Bronchitis has traditionally been regarded as a British disease. The earliest description of bronchitis was provided by an English physician more than 200 years ago.[1]
Chronic bronchitis (CB) is defined as a productive cough that lasts for more than 3 months over a period of 2 years. Homoeopathic medicines are considered effective across all age groups in the treatment of chronic bronchitis and other respiratory complaints, unlike the conventional mode of treatment.
The homoeopathic similimum should be selected by focusing on the probable causative factor, which may be mental as well as physical. In children, the mother’s obstetric history, the child’s desires and aversions, sleep position, and behaviour should also be considered.
This article presents an overview of bronchitis and its homoeopathic management using both polychrests and smaller remedies.
Cause and Prevalence
The occurrence of chronic bronchitis is estimated to be as high as 74% among those diagnosed with COPD. A survey on the prevalence of chronic bronchitis among 473 individuals from an industrial population aged 17 to 64 years in North India reported a prevalence of 12.5%.
More than 1.5 lakh people were included in the INSEARCH survey on asthma, respiratory symptoms, and chronic bronchitis conducted by Jindal et al. The estimated prevalence of asthma was 2%, while chronic bronchitis was found in 3.5% of the population, and one or more respiratory symptoms were present in about 9% of individuals.[2]
About 14-17% of chronic bronchitis patients have chronic obstructive pulmonary disease (COPD). Chronic bronchitis also affects 22% of nonsmokers.[3]
Relation Between Chronic Bronchitis and Anxiety or Depression [4]
A prospective, population-based cohort study showed that patients suffering from chronic bronchitis had a higher incidence of anxiety and depression compared to those without respiratory complaints. The association was strongest among smokers.
Chronic Bronchitis and Smoking Habit [5][6][7]
A prospective cohort study of 74,072 women aged 34 to 68 years who were free from major diseases found that current smokers were at significantly greater risk of chronic bronchitis than never-smokers. The incidence increased in direct proportion to the number of cigarettes smoked.
It was also found that about 5 years after quitting smoking, the risk of chronic bronchitis in former smokers approached that seen in never-smokers.
Air Pollution and Chronic Bronchitis [8]
A postal survey was conducted on a large population sample. Replies from 9,975 men and women aged 35 to 69 years were analysed along with census and other data.
The prevalence of symptoms increased with rising levels of air pollution independently of cigarette consumption. In the absence of cigarette smoking, local pollution appeared to have little effect.
Role of Homoeopathy in the Treatment of Chronic Bronchitis [9][10][11][12]
Both polychrests and smaller remedies play an equal role in the management of bronchitis. While polychrests are generally useful in long-term care, smaller remedies help manage acute episodes. Below are the polychrests and smaller remedies with their indications.
Polychrests
Aconitum napellus: Though it is more useful in the acute stage, it can be used in allergic coughs with physical and mental restlessness, fever, great weakness, complaints caused by exposure to dry, cold weather or draught of cold air, acute sensitivity to smell, pain at the root of the nose, dry mucous membrane, dry nose or scanty watery coryza, and a red, dry, constricted throat.
Antimonium tartaricum: It acts on hoarseness, burning sensations in the chest, rattling of mucus with little expectoration, short, rapid and difficult respiration, bronchial tubes overloaded with mucus, and emphysema in the aged.
Bryonia alba: It acts on pharyngolaryngitis and dry bronchitis. It covers a mostly dry cough excited by tickling in the throat, requiring the patient to sit up; stitching pain in the chest; expectoration of rust-coloured sputum sometimes with vomiting; and aggravation after eating or drinking. It also covers difficult, quick respiration, worse from movement, with the need to support the chest.
Drosera rotundifolia: It is a known remedy for whooping cough. It relieves rapidly recurring paroxysms, choking and retching, dry irritative cough aggravated by talking, hoarseness, and roughness in the throat.
Hepar sulphuris: Cough starts from sore throat and continues with shooting pain in the throat and even into the ears, as from splinters on swallowing, coughing, breathing, and turning the head. Difficulty in speaking and swallowing is reduced. Hawking up mucus and dryness in the throat are also relieved.
