– BENERJEE.P,

Asthma 

 Case no. 12
 17. 9. 1922.
 Mr.-, a Railway official. Age 35 or 36. Well built, fat and fair. Was suffering from asthma for the last 12 years, and all sorts of treatment were had, but without any benefit, and the patient had set it down at last that asthma was incurable. I was only called in one night when the fit was very severe, just to save him from inpending death. He never thought of having a course of Homœopathic treatment. However, I gave him a few doses of Carbo veg., and he slept quietly in a few minutes. It was admitted later on that he had never such quick relief in the past, not even from the gallons of Cod liver oil that he had taken. This fact of the quick relief and the old father’s request subsequently induced the patient to place himself under my treatment. And I recorded the case, as below. Evidently the patient was taking me for a fool when I was crossing him for eliciting such symptoms as did not relate directly to the asthma, because he could not find out what connection the condition of the mind, the likes and dislikes for different kinds of food, the history of his past life, as also the history of the parents, and such other symptoms, could have with his asthma.
 PAGE 375
 Symptoms:-
 During the fit, the patient had to sit bent forward. There was perspiration on the forehead, and this necessitated continuous fanning. There was an indescribable feeling of despair-as if he would not live, as if he would suffocate. Every breath seemed to be the last. There was profuse expectoration towards the morning, and this used to give some relief. There was burning in the hands, feet and head, and it became necessary to wash these parts with cold water. The patient was growing weaker and weaker every day, and the despair of life was consequently gradually increasing. Temper very irritable. Used to be put out at the slightest cause, and once put out, was not pacified easily. Much about his early history and the history of the family was not available. The only thing that I could gather was that the patient had suffered from itches between the fingers, on the elbow-joints and in the knee, in his childhood. These used to exude pus, and were aggravated in the rainy season. These were cured with ointment externally, and with Ayurvedic medicines internally. Marks of these itches were still visible in the parts mentioned.
 PAGE 376
 19. 9. 22. Carbo Veg-200, one dose every morning. There was much relief after three doses, and the patient kept well for about 20 or 25 days. Expectoration increased, and it seemed the patient was on his way to cure. But on 16. 10. 22, information was received that the patient had a very severe fit in the night. Carbo veg-200, but no effect. Then, after 4 days, Sulphur-30 and 200, successively. No effect.
 PAGE 377
 3. 11. 22. Carbo Veg-500, and placebo for some days.
 15. 11. 22. A very severe aggravation, so severe that the patient was almost dying. I repented the mistake of my prescription, because, there must have been a mistake, or the patient could not be dying like that. I referred to the record, but could not see that there was a mistake in the prescription. Luckily enough, the patient stated at this moment that his piles had re-appeared. Though there was no mistake in my prescription, as I could at once gather from the re-appearance of this old symptom, I could not congratulate myself on the incompleteness of the record. I ought to have crossed out of the patient that he had piles too. However, I administered at once (16. 11. 22.) Natrum snlph-1,000 in graduated doses, to be taken once every morning. On the second day, the fit of asthma seemed less. On the third day the asthmatic fit was totally gone, and on the fourth day, 19. 11. 22, there was no fit at all. Gave some placebo and left.
 8. 12. 22. The patient complained that the fit might return this night, as he was feeling a heaviness in the chest. This was his usual symptom before an attack, and as anticipated there was some asthmatic breathing that night.
 9. 12. 22. Natrum Sulph-1,000, one dose in the morning. There was no more asthma after this. But the piles continued unabated. After 3 or 4 months, Nitric Acid-200, was used on the totality of symptoms, as they developed then. And I expected to complete the course of treatment, and to cure the patient by Anti-Psoric and Anti-Sycotic treatment, but the opportunity for it was gone, the patient, who was a Railway official, having in the meantime been transferred away from the place, and there being a lack of earnestness on his part, owing to relief from his immediate sufferings. The treatment had therefore to be discontinued.
 PAGE 378
 Remarks:-
 (1) Catarrhal asthma is mostly Sycotic, and cure lies in Anti-Sycotic treatment. But where suitable similimums are not available, remedies agreeing with the totality of the symptoms (as distinct from the totality of the Sycotic symptoms) have to be given, and some suitable Anti-Sycotic remedy interpolated occasionally. This may not bring about radical cure in all cases, but substantial benefit is most certainly to be had.
 (2) Where, however, the asthma is not catarrhal, I had often had to use Tuberculinum or Bacillinum in spite of other deep acting Anti-Psorics, for a radical cure of the patient. In fact, I have never cured such cases without these remedies, and I am unable to say what the experiences of others are.
 (3) Asthma cases are very very difficult, as there is always a combination of miasms in them. Besides, while the general symptoms are available, the particulars are mostly absent. This causes difficulty in finding out the similimum.

