DIAGNOSTIC APPROACH TO MATERIA MEDICA

(DR. AMIT ARORA & DR. UDESH KUMAR)

Abstract: The Materia Medica is full of gems (i.e.

symptoms). Each symptom or a group of symptoms indicate

toward a diagnosis of a specific disease. My approach in this

article is to convert the symptomatic language of Materia

Medica into a diagnostic form, so as to show therapeutic

indications of that remedy. When in these common diagnostic

symptoms, the particular individual modalities are added;

they become the homoeopathic prescribing symptoms. In

this section we have describe some of drugs which consist of

symptoms related to chronic respiratory disorders like

Asthma, Chronic bronchitis, bronchiectasis, Allergic rhinitis,

sinusitis, chronic laryngitis and some cardiac conditions

giving rise to respiratory distress.

The cardinal symptoms of respiratory system are Cough, breathlessness, sputum and

sometimes pain in chest and haemoptysis. Some diagnoses related to different types of

cough are listed here:

•Dry or unproductive: Upper respiratory tract infection, bronchiogenic carcinoma,

smoker’s cough, bronchial asthma, psychogenic cough.

•Wet or productive: Bronchiectasis, fungal infections

•Paroxysmal: Asthma, cardiac failure.

•With wheezing: Asthma, chronic bronchitis, tropical eosinophilia

•Nocturnal: Asthma, post nasal drip in chronic sinusitis, reflux oesophagitis.

•In early hours of morning: Asthma, tropical eosinophilia.

•Winter episodes: Chronic bronchitis. 1

•Hacking (short, dry, irritating cough): in congestive conditions of pharynx and

upper respiratory passages, smoker’s cough.

•Cough related to exertion: Chronic bronchitis, Asthma, Bronchial carcinoma,

Interstitial lung disease, obesity, heart failure and valvular heart disease mainly mitral

stenosis and aortic regurgitation. .

•Cough related to meals: Hiatus hernia, oesophageal diverticula, trachea-oesophageal

fistula.

•Recent worsening in case of chronic cough: is a common presenting symptom of

bronchiogenic carcinoma.

Some drugs related to chronic respiratory

disorders along with the probable diagnosis

are:

1. Ambra Grisea:a) Violent cough is spasmodic paroxysms, with eructation (Allen) –

signifies reflex cough from reflex irritation of vagus, that is

cough due to distension of stomach, cough due to gastro-

esophageal reflux disorder.

b) Cough worse talking and reading aloud (Allen)– chronic

laryngitis.

c) Cough worse in presence of people (Boericke) - Psychogenic

cough

2. Ammonium carbonicum: Ammonia has a specific action on mucous

membrane of respiratory organs, causes inflammation of bronchial mucous

membrane.

a) Stoppage of nose, mostly at night (Allen) – Chronic sinusitis, Nasal polyp,

hypertrophied nasal turbinates.

b) One of best remedy in emphysema (Allen)

c) Cough from tickling in throat as from dust (Allen) – Chronic laryngitis, cough

due to post-nasal drip in sinusitis.

d) Loses breath when falling asleep (Allen) – Asthma, Chronic heart failure,

Pulmonary oedema, sleep apnoea.

e) Dyspnoea with palpitation (Allen) - clinical diagnosis could be dyspnoea due

to valvular heart disease mainly mitral stenosis and aortic regurgitation.

f) Dyspnoea worse by exertion or on ascending few steps (Allen) – Grade I

dyspnoea, can occur in early stages of chronic bronchitis, Asthma, Bronchial

carcinoma, Interstitial lung disease, obesity, heart failure, valvular heart

disease, cardiomyopathy.