Hyoscyamus niger: Dry, spasmodic cough at night, worse lying down and better sitting up. Cough from itching in the throat, as if the uvula were too long.
Ipecacuanha: It reduces spasmodic irritation of the chest. It acts on dyspnoea, chest pain, incessant and violent cough, rattling, and attacks of spasmodic and suffocative cough with nausea.
Kali bichromicum: It covers erythema of the soft palate, bright or dark red, with a relaxed and oedematous uvula and a sensation of a plug in the throat not relieved by swallowing. It helps lessen discharge from the mouth and throat that tends to be tough and stringy.
Mercurius iodatus ruber: Useful in dark red throat, painful swallowing, hawking of mucus from the posterior nares with sensation of a lump in the throat, and hawking up a hard green lump. It also relieves stiffness of the throat and neck muscles.
Nux vomica: Cigarettes, smoke, dust, and toxic stimulants have an adverse effect on the delicate tissues of the respiratory organs. These result in catarrhal hoarseness, spasmodic contractions, breathlessness, shallow respiration, oppressed breathing, hacking cough, and headache. These symptoms respond well to this remedy.
Phosphorus: It is indicated where the picture is of destructive metabolism, great lowness of spirit, neuralgia, the need to keep parts warm, chronic catarrh with small haemorrhages, a very painful larynx, sore throat, inability to talk because of pain in the larynx, and cough from tickling in the throat, worse in cold air.
Silicea: It covers accumulation of mucus in the throat, pain as from excoriation and pricking, and swelling of the palate and uvula with difficult swallowing. Expectoration of little granules like shot, which smell very offensive when broken, is also covered. It stimulates the healing process in general.
Spongia tosta: It acts on the respiratory organs. Hoarseness, dryness of the larynx leading to dry barking cough, croup, and short difficult respiration are covered. The cough is relieved while drinking or eating.
Stannum iodatum: It has a main action centred on the respiratory organs, especially chronic bronchial and pulmonary conditions characterised by profuse mucopurulent discharge. The chest feels sore and weak. It acts on persistent tickling dry cough, tracheal and bronchial irritation in smokers, where the cough is loud and hollow, ending with expectoration and purulent infiltration.
Smaller Remedies
Acalypha indica: Cough with bloody expectoration; sometimes violent dry cough precedes the expectoration.
Ailantheus glandulosa: Deep dry and hacking cough, with asthmatic expansion of lungs; cough with headache and congestion of face.
Aletris farinosa: Short, dry and tickling cough worse on waking and talking; discharge of urine during cough; cough suddenly relieved by menstruation.
Aralia racemosa: Cough associated with constriction of chest, worse lying down after the first sleep, with the need to sit up and cough violently; asthma with oppression as from a weight on the stomach, worse at night on lying down, better by raising a little tough mucus.
Asarium europaeum: Frequent cough followed by difficult breathing; cough caused by deep inspiration.
Blatta orientalis Q: It is a remedy for asthma, especially when associated with bronchitis, cough, phthisis, pus-like mucus, and threatened suffocation. The patient gets worse in rainy weather.
Blumea odorata: Barking cough with hoarseness due to cough.
Boerhavia diffusa: Indicated for dry cough as well as cough with whitish thick expectoration.
Coccus cacti: It is indicated for spasmodic and whooping cough, coryza, accumulation of thick viscid mucus that is difficult to expectorate, tickling in the larynx, suffocative cough, and chronic bronchitis.
Echinacea angustifolia Q: It is reported to have non-specific stimulant effects on the immune system and is used in cases of recurrent infections.
Ephedra vulgaris Q: It acts on the mucous membranes of the bronchi. It has proved to be of value for decongestion, relaxation, expectoration, and associated chronic cough. Mother tincture is used to control asthmatic attack; in reduced doses it is also helpful in pulmonary heart disease.
Glycyrrhiza glabra: Used as an expectorant; helps prevent recurrent respiratory infections.
Grindelia robusta Q: It is indicated for cough associated with bronchial asthma and chronic bronchitis. It is a remedy for wheezing, oppression of the chest with viscous mucus that is difficult to detach, and dyspnoea.
