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Upper Respiratory Infections & Homeopathy

Applied Anatomy

The upper respiratory tract includes the nose, nasopharynx, and larynx. It is lined by vascular mucous membrane with ciliated epithelium on the surface. The lower respiratory tract includes the trachea and bronchi. These form an interconnecting tree of conducting airways eventually joining via around 64,000 terminal bronchioles, with the alveoli to form acini. The lower respiratory tract is lined with ciliated epithelium as far as the terminal bronchioles. The larynx and large bronchi are richly supplied with sensory nerve receptors involved in the cough reflex. The acinus is the gas exchange unit of the lung and comprises of branching respiratory bronchioles leading to cluster of alveoli. The alveoli are lined mostly with flattened epithelial cells (type I pneumocytes).

Upper Respiratory Tract Infections

Clinically following major conditions are included in URI:

URI

Clinical features

Complications

     
Acute Coryza

(Common Cold)

Rapid onset. Burning and tickling sensation in nose. Sneezing. Sore throat. Blocked nose with watery discharge. Discharge usually green/yellow after 24/48 hrs due to sec infection.

Sinusitis. Lower respiratory tract infection (bronchitis/pneumonia)

Hearing impairment. Otitis media.

Acute laryngitis

Often a complication of acute coryza. Dry sore throat. Hoarse voice or loss of voice. Pain on speaking. Painful and unproductive cough. Stridor.

Chronic laryngitis. LRI.
Acute laryngotracheo-bronchitis (Croup)

Initial symptoms like common cold. Sudden paroxysms of cough accompanied by stridor and breathlessness. Cyanosis and asphyxia in small children.

Asphyxia. Death.
Acute Epiglottitis

Fever and sore throat. Stridor and cough in absence of much hoarseness

Death from asphyxia.
Acute Bronchitis

Often follows acute coryza. Irritating unproductive cough accompanied by retrosternal discomfort of tracheitis. Chest tightness, wheeze and breathlessness. Sputum is initially scanty, mucoid, viscid and may be streaked with blood. After a day or two, sputum becomes mucopurulent and more copious. May be associated with pyrexia.

Bronchopneumonia.
Influenza

Sudden onset of pyrexia associated with generalized aches and pains, anorexia, nausea and vomiting. Usually harsh unproductive cough. Post-influenza asthenia

Tracheitis, bronchitis, bronchiolitis and bronchopneumonia.

So we see that influenza and acute bronchitis (considered in URI because it is often a sequel of common cold) are the two most common reasons for URI pyrexia. We also see that most of the URI’s are interrelated as cause, complication, or symptamatology. Therefore clinically it may not always be possible to delineate just one URI for a patient.

And also it hardly matters because in Allopathy the treatment is nearly same, whatever be the name and in Homoeopathy we treat the patient guided by the symptoms, whatever be the name of the disease.

Symptoms of Upper Respiratory Infections

  • Sneezing
  • Burning and tickling sensation in nose
  • Blocked nose with watery discharge or
  • Greenish/yellow discharge
  • Sore throat
  • Hoarse voice
  • Chest tightness, wheeze and breathlessness
  • Dry unproductive cough
  • Sputum scanty, mucoid, viscid or
  • Mucopurulent and copious
  • Generalized aches and pains
  • Anorexia
  • Nausea and vomiting
  • Pyrexia, usually of sudden onset
 

Repertorial Rubrics

Although many symptoms may be considered for upper respiratory infections but we will here consider only those rubrics, which suggest that the URI is associated with fever.

Rubrics in Kent

  • Catarrhal fever – Acon, Bry, Hep, Merc / ars, ferr p, kali i, rhus t, sabad.
  • Coryza, fever with – Bry, Merc / acon, ars, bell, hep, sang // all c, gels.
  • Pain extremities, influenza during – Bry, Eup p / acon, caust, chel, euph, gels

Rubrics in Boericke

  • Influenza – Acon, Ars, Ars I, Bapt, Bell, Brom, Bry, Carb ac, Cepa, Ahin s, Dulc, Eucal, Eup p, Gels, Lob p, Nat s, Nux v, Phos, Rhus t, Sabad, Sang n, Sticta.
  • Bronchitis – Acon, Ant t, Bell, Brom, Bry, Caust, Dulc, Ferr p, Hep, Ipec, Kali bi, Merc s, Phos, Puls, Rumex, Sang, Sang n, Scilla, Sticta, Sul.
  • Cough, causes influenza – Eriod, Kali bi, Kreos, Pix l, Sang.

Materia Medica

Based on the above rubrics we will discuss the following commonly indicated medicines in URI pyrexia:

  1. Aconite
  2. Arsenic alb.
  3. Belladona
  4. Bryonia
  5. Eupatorium p.
  6. Euphrasia
  7. Ferrum phos.
  8. Gelsemium
  9. Hepar sulph.
  10. Merc sol.
  11. Natrum mur.
  12. Rhus tox

Aconite

Cause:

Exposure to dry cold air, dry North or West wind.

