Most of the time cases of chronic bronchitis come to homoeopaths at later stage with severe symptoms. These cases present the symptoms of wheezing, fatigue, persistent fever and irresistible cough. Initially homoeopaths may need to get the acute symptoms subsided with remedies based on acute totality. After the remission of acute episode, the patient has to be treated with a remedy based on totality of acute symptoms, generalities, past history, family history and familial tendencies, miasm, temperament and constitution. Usually in the duration of 6-12 months patient will get relief.
Respiratory disorders are one among those in which homoeopathy has good scope. There have been positive reviews of homoeopathic trials in respect to respiratory disorders. One such review of three randomized, controlled trials published regarding the use of homeopathy for asthma treatment in 154 patients concludes that two of the three trials were positive (Linde K, Jobst K., Homeopathy for chronic asthma, Cochrane Review, The Cochrane Library, 2002). In another study, published by a health maintenance organization in Israel, the authors found that integrating homeopathic treatment with conventional treatment for allergic disorders decreased overall use of conventional medications by 56%, resulting in a cost savings of approximately 60% in 3 months. The most significant reduction was in antihistamine use (a 70% reduction), followed by decreases in bronchodialator use (55%) and steroids (50%) (Frenkel M, Hermoni D., Effects of homeopathic intervention on medication consumption in atopic and allergic disorders, Altern. Ther. Health Med. 2002; 8:76-79).
Though the homoeopathic treatment is based on symptomatology, the diagnosis is to be made properly to manage the case. Chronic bronchitis is a type of COPD (chronic obstructive pulmonary disease). Cough with mucous most days for at least 3 months for 2 consecutive years is the main diagnostic criteria. The initial symptoms presented by the patients are cough with green or yellowish green mucous, shortness of breath worsened by exertion or mild activity. Over a period it becomes worsen with the symptoms of wheezing, chest pain, fatigue or malaise, persistent low grade fever, irresistible cough, swelling in the ankle, feet and leg, and blue-tinged lips due to lowered oxygen in the blood. If untreated, it may develop in to right sided heart failure (cor pulmonale), emphysema and/or pulmonary hypertension.
Initially patient may not respond for homoeopathic treatment due to the obstacles to cure. Such obstacles are smoking (even long term exposure to second-hand smoke), excessive use of drugs, sedentary lifestyle, junk foods, etc. In such cases some homoeopathic drugs which are often used for intoxication, like Andrographis paniculata Q, Azadirachta indica Q, Carduus marianus Q, Chelidonium Q, Hydrocotyle Q and Taxus buccata Q would be helpful. Along with medication, patient is advised appropriately to add more fruits, vegetables and nuts, to quite smoking and to do physical exercise by considering the patients’ ability and condition. In these cases the drugs which are keeping the patient survival are not to be stopped suddenly, but can be tapered as improvement takes place. When a patient is under the use of inhaler, it may be required only at acute episodes.
During the initial visit with acute episode, time may not permit to find out the right similimum. Even if the right similimum is found, the patient’s vital force may not respond to medium or high potency. Many homoeopathic drugs in low potency or mother tincture are helpful in such instances. After the acute episode comes down, patients’ vital energy has to be improved with nutritive diet, bio-chemic mineral supplements and some homoeopathic health tonics collateral to indicated drug.
As a long term goal, a polychrest is to be selected based on the parameters in the first paragraph. Similimum selected strictly based on such parameters is the right way to provide permanent solution to the patient. Whenever acute episode pops up, it can be managed with low potency initially and with medium potency if the patient’s vital energy is improved and responds. Over a period the frequency of acute episode will come down.
Unlike irritable bowel syndrome or ulcerative colitis, chronic bronchitis is usually a tri-miasmatic condition. Initially patient may present the picture of psora, but in later stage all three miasms can be seen in the case. The fundamental and dominant miasms are to be elicited to select a right remedy, which would act deeply and at all dimensions. If there is stagnation in the improvement, it indicates that superficial layer of the disease is removed and patient needs follow up remedy to act further deep.
Following are the deep acting polychrests commonly used for chronic bronchitis: Ammonium carbonicum, Antimonium arsenicosum, Antimonium iodatum, Antimonium tartaricum, Arsenicum album, Arsenicum iodatum, Belladonna, Calcarea carbonica, Carbo vegetabilis, Causticum, Chininum arsenicosum, Drosera rotundifolia, Grindelia robusta, Hepar sulphur, Ipecacuanha, Kalium bichromicum, Kalium iodatum, Lachesis mutus, Lycopodium clavatum, Pulsatilla pratensis, Phosphorus, Rumex crispus, Sanguinaria, Sepia, Silicia, Spongia tosta and Sulphur.
Following are the remedies commonly used for acute episodes of chronic bronchitis in low potency. Note: Authenticity of the product and its strength is important because it act at the site of COPD.
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, has to sit up and cough violently; asthma, with oppression as from a weight on stomach, worse 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: Asthma associated with bronchitis, suitable for fatty people, cough associated with dyspnoea.
Blumea odorata: Barking like cough controls hoarseness due to cough.
Boerhavia diffusa: Indicated for dry cough as well as cough with whitish thick expectoration.
Ephedra vulgaris: Mother tincture is used to control asthmatic attack; in reduced doses it is also helpful in pulmonary heart disease.
Glycyrrhiza glabra: Used as expectorant; prevents recurrent respiratory infections.
Grindelia: Tenacious mucous difficult to detach.
Justicia adhatoda: Violent cough with tough expectoration and tightness of chest; great fear of suffocation; usually cough associated with vomiting.
Pothos foetidus: Asthma worse from any inhalation of dust.
Rumex crispus: Cough usually with headache; worse eating, in the evening and on lying down.
PS: This article was written by Dr. R. Valavan and published in the Feb 2008 issue of the medical magazine Homeopathy for All.