LECTURES IN CLINICAL THERAPEUTICS, PNEUMONIA


Pneumonia affecting the lower lobe of the right lung, a lobar pneumonia. Sensation as if he could not get air enough into the chest; feeling of exhaustion and weakness in the chest, where constriction impedes respiration, with dry, tickling cough; hepatization of lower lobes; nosebleed. Emphysema following pneumonia; cannot lie down at night, fears to suffocate; loose cough at night and day but no expectoration; cold feeling in chest.


ACONITUM.

First stage in robust persons. Chill of more or less severity, followed by intense fever, hot, dry skin, quick and hard pulse; accelerated, labored, incomplete respiration, with restless palpitation, fear of death, hard, painful, dry cough, soreness and heat in the chest; during the second stage, burning-shooting or burning-pressing pains in the chest, with painfulness to external pressure; oppression and acceleration of respiration, sense of weariness and exhaustion in the chest; pulmonary hyperaemia, sputum thin, frothy, tinged with blood. Percussion sound is still clear, and crepitating rales are distinctly audible.

AMMONIUM CARBONICUM.

Great debility with symptoms pointing to heart-clot; bronchopneumonia of the aged, with rattling of large bubble in the chest, sputum thin, foamy; adynamia; incessant cough and copious expectoration, excited as if from down in the larynx, aggravation 3 to 4 a.m., followed by great exhaustion, especially when complicated with coryza or influenza.

ANTIMONIUM TARTARICUM.

Pneumonia biliosa with hepatic congestion; pleuropneumonia, when parts of lung are hepatized and fine rales are heard over hepatized area; great oppression of breathing towards morning, must sit up to breathe.

Bronchopneumonia, pneumonia catarrhalis. Second stage. Resolution has set in but fails, and oppression and prostration prevail. At first we found the sharp, stitching pains of Bryonia, but now the pains have ceased, mucous rales are heard distinctly over the chest, with extreme want of breath; rattling, hollow cough, with heat and moist, hot sweat on the forehead; dyspnoea with desire to cough, and though chest is full of mucus, inability to bring it up; vertigo with dimness of vision and pressing headache; eyes congested, staring, dull, unsteady, half open or one closed; face red, bloated, anxious, or cool, pale and sallow; nostrils dark, sooty, dilated; mouth open, parched; tongue dry and brown; great thirst; tendency to diarrhoea or constipation. Pneumonia of drunkards, with bilious complications; oedema pulmonum; impending paralysis of lungs or heart; suitable especially to infants and old cachectic people.

ARSENICUM.

Extreme prostration, clammy perspiration, urgent thirst, drinking little and often; shortness of breath on slight exertion; dry and dark tongue and lips; diarrhoea; singing and buzzing in ears; tendency to colliquation and dissolution; threatened gangrene, with ichorous expectoration, foetid or dingy green (Chin., Lach.). In sudden oedema pulmonum, with passive hyperaemia of the lungs, sometimes caused by defects of the right side of the heart; hypostatic pneumonia; pneumonia in old people, with danger of paralysis of lungs; hoarse after midnight; sudamina.

ANTIMONIUM ARSENICATUM (Arsenicum stibiatum).

Pleuropneumonia, especially when left side is affected, with recent or old exudation, chiefly in desperate cases, threatening asphyxia.

BELLADONNA.

Young persons of full habits; temperature and fever high; skin intensely hot to touch, face flushed, eyes congested; great nervousness and restlessness; insomnia; cerebral complications; delirium or threatened convulsions; tickling, dry cough, worse at night; pressive pain in chest, with shortness of breath, affecting the heart; pulse accelerated, often full, hard and tense, worse from lying on affected side; typhoid pneumonia from the start, picking at bedclothes, mottled redness of the face; pulse small and soft, intense and constant delirium.

BROMIUM.