Exposure to draught of cold air, while in perspiration.

Bad effects of fright, heat of sun, excitement.

Symptoms indicating URI pyrexia

  • Mucus membrane dry, nose stopped up; dry or with scanty watery coryza.
  • Pain at root of nose
  • Coryza; much sneezing; throbbing in nostrils.
  • Throat red, dry, constricted, numb, prickling, burning, stinging.
  • Tonsils swollen and dry.
  • Hoarse, dry, croupy cough.
  • Cough dry, short, hacking; worse at night and after midnight.
  • Fever: chill and heat alternate.
  • Hot hands and cold feet.
  • Cold stage marked. Cold sweat and icy coldness of face.
  • Cold waves pass through him.
  • Thirst and restlessness.
  • Sweat absent or on parts lain upon.

Concomitants:

  • Fear, anxiety, and restlessness.
  • Smell acutely sensitive.
  • Intense thirst for cold water.
  • Retention of urine

Modalities:

< In warm room, in evening and night, dry-cold winds.

> In open air.

Belladona

Cause:

Exposure to draught of cold air, uncovering the head, from hair cut, summer sun.

Symptoms indicating URI pyrexia

  • Nose red and swollen
  • Coryza; mucus mixed with blood
  • Throat dry, as if glazed; red, worse on right side
  • Tonsils enlarged; throat feels constricted; difficult deglutition; worse liquids
  • Oesophagus dry, feels contracted
  • Sensation of a lump. Continual inclination to swallow.
  • Dryness in throat, fauces, larynx and trachea.
  • Tickling, dry, short cough; worse at night.
  • Larynx ver painful.
  • Fever, high, with sudden rise.
  • Fever with burning, steaming heat.
  • No thirst with fever
  • Perspiration only on covered parts or absent.
  • Skin red, hot esp. red face with throbbing of carotids.
  • Pulse strong and quick

Concomitants:

  • Acuteness of all senses.
  • Headache from suppressed catarrhal flow.
  • Headache and congestion, esp. in forehead, also in occiput and temples.
  • Headache with throbbing of carotids.
  • Pain worse light, noise, and jar, lying down and in afternoon; better by pressure.
  • Conjunctiva red; dry, burning, with photophobia.
  • Sleeplessness, with drowsiness.

Modalities:

< Touch, jar, noise, draught, after noon, lying down

> Semi-erect

Bryonia

Cause:

After taking cold or getting hot in summer.

when the days are hot and nights are cold.

Cold food and drinks.

Symptoms indicating URI pyrexia

  • Coryza with shooting and aching in forehead.
  • Lips parched, dry, cracked.
  • Dryness of mouth, tongue, and throat, with excessive thirst.
  • Tongue coated white, yellowish.
  • Tough mucus in larynx and trachea loosened after much hawking; worse coming into warm room.
  • Thirst for large quantities of cold water at long intervals.
  • Cough dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust colored sputa.
  • Coming into a warm room excites cough.
  • Frequent desire to take a long breath.
  • Fever with internal heat.
  • Chill with external coldness, dry cough, stitches.
  • Easy, profuse perspiration.
  • Pulse full, hard, tense, quick.

Concomitants:

  • Irritability.

Modalities:

< Warmth, any motion, morning, eating, hot weather, exertion.

> Lying on painful side, pressure, rest cold things.

 

Arsenic alb

Cause:

Chill, in winter, taking ice, ice cream, cold fruits

Symptoms indicating URI pyrexia

  • Hay fever and coryza; worse in open air, better indoors
  • Sneezing without relief.
  • Thin, watery, excoriating discharge
  • Nose feels stopped up. Burning and bleeding.
  • Throat swollen, edematous, constricted, burning, unable to swallow.
  • Suffocative catarrh. Unable to lie down; fears suffocation.
  • Wheezing respiration.
  • Cough worse after midnight; worse lying on back
  • Cough dry, as from sulphur fumes; after drinking.
  • Expectoration scanty, frothy.
  • Darting pain through upper third of right lung.
  • Fever with high temperature.
  • Great heat at about 3 a. m.
  • Periodicity well marked with adynamia.

Concomitants:

  • Burning in eyes, with acrid lachrymation and intense photophobia.
  • Tongue dry, clean and red
  • Mental restlessness with physical exhaustion
  • Great prostration, sinking of strength out of proportion to the degree of illness.
  • Thirst for small quantities of water at short intervals.
  • Mid-day, mid-night aggravation

Modalities:

< Wet weather, after midnight, from cold, cold food and drinks. Right side.

> Heat, head elevated, warm drinks.

Eupatorium perf.