3. Antimonium tartaricum :a) Emphysema of aged (Boericke)

b) Bronchial tubes overloaded with mucus. Great rattling of mucus but little is

expectorated (Boericke)- Rattling cough is a natural response of bronchial

inflammation. The mucus is difficult to expectorate, due to

bronchoconstriction – this state can occur in asthma, chronic bronchitis,

bronchiectasis.

c) Face pale, cold, blue (if along with respiratory distress) (Allen) – This

indicates cyanosis with respiratory distress. The cause could be Atelectasia,

emphysema, lung fibrosis, complication of chronic bronchitis, acute episode in

chronic asthma

d) Antimonium tart acts upon the respiratory nerve centres (Burt) - Respiratory

nerve centres are present in medulla. So any condition which affects medulla

like haemorrhage or ischemia may lead to respiratory arrest and may require

mechanical ventilation. So in such cases this drug could be tried in case of

bronchial infections, when lungs get congested with mucus and patient is not

able to expectorate anything.

4. Argentum Nitricum:

a) Chronic laryngitis of singers (Allen)

b) Vocal nodules (Boericke)

c) High notes causes cough, chronic hoarseness (Boericke)– Chronic laryngitis

5. Arsenicum album: Arsenic causes irritation in mucous membrane, and thus

causes cough – so it can be given in conditions like Allergic rhinitis, laryngitis,

nasobronchial allergy, asthma, bronchitis.

a) Breathing asthmatic; must sit or bend forward (Allen) – Moderate to severe

degree of asthma, where patient has difficulty to recline, but can breath in better

way while sitting and bending forward.

b) Unable to lie down, fear of suffocation (Allen, Boericke)– Asthma, Chronic

heart failure, Pulmonary oedema.

c) Expectoration frothy (Boericke)- Pulmonary oedema.

6. Arsenicum iodatum:

a) Thin, watery, irritating, excoriating discharge from anterior and posterior

nares. Sneezing. Hay fever. Irritation of nose with constant desire to sneeze

(Allen) – Allergic rhinitis

b) Chronic nasal catarrh, profuse, thick, yellow discharge (Allen) – Chronic

sinusitis.

7. Aspidosperma:

a) Want of breath during exertion (Boericke)- Grade I dyspnoea, can occur in early

stages of chronic bronchitis, Asthma, Bronchial carcinoma, Interstitial lung disease,

obesity, heart failure, valvular heart disease, cardiomyopathy.

b) Stimulate respiratory center (Boericke)

8. Blatta orientalis: Indicated after arsenic when this is insufficient.

a) Asthma with bronchitis (Boericke)

b) Much pus like mucus (Boericke) –Bronchiectasis, chronic bronchitis

9. Calcarea carbonica: it causes increase secretion of mucus, so this remedy can be a

good remedy for sinusitis, hupertrophied nasal turbinates, chronic bronchitis,

bronchiectasis.

a) Stoppage of nose with foetid yellow discharge – Chronic sinusitis

b) Tickling cough troublesome at night, dry and free expectoration in morning

(Boericke)– Post nasal drip in sinusitis.

c) Tightness of chest worse going upstairs or slight ascent, must sit down - Grade I

dyspnoea, can occur in early stages of chronic bronchitis, Asthma, Bronchial

carcinoma, Interstitial lung disease, obesity, heart failure, valvular heart disease,

cardiomyopathy.

10. Carbo vegetabilis:

a) Asthma dates from measles or pertusis of childhood (Allen)- As per a study in PubMed,

Sept 2012, Childhood infection and risk of Asthma, it states that Pertussis and measles

were associated with new-onset asthma after childhood. Pertusis was associated with

preadolescent incident asthma, while measles was associated with adolescent associated

asthma.

b) Persons who have never recovered from the effects of some previous illness (Boericke) –COPD and bronchiectasis (which may occur after childhood infections like measles,

pertusis)

c) Asthma in aged with cyanosis (Boericke)

d) Imperfect oxidation. Body become blue (Boericke) – Respiratory conditions which are

associated with cyanosis are Atelectasia, emphysema, lung fibrosis, complication of

chronic bronchitis.

11. Digitalis:

a) Passive congestion of lung, giving bloody sputum due to failing myocardium (Boericke) –this could be a feature of valvular heart disease (mitral stenosis) where pulmonary

congestion causes haemoptysis, left ventricular failure.