Pneumonia affecting the lower lobe of the right lung, a lobar pneumonia. Sensation as if he could not get air enough into the chest; feeling of exhaustion and weakness in the chest, where constriction impedes respiration, with dry, tickling cough; hepatization of lower lobes; nosebleed. Emphysema following pneumonia; cannot lie down at night, fears to suffocate; loose cough at night and day but no expectoration; cold feeling in chest.

BRYONIA.

Pleuropneumonia, true croupous pneumonia. Indicated after Aconite when hepatization or stage of exudation has set in; pulmonary oppression with feeling of anxiety; heavy pressure just over sternum; bruised feeling and shooting pains in the chest, worse by every motion, and pains more bearable when lying on the affected side (Bell. worse); cough still hard and painful, but expectoration viscid, tenacious, of a brick dust color; abdominal breathing; foul tongue; constipation; gastric catarrh; thirst for large quantities of water.

CANNABIS SATIVA.

Pneumonia infantilis, stimulating meningitis, with high fever and delirium, the lung lesion often only limited, confined to the apex. Mostly indicated late in the third stage, stage of absorption, where the deposit is limited to the lower portion of the lungs, with difficult, greenish expectoration, delirium during fever and green, bilious vomiting, cough frequent, dry, teasing; complication with diseases of the heart and of the larger blood vessels.

CAPSICUM.

Cough excited by drinking coffee; cough prevents sleep at night; when coughing the air from the lungs causes a strange offensive taste in the mouth; very foetid air rises from the lungs when coughing; worse when lying down; better by drinks of cold water; general cyanosis with burning, biting heat, objectively apparent; burning in air passages; pleuro and broncho-pneumonia with dirty brown, not rusty, sputum; during cough splitting pain in the head, drawing or stinging inside of the chest; stitches in back and bladder; pressive, ulcerative pain in neck and ear; cough from any draught, warm or cold, after warm drinks, from depressing emotions or exposure.

CARBO ANIMALIS.

Last stages of pneumonia and suppuration of right lung. Worse from lying on the right side; suffocating, hoarse cough producing shaking of the brain as if the brain were loose in the head; cold feeling in the chest (Brom.); expectoration of green, purulent and horribly offensive sputum, coming from the right lung; sensation of smothering as soon as he closes his eyes.

CARBO VEGETABILIS.

Spasmodic cough, with deep, rough voice or aphonia; decided burning in chest; profuse, yellow, foetid expectoration, especially in aged patients, with a great deal of rattling in the chest; dyspnoea, worse on turning over in bed and on dropping off to sleep; great prostration; tongue dry with little or no thirst; foul, decaying, diarrhoeic stools; breath foul; craves fresh air; foulness of all secretions; pneumonia complicated with affections of right heart, or in emphysematous patients, with old bronchial catarrh. Paralysis pulmonum.

CHELIDONIUM.

Infantile pneumonia and capillary bronchitis with prevalence of hepatic symptoms; pneumonia biliosa; face deep red; great oppression of the chest, fan-like expansion of alae nasi (Lyc.); one hot and one cold foot (Lyc.); quiet delirium, mostly at night, followed by lethargy which continues during the day; grayish-yellow, sallow, sunken features; heat in face with dark red cheeks; sudden restlessness of limbs, feet move involuntarily; severe chills, followed by heat and sorrowful, anxious mood; irregular palpitation of the heart; bright yellow stools; hollow, short, exhausting, racking cough, with forcible ejection of small lumps of mucus or inability to raise or dislodge; straining cough, worse mornings, with expectoration deep from lungs; violent stitches in right lung going to lower edge of right shoulder blade.

DIGITALIS.

Pneumonia senilis, the hearts action failing; respiration irregular and performed by frequent deep sighs; respiratory murmur feeble; cough worse about midnight or towards morning, from talking, from drinking anything cold, from bending body forward; passive congestion of lungs, depending on a weakened, dilated heart; cough with profuse, loose, purulent sputum of a sweetish taste, sometimes with a little dark blood; passive hyperaemia of the brain, which feels fatigued and weak.

ELAPS.

