonium. Elective action on the right base (Acute or chronic congestion).
China and Chininum Sulph. Abundant expectoration with congestive tendency, weakness.
Digitals and Veratrum album. Old bronchitis patients suffering from emphysema which dilates his right heart.
Veratrum album. There is weakness of the vagus. In Digitalis hyposystole or asystole.