This has been a year for coughs in New York. I dont know what it has been in Akron, but there is always an epidemic, some years it is croups and some years pneumonia; but this year New York City has coughed its head off. That suggested to me I might briefly give you a few ideas about cough as it seemed to me this year.
I was educated by Pierre Schmidt, over in Europe. I have to mention it so as to have the spirit, and he said, “When you do the Kent Repertory, study mind first, generals second, and cough third.” I was a young thing that was many years ago and I thought, “Why cough third?” but this winter I know why.
The most handy thing, aside from the repertories and your own knowledge of the materia medica, is that little gem, Lee & Clarkes little repertory on Cough. It is what Bells Diarrhoea is to diarrhoea. Also, if you are a user of Dr. Bogers Card Repertory I play with it since Dr. Hayes says it does so well for him you will find one-third of the cards in his box are pertinent to cough. That is simply amazing. So, you see, cough is quite a subject.
Every remedy in the materia medica, practically, has cough, so how are you going to know what kind of cough? What symptoms do you need to guide you?.
I have a British husband and he came to me the other day and said, “Woman, I have a cough. Give me something for it or I shall go to the allopath”.
I said, “What kind of cough have you, dear?”.
He said, “Begging your pardon, a hell of a cough”.
Well, you cant find that in the repertory, and yet there are certain remedies which have a hell of a cough, and I dont ever want to go out on an acute house visit without those few remedies. It is really beginning at the end instead of at the beginning to tell you what I consider those few remedies to be, but certainly one of them is Belladonna.
I have had two cases this winter in which the coughing was so dreadful I really thought one old lady, who has a little aneurism, would burst something if we didnt stop it. She had been coughing for hours before she called for me, and she lived way up in the sticks, and when I got there she was in such a continuous spasm of coughing I think an allopath would have given her chloroform. I didnt even look at her. I went into the bag I could tell by the sound and got Belladonna 50M., and in two minutes she said, “Oh, well, that is the first time I havent coughed like that in six hours”.
So you want always to carry Belladonna for some of these perfectly frightful coughs.
Then I had a small boy whose family telephoned me one morning. Literally he had coughed every sixty seconds all night, and the whole house had been up just “Bing, bing, bing, bing, bing, bing!” You know what that is the minute they begin to cough, and there were practically no symptoms of consequence except the second of that sharp repeating. He had no cold or fever, felt perfectly well, couldnt get his breath, and coughing, coughing, coughing, dry, unproductive.
I looked at him and said, “What did you want to eat today?”. His mother laughed and said, “He has been impossible. He wont eat anything. He went out in the pantry and grabbed a jar of anchovies, which we dont let him eat, and he ate them, and went and got a box of salt crackers and ate them in between his “Bing, bing, bing”.
You all know how Corallium rubrum, “craves salty things,” and the poor child had one other symptom I got out of him, felt every little bit of air that went by went all through him, and that is in the book, “sensation as though a draft of air goes through your head and chills your air passages when you breathe.” That child, again inside of ten minutes after a 10 M. dose of Corallium rubrum, stopped that dreadful “Bing, bing, bing !”.
There is another one to carry around with you.
Then some of the worst coughs I have even seen, curiously enough, needed Ignatia. You never would think of it, but i had a very charming French lady, of most uncertain age, who was so daintily dressed and so delightful, and I found her children had spoiled her, and she came and told me that she coughed every night, chiefly, but pretty much also all the day, and that it had such a spasm.
She never coughed when she came to my office, and I couldnt make her cough. I said, “Please, madam, will you cough?”.
She said, “But I cant”.
“Do you really cough as badly as you think you do?”.
The daughter-in-law said, “It is just terrible how she coughs”.
I tried to get out of her something about her, and I said, “why dont you cough when you come to my office?”.
She said, “I dont know. I dont want you to see me at a disadvantage”.
