Usually patients will just hand it to you, if you just say, “Tell me about your cough.” They come out in the most charmingly naive way and tell you just the symptoms you need to repertorize, or what you need to know if you are blessed with good homoeopathic patients. When you get an allopathically-trained patient, you have to work for it.
They tell you everything you dont want to know and nothing you do want to know, and you have to help them, and with them I say, “What is queer and strange about your cough?” and they sit and look at me as though I were crazy, and begin to think what is queer about it and tell me some little funny trifle. One said, “I cough chiefly when I laugh. It is perfectly silly. I cant go in company, I cant go anywhere socially. I laugh and go into one of these awful coughs.” That helped me. It was interesting and the patient had not realized it.
Then we want to know what the modalities of anything are. Dr. Carr said that a strong general is a great thing and in wartime we all know it is and a strong modality is a great comfort, and very often you can get quite a few very distinct modalities from patients once you have taught them what it is and what it is you want to have.
Then one thing that helps me in prescribing for coughs particularly is the concomitants of a cough. Now I sound like Boenninghausen. Dr. Roberts should be here! But very often patients should have some little thing they dont connect with the nature of their cough and often they dont know they do it. A child will get a fit of coughing in your office and not cry but tear while they cough, or get red in the face while they cough, and a woman will tell you that she spurts a little urine when she coughs, and those concomitants are priceless rubrics for picking a really exact remedy.
Then there are some coughs very troublesome, which I call terminal coughs, which come after something else; after you have cleared up some sort of illness, they come, and those I find usually dont need a specific remedy. They need the patients constitutional, if you know what it is or if you can determine it, or one of the nosodes, Tuberculinum, Bacillinum, Medorrhinum, or even sometimes, if you know the cause, Influenzinum, to clear a cough, terminal, long after an influenza.
I could go into a much longer list of the remedies for coughs, but we have a big afternoon ahead of us. I should like to tell you what remedies I would put in my cough kit if I carried one. I have often wished I could have a little trailer to go behind me with a kit especially made up for everything; it would be so easy.
I would put in the cough kit: Antimonium tart. You all know why. Curiously enough, Alumina for the horrid little dry hacks, where they have a wad of phlegm down here and have uvulas that are too long. Belladonna, and, of course, Bryonia, everybody thinks of first for coughs, yet Bryonia doesnt get cough alone, only those going in pneumonia, but for just a plain cough, Bryonia is not much good to me. Bromium if it has hoarseness and feeling of fumes in the throat.
Have you ever smelled hydrocyanic acid? It hits you in the back that is the nasal pharynx, and Bromium does that, burns and hurts. Of course, Carbo veg. and Causticum. Speaking of sounds, you can hear the Causticum. You hear it scrape the trachea, the way you hear something scrape along a pipe. Cina how I love Cina in the naughty children. Rub the end of their nose and they fly in a tantrum and wont let you examine them, and cough their heads off, and throw up about it.
Coccus cacti I never have very good luck with it, but once in a while you do. I should like to hear some of your experience with it. I have borrowed potencies and bought potencies and restudied and restudied it, and rarely have any luck with it. Corallium, of course; Chromium beautiful cases of Chromium. Cuprum you couldnt do without that; Drosera, Hepar, Hyoscyamus, Ignatia, Iodum, Ipecac, Kali carb. my cough wouldnt have Kali carb. in it; for pneumonia, yes, cough with asthma, yes, but not plain cough, just cough. Kreosotum, sometimes. I should like to hear your experiences with Kreosotum. From the allopathic point of view, of course; it is very popular, and I have had a couple of cases in men of a syphilitic background with a great deal of catarrh, in whom Kreosotum was brilliant, but I personally dont see it often.
Strangely enough, Lachesis has cured many a tough cough for me and so has Arsenicum, although one doesnt connect either of them particularly with that; Mercurius, sometimes, though I think I see it less than some people do; Phosphorus, very often; Pulsatilla, universally the number, of course, that yield to that, nobody would believe if one didnt know. Rumex and Sanguinaria are among the big polychrests and constitutionals.