Affects right lung more, and the morning pain is severe enough to prevent his getting up; feeling of coldness in chest after drinking; cough with intense pain in the chest, and sensation as if the right apex would be torn out, and as if the heart were being squeezed; tubercular diathesis.

FERRUM IODATUM.

Chronic pneumonia and bronchopneumonia; great oppression of the chest; is obliged to take a deep breath which causes a feeling of soreness in the chest, with a feeling of oppression as if expansion of thorax were prevented; short, hacking cough, with yellowish-white, rather thick expectoration, rather tenacious and drawn out in threads.

FERRUM PHOSPHORICUM.

First stage of infantile pneumonia, especially when caused by checked perspiration on a hot summers day. Pneumonia of adults, as long as no exudation has taken place, pulse full, round and soft, very little thirst; general heat of the body; nosebleed; profuse expectoration of almost pure blood or of frothy, pink mucus. Secondary congestion following pneumonia, one side being inflamed when suddenly the other side also becomes affected. Most excellent, should be given low.

GELSEMIUM.

Congestive pneumonia, with suffering under scapulae, both sides, caused by checked sweat; short paroxysms of pain in superior part of the right lung, when taking a deep breath; pulse slow, full. Catarrhal pneumonia growing out of relaxed and debilitated condition of the system on return of warm weather at close of winter; hoarseness with dryness of throat; burning in larynx and chest when coughing.

IODUM.

Pneumonia crouposa, beginning of plastic exudation; tendency to bronchial and pulmonary congestion and haemorrhage; fever will not abate; continued great thirst; cough with great dyspnoea as if the chest could not expand; sensation of weakness in the chest, with anxiety and oppression, and burning, stabbing pains; blood-streaked sputum. Also, during third stage, where slow suppuration gets in without marked febrile symptoms in tuberculous patients and causes a low, progressive, hectic condition entirely confined to the lungs. Better in open air than in a warm room.

HYOSCYAMUS.

Pneumonia with cerebral symptoms, delirium, sopor; dry, fatiguing night cough, or rattling in the chest; pneumonia complicated with typhoid; hypostatic pneumonia in the course of other chronic affections; pneumonia senilis, with acute oedema of the lungs; pneumonia of drunkards.

IPECACUANHA.

Pneumonia infantum; breathing spasmodic and wheezing as from spasm of lungs; respiration rapid, difficult; severe dyspnoea, due to clogging of the larger bronchi by inflammatory exudation; rattling of large bubbles, or fine rattling noises in the chest, with spasmodic cough and nausea; face blue or pale; hyperaemia of the brain, without sopor; convulsions.

KALI CARBONICUM.

Pneumonia infantilis, capillary bronchitis; intense dyspnoea, although there is a great deal of mucus in the chest, it is raised with difficulty; breathing wheezing, whistling, oppressed, so that child can neither sleep nor drink; cyanotic symptoms with puffiness over either eyelid; inability to breath deeply; stitching pains, chiefly in the walls of the chest, especially in lower third of right lung, going through the chest to back, but the may occur all over the chest. Worse from any motion or at any time.

Later stages of pneumonia with copious exudation in the lungs and great rattling of mucus during cough; expectoration contains little globules of pus; worse about 3 a.m.; hepatization of right lung with inability to breathe deeply or to lie on right side; sweat on upper lip during sleep, especially in children; abscess of lung, with expectoration of pus and blood. In old unhealed pneumonia aids in clearing lungs.

KALI IODATUM.

Hepatization develops symptoms of cerebral congestion with effusion, dilated pupils, face red, hot; dropped jaw, coma, palsy of limbs; great dyspnoea with dullness on percussion and pain in the left lung, particularly in tuberculous constitutions; sputum frothy like soap suds, showing pulmonary oedema, or copious, purulent, green sputum; stitches from sternum to back, worse from any motion; pleuritic stitches, effusion.

KREOSOTUM.

Gangrene of lungs; anxious feeling of heaviness in chest, better by pressure; after every coughing spell copious, purulent expectoration, periodical haemoptysis, with greenish-yellow, purulent sputum; expectoration of black, coagulated blood; chest feels bruised, as if beaten and frequent desire to take a deep breath, with puffiness of cheeks and violent working of nostrils.