12. Cuprum metallicum:

a) Angina with asthma symptoms – it is a feature of cardiomyopathy, aortic stenosis.

13. Dulcumara:

a) Winter cough, dry, teasing (Boericke) - Chronic bronchitis.

14. Eucalyptus globulus:

a) Ethmoid and frontal sinusitis (Boericke)

b) Profuse expectoration of offensive muco-pus. Foetid form of bronchitis,

bronchial dilatation and emphysema – Chronic bronchitis, emphysema,

bronchiectasis.

15. Eriodictyon: Asthma, chronic bronchitis, bronchial secretion gives relief

(Boericke).

16. Grindelia Robusta:

a) Asthmatic and bronchitis patients (Boericke)

b) Mucus difficult to detach (Boericke) – Asthma

c) Efficacious remedy for wheezing and oppression (Boericke)– Chronic

bronchitis, asthma, interstitial lung diseases

d) Asthma relieved by expectoration (Boericke)

e) Weak heart and respiration (Boericke) – Cardiomyopathy

f) Cannot breath when lying down (Boericke) - Asthma, Chronic heart failure,

Pulmonary oedema, sleep apnoea.

17. Lobelia inflate:

a) Dyspnoea from constriction in chest, worse from any exertion –Asthma, chronic bronchitis.

b) Senile emphysema.

18. Pothos: Asthmatic complaint from inhaling dust – Atopic asthma

19. Sanguinaria:

a) Cough of gastric disorder, relieved by eructation – Reflex cough due to

GERD

b) Asthma with stomach disorders- it may be due to tropical eosinophilia,

which can be presented in various forms, respiratory form

(commonest), alimentary form

20. Syphilinum: Asthma in summers (Boericke)

21. Aralia, Naja: Asthma preceded bycoryza

Miscellaneous: Most of asthma attacks occur between midnight to 4 Am. The

bronchial muscle tone is regulated by sympathetic and parasympathetic nervous

system. The sympathetic nervous system regulates body function when the person

is active while during the day and parasympathetic system during the night when

person relax. During sleep, the blood circulation decrease, pulse rate, respiratory

rate decreases and activity of adrenal glands also decreases. The reasons why

asthma attacks during this time are

The activity of vagi cause constriction of bronchial muscles.

Decrease in production of adrenalin in night. As adrenalin helps in

bronchodilation.

Decrease in cortisone production by adrenal cortex. Cortisone helps in

bronchodilation.

Levels of these two substances (cortisone and adrenalin) are lowest between

midnight and 4AM, making it more likely you will experience asthmatic symptoms

during these times.

Specific allergens such as pollens predispose asthmatic attack. Much pollen is

released early in the morning, shortly after dawn. This could also be the reason

why asthmatic attacks occur in early morning.

BIBILIOGRAPHY

1. Boericke,W,2006, New Manual of Homoeopathic Materia Medica and

repertory, 9th edition, B Jain Publishers Pvt Ltd, New delhi

2. Allen H.C., 2002, Keynotes and characteristicks with comparisions, Reprint

editin, A.B. publications, Kolkata.

3. Burt W.H., 2013, Physiological Materia Medica, 3rd edition, B Jain Publishers

Pvt Ltd, New delhi

4. Savill’s system of medicine, 1998, 14th edition, CBS publishers and

distributors, New delhi

5. Davidson’s Principal and Practice of medicine, 1999, 18th edition, churchil

livingstone

6. Golwala, Medicine for Students, 2003, 20th edition, published by Dr. A.F.

Golwala, Express court, Backbar reclamation, chruchgate, Mumbai

7. Mathew K. George, Preparation manual for undergradulates, 2001, B.I.

Churchil Livingstone Pvt Ltd, ND

8. www.ncbi.nlm.nih.gov/m/pubmed/22459783/

9. www.lung.org/associations/states/colorado/asthma/Asthma.html

Presented by

1.Dr. Amit Arora (SMO), Dte of AYUSH, Gnct of Delhi

2.Dr. Udesh Kumar (SMO), Dte of AYUSH, Gnct of Delhi