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Introduction
When a homeopath prescribes a remedy, say Allium cepa, to a patient with acute upper respiratory viral infection, patient either gets complete relief of viral infection or speedy recovery towards next phase of the condition. If it speeds the course of the condition with in few hours patient goes to another phase of Pulsatilla, Kalium bichromicum, Hepar sulphur or etc. The second prescription can be made only after knowing the clear picture of the condition. Kent states “The second prescription may be a repetition of the first, or it may be an antidote or a complement; but none of these things can be considered unless the record has been again fully studied, unless the first examination, and all the things that have since arisen, have been carefully restudied that they may be brought again to the mind of the physician”. The difficulty associated with fast lifestyle is, patient wants to visit the doctor only once for such acute problems and expects that all the problems should be resolved.
In circumstances where the patient is under only the first prescription and the follow up could not be taken there may be stagnation in the improvement. Some genuine patients sometimes tell us ‘doctor, time being I have taken couple of allopathic doses as I could not meet you, now please give me some homeopathic medicines for so and so problem”. It cannot be blamed in the present busy life schedule.
To counter this challenge different homeopaths follow different methods. One is giving few follow up remedy doses with suggestions like if your condition changes into symptom ‘A’ take dose no. 1 or if your condition changes into symptom ‘B’ take dose no. 2 and so on. Another way is giving 2 or 3 follow-ups with alternating the dose once in an hour or so. The third is putting all together in one container after ensuring there is no inimical or antidote each other. The fourth, which is also followed by some homeopaths, is giving very low potency doses in the form of one or few mother tinctures or low potency, which have a definite action on the respiratory catarrh irrespective of the individual symptoms. The fifth one is prescribing the formulated products available in the market with “condition-specific formulations” and low potency remedies. Many options or pattern of prescriptions are in existence.
Hahnemann had accepted frequent repetition of doses in 6th edition in the form of LM potency, which he did not accept in the previous editions. Changes are necessary in the evolution of any scientific concept, where there is a process of trial and error. The errors are eliminated and the concept is changed towards more perfection.
Usually the first prescription in acute upper respiratory viral infection (common cold) is from any of the following: Aconitum napellus, Allium cepa, Belladonna, Euphrasia, Hepar sulphur and Kalium iodatum. Clear understanding of the picture of these remedies would help to prescribe the right remedy. Such prescriptions with better understanding would not let the patient to go for the next phase of the condition and limit the infection with the first prescription. Though the symptoms of acute upper respiratory viral infection would be looking similar in all the patients in the view of modern medicine, differentiation is needed and can be made for homeopathic prescription.
Mental restlessness, unknown fear and anxiety are predominant symptoms along with common symptoms in patients who need Aconitum napellus. Allium cepa, often-used example to explain the principle of similia to non-homeopaths, is indicated for profuse, watery and acrid nasal discharge with profuse bland lachrymation which worse when entering into warm room. Throat symptoms like congestion, constriction and difficult deglutition are the chief indication (than nasal symptoms) of Belladonna. Acrid lachrymation and bland coryza are the symptoms of Euphrasia. Cold due to slightest exposure to cold air is the indication for Hepar sulphur. Hepar sulphur is a remedy for both acute and sub acute conditions unlike the previous remedies. If these symptoms accompany with the pain in maxillary and/or frontal bones, it calls for Kalium iodatum. Apart from these remedies, there are other remedies like Ammonium muriaticumm, Arsenicum iodatum and Arum triphyllum with similar indications. These remedies are primarily useful for managing acute episodes of allergic rhinitis.
Choice of second prescription in acute upper respiratory viral infection
When the condition changes after first prescription and the case comes to a standstill state the right choice of remedy is to be made for second prescription. The condition can go by any direction, a right remedy is to be selected according to the changed symptoms. There is no need to interfere into the first prescription if patient is improved, even if symptoms are changed. Usually the first phase of symptoms like running nose, sneezing, congestion and etc. would subside with in a day after the administration of rightly selected first prescription. If it would go to the next phase the symptoms usually would be thick nasal/pharyngeal discharge, dry or productive cough, rattling in the chest, etc. It indicates a) the first prescription is partially similar, b) the disease force is more stronger than the medicinal force, c) vital force is too weak to react to remedy and/or d) the external forces like climate, environment, improper diet & regimen, etc. do not allow the patient to restore the health.