LACHESIS.

Late stage of pneumonia, when it assumes a typhoid form, especially when an abscess forms in the lungs; sputum frothy, mixed with blood, purulent, profuse sweat; cough during sleep and feels worse on waking from sleep; brain symptoms, such as muttering delirium and hallucinations. Tuberculous or low grade chronic pneumonia, developing during the progress of other diseases; hepatization, mostly of the left lung, with great dyspnoea on waking; has to cough hard and long before she can raise; chest feels constricted and stuffed. Threatened gangrene of lungs with foetid breath and sputum.

LAUROCERASUS.

Typhoid pneumonia, when paralysis of lungs threatens with dyspnoea; hurried and rattling breathing; compressible pulse; cold extremities; continual irritation by tickling; short, little cough; irritative cough, depending on cardiac affections; patient coughs and spits a great amount of phlegm, sprinkled over and through with distinct clots of blood; lightness of breathing; lack of energy of the vital powers and lack of reaction.

In nodular lesions. Cardiac insufficiency.

LYCOPODIUM.

Maltreated or neglected pneumonia, passing into a typhoid state, particularly if suppuration of the lungs impends, with adynamia and night sweats; extensive hepatization, with diaphragmatic breathing and fan-like motion of the nostrils and great dyspnoea. Right side mostly affected, but also the left. Scanty, gray sputum, or loose cough, full and deep, sounding as if the entire lungs were softened, the patient raising a whole mouthful of mucus at a time, of a light rusty color, but not thick, more stringy and easily separated (Bry., round, jelly-like lump, almost a yellow or soft brick shade); circumscribed redness of the face; coldness of one foot (right one) while the other is warm or hot.

MERCURIUS.

Bilious pneumonia (Chel.) with blood-streaked expectoration and sharp pains shooting through the lower portion of the right lung to the back, cannot lie on the right side; icteroid symptoms; slimy stools, attended with great tenesmus before, during and after stool (Chel., free discharges). Asthenic pneumonia with a feeling of weight in the lungs, worse walking or ascending; short cough and expectoration of bloody saliva; epidemic broncho- pneumonia, with deep irritation of the nervous system; nose, larynx and trachea become suddenly dry, dyspnoea sets in with spasmodic cough, worse at night, and a yellow-green blood- streaked expectoration; skin burning hot, at times covered with copious sweat; tongue yellow, soon becomes dry; senses dull, violent headache, soporous condition with light delirium; complains of little or no pain (influenza); infantile lobular pneumonia.

NATRUM SULPHURICUM.

Sycotic pneumonia; inexpressible agony; slowly coagulated blood; stitching pain running up from abdomen to left chest; dry cough with soreness in chest; rough feeling in throat, particularly at night; had to sit up and hold chest with both hands; loose, purulent sputum in the morning; all gone, empty feeling in the chest (Bry., Stann.).

NITRIC ACID.

Pneumonia of old and cachectic people; sputum raised with difficulty; awakens often all stopped up with mucus and must expectorate before he can breathe more easily; sputum of blood mixed with clots during the day; pulse intermits.

NUX VOMICA.

Bronchopneumonia especially of drunkards, or of persons suffering from piles. Pneumo-typhus; gastric symptoms prevail.

PHOSPHORUS.

Bronchopneumonia; dryness of air passages; excoriated feeling in upper chest; great weight on chest or tightness; chest sore, bruised; hepatization of lower half of right lung, later part of period of deposit and early part of period of absorption, with wing-like motion of the aloe nasi; worse from lying on the left side; dullness of sound on percussion; bronchial respiration, frequently attended with crepitation and rattling.