Symptoms indicating URI pyrexia

  • Influenza, with great soreness of muscles and bones.
  • Coryza, with sneezing.
  • Hoarseness and cough, with soreness in chest; must support it.
  • Chronic loose cough, chest sore; worse at night.
  • Cough relieved by getting on hands and knees.
  • Chill between 7 and 9 a. m., preceded by thirst with great soreness and aching of bones.
  • Nausea, vomiting of bile at close of chill or hot stage; throbbing headache.

Concomitants:

  • Occipital pain after lying down, with sense of weight.

Modalities:

< Periodically

> By conversation, by getting on hands and knees.

Euphrasia

Symptoms indicating URI pyrexia

  • Profuse, fluent coryza, with violent cough and abundant expectoration.
  • Bland coryza, worse in morning.
  • Catarrhal conjunctivitis; discharge of acrid matter.
  • The eyes water all the time.
  • Catarrhal headache.
  • Fever with chilliness.
  • Sweat mostly on chest, at night during sleep.

Concomitants:

  • Frequent yawning when walking in open air.

Modalities:

< in evening, indoors, warmth; south winds; from light

> in dark, from coffee.

 

Rhus tox

Cause:

Wetting, too much summer bathing, getting wet when heated.

Symptoms indicating URI pyrexia

  • Sneezing; coryza from getting wet.
  • Tip of nose red, sore, ulcerated. Swelling of nose.
  • Sore throat with swollen glands.
  • Sticking pain on swallowing.
  • Dry teasing cough from midnight until morning, during a chill, or when putting hands out of bed.
  • Tickling behind sternum.
  • Influenza, with aching of bones.
  • Fever, adynamic, with restlessness and trembling.
  • Chill with dry cough and restlessness.
  • Chilly as if cold water was poured over him, followed by heat and inclination to stretch.

Concomitants:

  • Triangular red tipped tongue
  • Restlessness, changes place frequently
  • Sensitiveness to open air.
  • Better by motion.
  • Desire for milk

Modalities:

< During sleep, cold, wet rainy weather and after rain, at night, during rest, drenching, when lying on back or right side.

> Warm, dry weather, motion, change of position, rubbing, warm applications, from stretching out limbs.

Hepar sulph

Cause:

Cold in general.

Symptoms indicating URI pyrexia

  • Soreness of nostrils with catarrhal troubles.
  • Sneezes every time he goes into cold, dry wind, with running from nose, later thick, offensive discharge.
  • Nose stopped up every time he goes into cold.
  • Smell like old cheese.
  • When swallowing, sensation as if a plug and of a splinter in throat.
  • Quinsy, with impending suppuration.
  • Stitches in throat extending to the ear when swallowing.
  • Hawking up of mucus.
  • Loses voice and coughs when exposed to dry, cold wind.
  • Dry hoarse cough. Cough troublesome when walking.
  • Cough excited whenever any part of the body gets cold or uncovered, or from eating anything cold.
  • Croup with loose, rattling cough; worse in morning.
  • Choking cough. Rattling, croaking cough.
  • Suffocative attacks, has to rise up and bend backwards.
  • Fever with dry heat at night.
  • Chilly in open air or from slightest draught.
  • Profuse sweat; sour, sticky, and offensive.

Concomitants:

  • Oversensitive both physically and mentally.
  • Sweat profusely day and night without any relief, which is sour and offensive.
  • Sensation of splinter, fish bone, or plug in throat.
  • Discharges are very much sour.

Modalities:

< From dry cold winds; cool air; slightest draught; touch, lying on painful side.

> Damp weather, from wrapping head up, from warmth, after eating.

Merc sol.

Symptoms indicating URI pyrexia

  • Much sneezing. Sneezing in sunshine.
  • Nostrils raw, ulcerated; nasal bones swollen.
  • Coryza; acrid discharge, but too thick to run down the lip; worse warm room.
  • Coryza, with sneezing; sore, raw, smarting sensation; worse damp weather.
  • Coryza profuse, fluent. Copious discharge of corroding mucus.
  • Profuse burning, acrid discharge from eyes.
  • Soreness from fauces to sternum.
  • Cannot lie on right side.
  • Cough with yellow, muco-purulent expectoration.
  • Paroxysms of two; worse night, and warmth of bed.
  • Catarrh, with chilliness; dread of air.
  • Stitches from lower lobe of right lung to back.
  • Fever, with profuse nightly sweat; debility, slow and lingering.
  • Heat and shuddering alternately.
  • Yellow perspiration. Profuse perspiration without relief.
  • Creeping chilliness; worse in the evening and into night.
  • Alternate flashes of heat in single parts.

Concomitants:

  • Intense thirst for large quantities of cold water.
  • Tongue moist, large, flabby, yellow, with imprint of teeth.
  • Salivation increased.

Modalities:

< at night, wet, damp weather, lying on right side, perspiring, warm room

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