And I thought, “My goodness, she doesnt have to cough. She can stop coughing,” and so I thought, “I was foolish. I should have given it right away, but I didnt for she said, “The cough simply strangles me and I almost vomit,” and I was in a hurry Dr. Plumb Brown where is he? and I did a little “rapid-firing,” and gave a dose of Cuprum. That has “lovely spoiled ladies and spasmodic coughs,” and I sent her home feeling very proud of myself, and the next day the family said, “Mama is terrible! She coughed all night again”.
I thought, “That wont do.” Then I remembered she didnt cough when she came to see me because she didnt want to make a bad impression, and I sent up to her Ignatia 50M., one dose. She had been coughing like this nearly two weeks, but she never coughed again.
It is very interesting what those remedies will do when they really are badly needed.
Then of course, you all know of coughs that are quite desperate, that bark and that choke, and that want to have three or four pillows, and crave hot drinks, and that sound like sawing through a board if you ever do, and I do, even though I am a doctor and often Spongia will bring peace in the household with those. That is another of my “hell of a remedies”.
But my good man didnt need any of those, and as he wouldnt tell me any symptoms, I stuck around and listened to him, and he sounded like somebody ringing a bronze gong when he coughed, a most terrific metallic noise. How a human chest can make it, I dont know. He has a big one, and I suppose that is why. It is really like a metal thing. He said he had no other symptoms whatsoever. He loves beer, and I said, “For you, Kali bichromicum,” and he took it and his cough went away. He didnt have to go to the allopath!.
Now, to stop being frivolous for a moment, and come back from these terrific remedies, what is it really we want to know about coughs in order to be able to prescribe for them?.
I, unfortunately, have a “mail order” practice. It sounds most illegal, but it isnt. I have lots of suburban patients and they write in and telephone in and expect me to do a little miracle out of the little case they have at home. I say, “Get the patient to the phone. Let me hear her cough.” The one thing I want with a cough is to hear it, and often over the phone you can get an instant reaction to something from the sound of that cough.
I should like to remind you of the sound of certain coughs that I know. I wish I could imitate them. Do you know the people that go “H-h-h-e-ah-he-he-ah” so feeble they havent got pep enough to cough; you say, “For goodness sake, come across and cough,” and they do it and do it, and do it, and you worry about them. I worry about them much more than the people, these terrible people, who need not Cuprum and Spongia, those mean little “Aheh- heh” coughs they just vanish often with a dose of Tuberculinum or Bacillinum. Those little coughs are very nasty and I dont know any so-called acute remedies which will reach them as those nosodes will.
Then there are the terrible barks to whom you give Aconite, croupy barks, a different sound, again, from Spongia; sound almost animal Aconite, Belladonna, Aconite, and the croupy sounds, sounds metallic. Spongia, sounds woody, like a woodywind, instead of like an animal to me, that is I suppose everybody hears things differently, but you get a perfectly definite sense as you do in the realm of smell some doctors come in a house and can smell diphtheria. They dont have to see the patient; they know what it smells like, and certain diseases do smell like that.
I was called another day to a tonsillitis and got that smell, and took a throat culture, but the Board of Health said it was negative, but it got a remedy which is great for diphtheria, which has that kind of thing.
Have you heard Ipecac patients cough? They cough with a wheeze mixed in, a kind of tension, tightness, and, on the contrary, Antimony coughs with a cough so rattley and feeble and cant do anything about it. One cough I like to hear is the Iodine cough. It is as hard as Phosphorus and as violent sometimes. All the Iodine things are violent as violent almost as Corallium and yet it has a roughness like somebody playing badly. Take Bromium that is a curious combination of hardness of Phosphorus and roughness of the Halogens. It is a very distinctive cough. “Concussed” is the word should use for it.
Well, you will think my prescribing is very funny, but sometimes if you get those things into your soul, it saves you a lot of time and you dont have to repertorize. You know what they need on those. So, I like to hear them cough, if I can, but very often I cant. Then what do I want to know?.