Whatever the reason, often used remedies in second phase symptoms are Antimonium tartaricum (rattling in the chest, but nothing comes up), Argentum nitricum (thick mucous in the throat with constricted feeling), Hepar sulphur (sneezing and watering start due to exposure to cold wind and later turn to thick, lump and offensive discharge), Ipecacuanha (cough and rattling mucous with clean tongue and constant nausea), Kalium bichromicum (tough stringy mucous), Pulsatilla (thick, bland and yellowish mucous), Spongia (dry cough like a saw driven through a board worse sweets, cool drinks, smoking, lying with head low) and Stannum metallicum (cough deep and hallow as if from empty chest with three paroxysms; sometimes with mucous like white of egg). Kalium bichromicum, Hepar sulphur and Pulsatilla cover majority of cases. Antimonium tartaricum and Ipecacuanha may come in the next place which are complementary each other and Ipecacuanha is antidote to Antimonium tartaricum. It may be given alternatively in a situation where patient cannot report for second prescription. Since Antimonium tartaricum, Kalium bichromicum and Hepar sulphur are not antidote or inimical each other, these are being put together and given to the patient as a home kit. A leading clinician had presented a paper in a national workshop that what are the rational combinations he uses in such circumstances and according to the change of weather in that particular region. Many other senior homeopaths also be presented there and few of them took a note of it.
Specific mother tincture and low potencies for acute upper respiratory viral infection and their indications
Acalypha indica
Violent dry cough with constant and severe pain in the chest.
Agraphis nutans
Catarrhal conditions with obstruction of nostrils; enlarged tonsils; inflammation extended to ear followed by discharge and deafness.
Andrographis paniculata
First stage of cold and cough with fever.
Antimonium sulphuratum aureum
Dry hard cough with accumulation of tough mucus in bronchi and larynx of sweetish taste; congestion of upper lobe of the lung.
Balsam tolu
Profuse thick expectoration with loud rales in the chest and irritative cough.
Blatta orientalis
Acute upper respiratory viral infection turned into bacterial LRTI. Dyspnoea is the predominant symptom with cough and mucous.
Bryonia alba
Dry cough with tickling in the throat and stitching in the chest.
Cinnabaris
It rapidly liquefies the blocked secretion in the nose and paranasal sinuses.
Coccus cacti
Spasmodic and whooping cough, coryza, accumulation of thick viscid mucus which is difficult to expectorate and tickling in the larynx.
Drosera rotundifolia
Spasmodic irritative cough, tickling in larynx, sensation as if there is feather in the larynx. Cough worse at night, in evening and immediately after lying down.
Echinacea angustifolia
Stuffiness, rawness and soreness of nostrils with mucus in nares and pharynx with feeling of fullness; sensitive to cold.
Eucalyptus globulus
Irritative cough with thick, white, frothy, offensive mucus. Leaves and oil are used.
Eupatorium perfoliatum
Coryza with sneezing, hoarseness and cough with soreness in chest with the chief guiding symptom of severe bony pain.
Hydrastis Canadensis
Watery coryza, sneezing and dull frontal headache with scanty discharge in indoor and profuse in outdoors.
Justicia adhatoda
Cough with tightness of chest and dyspnoea; yellowish sputum worse due to lying on left side.
Ocimum sanctum
Cold and cough with white or yellowish discharge from the nose; ulcerated nostrils.
Rumex crispus
Dry cough with raw sensation in the larynx and trachea from slightest inhalation of cold air.
Solanum xanthocarpum
Hoarseness with cough and dyspnoea.
Sticta pulmonaria
Coryza, bronchial catarrh and influenza with raw throat, dropping of mucus posteriorly, dry hacking cough at night and tracheitis. Senega -Hoarseness leading to temporary loss of voice, hacking cough, oppression in the chest, bronchitis, rattling.