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.

George E. Dienst