LECTURES IN CLINICAL THERAPEUTICS, PNEUMONIA



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.

George E. Dienst