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-SMALL A. E.,
Is an affection of the lungs and chest, characterised by difficulty of breathing, occurring in paroxysms, attended with suffocation, constrictive sensations, cough, and wheezing. The patient usually sits or stands, his arms elevated so as to lift upward and outward the walls of the chest; often requests the windows and doors to be opened, and makes frequent efforts to expel something from the air passages by hawking or coughing; the face has an anxious expression; the extremities are generally cold; and there is often cold perspiration on the forehead, face or chest; there is frequently palpitation of the heart or arteries, the pulse is

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irregular, quick or intermittent, and expectoration does not always afford relief. It has been divided into the dry and the humid asthma; the attacks of the former are much more sudden, violent, and of shorter duration than those of the latter; the cough is slight, and the expectoration scanty; whilst in moist or humid asthma the attacks come on more slowly, and are more protracted, the cough is unusually more severe, expectoration commences early, and when it becomes copious usually affords relief.

The remedies most used by homoeopathic practitioners are Aconite, Arsenicum, Belladonna, Bryonia, Cuprum, Ipecacuanha, Lachesis, Moschus, Nux vomica, Pulsatilla, Sambucus, Tartar emetic and Veratrum.
Aconitum napellus
For persons of a full or plethoric habit; for young persons and children when there is active palpitation of the heart; congestion to the head; vertigo; or when the paroxysm follows some mental excitement.
DOSE. – One drop of the dilution, or six globules, may be infused in ten spoonfuls of water; give a spoonful every half hour, or in extreme cases it may be given every fifteen minutes, or alternated with Ipecacuanha or Belladonna.
Arsenicum album
Extreme agitation and moaning; exhaustion and anguish as if at the point of death, with cold perspiration; in confirmed asthmatics, and in old people, when the least exertion brings on a paroxysm; or when paroxysms recur soon after lying down, or with remissions, and continue until after a fit of coughing; a few lumps of viscid mucus filled with vesicles is expectorated; also when paroxysms are liable to be brought on by exposure to cold air, or to changes of temperature; sense of weakness or burning pain.

DOSE. – One drop of the dilution, or six globules, in ten spoonfuls of water; a spoonful to be given every four hours, or oftener, according to the urgency and severity of the symptoms.
Belladonna
For plethoric women, and for children of irritable habits, and if subject to spasms; constriction at the throat, with loss of consciousness, gasping for breath, and constant efforts to dilate the chest; constriction, and feeling as if suffocation would ensue.
DOSE. – The same as Aconite.
Bryonia alba
If with the asthmatic symptoms there are pains in the hypochondria, and inability to lie on the right side; or if the patient is constrained to lie on his back; shootings in the chest on breathing deeply, or on coughing, or from movement; difficulty of breathing, aggravated by talking or by movement; cough with expectoration, at first frothy, afterwards glutinous, attended at times with vomiting or retching.
DOSE. – One drop of the dilution, or six globules, in ten spoonfuls of water, give a spoonful every hour; in extreme cases, every half hour, until some change is manifested; after which, select some other remedy for the remaining symptoms.
Cuprum metallicum
For hysterical women after fright or anger, or before or during the menses, when there are spasms, oppression at the chest, with short dry cough, aggravated by talking.
DOSE. – The same as Belladonna.
Ipecacuanha
Spasmodic constriction of the throat in nightly paroxysms, with suffocation and rattling from an accumulation of mucus in the chest; redness and heat, or paleness and coldness, and ghastliness of the face; nausea, and cold perspiration on the forehead; coldness of the feet, anxiety, and dread of suffocation; spasmodic rigidity; feeling as if dust were being drawn into the lungs.