I would say I had cured more coughs with Lycopodium and Sepia than with any of the other big constitutional remedies; and finally Spongia, Stannum, Squilla, not often, but when you want it, how beautiful it is! Dr. Roberts says he never goes out without Cantharides and Squilla. Why, I wouldnt know. He told me that, He looked at my case and said, “Whats the matter? Never go anywhere without Cantharides and Squilla”.
Finally, Sulphur, the old standby, which has cured many an old, stubborn cough after I have tried to prescribe for it and have not succeeded.
This is just a humorous sketch of what the cough remedies can do but it may give you some ideas and I hope you will give me some ideas on ones I have omitted. I should like to know whether anybody uses Arabia racemosa. One of our old members, Dr. John Hutchinson, used to tell me that was his favorite cough remedy. I never see it indicated and never have any luck with it. Perhaps some of you have and can enlighten me.
DISCUSSION.
DR. SUTHERLAND: I should like to make a comment and ask a question. Coughs are my bugbear. I hate coughs. I cant do a damn thing with coughs, and I am glad to hear this paper. I think I have some useful information now.
There is a group of remedies you dont have a chance to read very often, and you have to remember Spongia, Medorrhinum, and Zinc, all aggravated, particularly Zinc and Medorrhinum, by candy. I had a patient over whom I sweat blood for a week and a half until I found that she invariably coughed worse when she ate a piece of candy. I looked it up and Zinc was the remedy, and it disappeared in twenty-four hours. So those three I will never forget, but I dont have a chance to use them because you dont have those modalities very often. Rumex cough is aggravated by cold air. If he holds his hands in front of his face, he wants Rumex, and if they cough harder when you touch the throat, you know it is Allium cepa, which is similar to that.
I had a patient who needed Rumex, who kept still, and that was exactly the same kind of cough he had, always had, I suppose, and Rumex didnt touch it, but I found after further questioning he had Allium cepa symptoms. I looked it up and found this: “Cough aggravated by the least cold air.” He had to walk around the street this way (demonstrating) to keep the cold air away, and when the door opened and the air changed in my office, he held his hand up in front of his face to keep it at an even temperature. That is Allium cepa. Incidentally, he had an Allium cepa nasal discharge. I had that to serve as a differentiation.
The question I wish to ask is this: What remedy would be suggested by a cough that occurs in three, not three paroxysms of cough, but three short coughs, “Hack, hack, hack,” and then intervals and “Hack, hack, hack,” and another interval? I once saw that in a child who was coming down with measles and I looked it up and the nearest thing I could find was Cuprum and it didnt do a thing, so what would you do? Nature got her well, as in most measles cases. What is the remedy? She continued to cough until the eruption was well out and began to subside. Cuprum was the only remedy I could find that suited that, but it didnt suit that patient. Maybe I didnt give it high enough. I only gave her 200.
DR. WILSON: Doesnt Mercury help that?.
DR. SUTHERLAND: This wasnt a paroxysm; like a whooping cough paroxysm, where they have an actual paroxysm, and another repeated and another on top. This was three coughs, three single coughs.
DR. GRIGGS: Next time you get that symptom, you give nosode Marrubium in 10M. or CM. I have seen it work.
I am going to try to answer something about Kreosotum that Dr. Wright Hubbard mentioned simple, straight cough, but what was diagnosed as bronchitis, a little child, three and a half years old, with a recent hard, hacking type of cough, and admitted to the hospital for it after she got it. After she was there about twenty-four hours, the children complained, so that we had to isolate her because with the fetid bronchitis she smelled so bad. She coughed up a greenish-gray mucopurulent expectoration.
This expectoration became so offensive that even the nurse demurred to go and attend her, and we put a screen up around her. She was a dirty-looking, poor little mortal. I gave her Psorinum for three or four days. It did not do anything, but this time it had a grayish-green, pungent offensive expectoration. Coming along, the child had a zigzag temperature, and was very ill, and so offensive that I didnt bother listening to the chest effect. I couldnt stand it, so I gave Kreosotum to the child in the 200th potency and inside of a week I had the children all back in the ward. The offensiveness was all cleared and in two weeks I had the cough cured, which had existed for sometime before, several months before, so Kreosotum does cure a very pungent, offensive expectoration, accompanied by a hard, racking cough.