Typhoid pneumonia, not a genuine inflammation, rather an accumulation of blood in the veins, and extravasation of fluid blood in the tissues of the organ; the patient is weak, with feeble pulse, sighs occasionally, is unable to use his lungs, not from pain but merely from weakness and hyperaemic stagnation; pulse thready; cold sweat; pleuropneumonia, with extensive involvement of the pleura; hepatization, with mucous or bloody sputum; coughing increases the difficulty of breathing. During the third stage purulent infiltration of the parenchyma, with mental depression, slight delirium, carphologia and subsultus tendinum; rapid prostration; cold, clammy sweat; small, feeble, frequent pulse; dim eyes; sunken features; dry lips and tongue; short, laborious breathing; oppression and anxiety; tedious cough and expectoration; involuntary diarrhoea; threatened paralysis of the lungs. Tuberculosis in tall, slender, weak-chested persons. Phosphorus is our great tonic to the heart (venous heart) and lungs.

PULSATILLA.

Pneumonia morbillosa; bronchopneumonia in chlorotic and anaemic women; a loose cough lingers after the resolution of a severe inflammation; debility and inertia of mind and body; free, yellowish-green sputum.

RHUS TOXICODENDRON.

Typhoid pneumonia, often from reabsorption of pus, with tearing cough and restlessness, as rest aggravates the pain and dyspnoea; tongue red at the tip; loss of strength; sopor; hardness of hearing; unconscious defecation and urination; dryness and heat of the skin;dry and sooty tongue; dyspnoea worse from distension of pit of stomach; sputum bloody or brick-dust color, or green, cold mucus, smell putrid.

SANGUINARIA.

Second and third stage; cough dry at first, excited by tickling and crawling in the trachea and upper portion of the chest; tough and rusty sputum during red hepatization, purulent and offensive in the third stage; hectic fever; diarrhoea; night sweats; prostration; distressing amount of dyspnoea; hands and feet burning hot or cold; lies on back with head elevated; failure of heart action before amount of hepatization can account for it; heart beat weak and irregular; patient feels faint; covered with sweat and suffers from nausea; pulse small and quick; fever 2 to 4 p.m. with flushed cheeks.

SILICA.

Chronic, neglected pneumonia, passing over into suppuration; dyspnoea when lying on back or coughing; lungs feel sore; excruciating, deep-seated pains in the lungs; sputum profuse, foetid, green and purulent, often tasting greasy.

SPONGIA.

Broncho and croupous pneumonia; sputum has sour or salty taste; worse lying down; wheezing, anxious breathing; burning and soreness in the chest; during the stage of resolution profuse secretion and expectoration of mucus, inability to lie down; the cough is relieved by eating and drinking.

SULPHUR.

Pneumonia assumes a torpid character, with slow solidification of the lungs; there may still be much rattling of phlegm in the chest; frequent, weak, faint spells, and flushes of heat; feels suffocated; wants doors and windows open; constant heat on top of the head. Torpid typhoid pneumonia, with short, rapid breathing, a mere heaving of the chest; cough and expectoration nearly impossible; the patient responds sluggishly, comprehends slowly; worse about midnight.

Neglected or occult pneumonia, occurring in psoric patients, pneumonia which threatens to terminate in pulmonary tuberculosis or in phthisis pituitosa. Pneumonia passing through its first stage normally and then remaining stationary; such a deficiency of reaction points to Sulph. as the remedy. In such cases it accomplishes the absorption of the infiltration and prevents suppuration if there are no typhoid symptoms or a tendency to phthisis pulmonum; bronchial respiration and hepatization most plainly heard in the back. Pneumonia in infants and old people.

VERATRUM VIRIDE.

Pulse hard, strong, quick, full, incompressible; engorgement of the lungs; sputum contains large masses of blood, with faint feeling in the stomach, nausea, slow and intermittent pulse; constant burning distress in cardiac region; heart beat loud, strong and at the same time respiration is difficult, slow and labored; great arterial excitement; great cerebral congestion; red streak through centre of tongue; sinking, cold feeling in pit of stomach on attempting to sit up, nausea; cold sweat; orthopnoea, threatening cardiac paralysis from over exertion of the heart.

AURORA, ILL.

George E. Dienst