Justicia adhatoda Q: It is a highly efficacious remedy for acute catarrhal conditions of the respiratory tract. Coryza with cough, hoarseness, paroxysmal cough with suffocating obstruction of respiration, dyspnoea, symptoms of asthma, and whooping cough are also covered. Violent cough with tough expectoration and tightness of chest, great fear of suffocation, and cough associated with vomiting are commonly seen.
Lobelia inflata: It is indicated for asthma with spasmodic cough and dyspnoea from constriction of the chest, aggravated by exertion. It is useful during acute attacks of bronchial asthma accompanied by nausea, vomiting, and sweating.
Naphthalinum: It is reported to be useful in chronic cough from coryza, hay fever, phthisis pulmonalis, whooping cough, acute laryngo-tracheitis, and bronchitis when the spasmodic element is associated with tenacious expectoration and oppression, as well as spasmodic asthma improved in the open air.
Pothos foetidus: Asthma worse from inhalation of dust.
Rumex crispus: Cough usually with headache; worse after eating, in the evening, and on lying down.
Senega: It acts on catarrhal symptoms of the respiratory tract. Hoarseness leading to temporary loss of voice, backache on coughing, hacking cough, oppression in the chest, bronchitis, rattling, difficult raising of tough profuse mucus, and chronic emphysema are covered.
Sticta pulmonaria: It is indicated for coryza, bronchial catarrh, and influenza. Raw throat, dropping of mucus posteriorly, dry hacking cough at night, and tracheitis are covered. In cases of loose cough, it facilitates expectoration.
References
[1] S.N. Dhar and A.G.S. Pathania, Bronchitis due to Biomass Fuel Burning in North India: “Gujjar Lung,” an Extreme Effect. Seminars in Respiratory Medicine, Volume 12, Number 2, April 1991.
[2] Jindal SK, Aggarwal AN, Gupta D, Agarwal R, Kumar R, Kaur T, Chaudhry K, Shah B. Indian study on epidemiology of asthma, respiratory symptoms and chronic bronchitis in adults (INSEARCH). Int J Tuberc Lung Dis. 2012 Sep;16(9):1270-7.
[3] Kim V, Criner GJ. Chronic bronchitis and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2013 Feb 1;187(3):228-37.
[4] Wagena EJ, van Amelsvoort LGP, Kant IJ, Wouters EFM. Chronic Bronchitis, Cigarette Smoking, and the Subsequent Onset of Depression and Anxiety: Results From a Prospective Population-Based Cohort Study. Psychosomatic Medicine. July-August 2005;67(4):656-660.
[5] Cerveri I, Accordini S, Verlato G, Corsico A, Zoia MC, Casali L, Burney P, de Marco R. Variations in the prevalence across countries of chronic bronchitis and smoking habits in young adults. European Respiratory Journal. 2001;18:85-92.
[6] Troisi RJ, Speizer FE, Rosner B, Trichopoulos D, Willett WC. Cigarette Smoking and Incidence of Chronic Bronchitis and Asthma in Women. Chest. 1995;108(6):1557-1561.
[7] Oswald NC, Medvei VC. Chronic Bronchitis. The Effect of Cigarette-Smoking. Lancet. 1955:843-844.
[8] Lambert PM, Reid DD. Smoking, Air Pollution, and Bronchitis in Britain. The Lancet. 1970;295(7652):853-857.
[9] Calvin B. Knerr. Hering’s Guiding Symptoms of our Materia Medica. B. Jain Publishers Pvt. Ltd., New Delhi.
[10] J. H. Clarke. Dictionary of Practical Materia Medica. Reprint Edition 1992, B. Jain Publishers, New Delhi.
[11] W. Boericke. New Manual of Homoeopathic Materia Medica and Repertory. Second Re-Augmented and Revised Edition based on Ninth Edition, Reprint Edition 2002, B. Jain Publishers, New Delhi.
[12] Dr. P. N. Varma, Kusum Yadav, Ramachandran Valavan. A Compendium of Rare and Clinically Established Mother Tinctures, 4th Edition, Dr. Willmar Schwabe India Pvt. Ltd., Noida.