DOSE. – One drop of the dilution, or six globules, in ten spoonfuls of of water; give a spoonful every half hour, or oftener, for one or two hours, or until four doses are given; afterwards, alternate with Arsenicum, or some other indicated remedy.
Lachesis mutus
Wheezing respiration after eating, or attacks of suffocation; worse when lying down, or after sleeping, with sensations of fulness or bloatedness; and for women after the change of life.
DOSE. – Same as Belladonna.
Moschus
Asthma of hysterical females, with spasmodic constrictions, and paroxysms of suffocation, commencing with a fit of coughing, followed by distressing oppression, constriction, almost driving the patient to madness and distraction.
DOSE. – The same as Belladonna.
Nux vomica
Suffocative tightness at the lower part of the thorax, near the stomach and hypochondria; aching and pressive pains in the region of the liver and stomach, with distension of the abdomen and stomach pit; flatulence; inability to endure the slightest pressure, even from the clothing around the chest or waist; clothing seems to press, even when loose; sufferings worse in the morning, or when walking in the open air, especially if cold; also after exertion; alleviated by lying on the back, or by frequently changing the position; for persons of irritable temperament, and for those addicted to the use of ardent spirits. Before or after Arsenicum.
DOSE. – One drop of the dilution, or six globules, in ten spoonfuls of water, a spoonful every half hour during the paroxysm; to be continued afterwards every four hours if necessary; or give Nux vomica, a spoonful at three o’clock, in the afternoon, and at bed time, and Arsenicum at six and at ten o’clock in the morning, to overcome a predisposition to such attacks, every alternate four days, for one month, then wait till the next attack

Pulsatilla pratensis
Asthma of females after cessation of the menses; or from suppression by cold; choking, suffocative paroxysms, with death-like anguish, and palpitation of the heart; much mucus expectoration, streaked with blood, which is at times coagulated, sense of fulness and pressure in the chest. Before or after Lachesis.
DOSE. – One drop of the dilution, or six globules, in ten spoonfuls of water, a spoonful every two hours until a change is effected. In severe cases alternate with Lachesis or Moschus. Also after Aconite.
Sambucus nigra
If the respiration be rapid, laborious, wheezing, with anguish, and dread of suffocation; oppression of the chest, as from a weight, and sometimes with swelling and lividity of the face and hands, sometimes general heat, tremor, and inability to speak above a whisper; worse when lying down; also for children, when they wake from sleep in a start, and exhibit many asthmatic symptoms; also if there is much perspiration. Often useful after Ipecacuanha.
DOSE. – The same as Ipecacuanha.
Antimonium tartaricum
Oppression at the chest, with excessive secretion of mucus, low down in the bronchia; difficult breathing; suffocative cough; and anxiety at the praecordial region; especially for old persons and children, with paroxysms of retching, choking, and suffocation, especially in the evening.
DOSE. – One drop of the dilution, or six globules, in ten spoonfuls of water, a spoonful to be given every half hour, or oftener, according to the symptoms.
Veratrum album
In violent attacks of spasmodic asthma, with suffocative symptoms; coldness of the nose, ears, and feet, with cold perspiration especially in females, before the menstrual period; and if aggravated by movement.
DOSE. – The same as Tartar emetic.

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-JAHR Georg Heinrich Gottlieb

Asthma

Description of disease:
Difficulty of breathing, without fever, occurring at uncertain periods, attended with a suffocating feeling of constriction across the chest, with cough and wheezing respiration. In some cases the cough is dry, and in others attended with expectoration.

Medicinal treatment
Arsenicum album
If there are attacks of suffocations, with great distress and anxiety, or accompanied with great weakness and cold perspiration.
Dose. -Two drops in a dessertspoonful of water, every half hour to four hours in severe cases. In chronic cases, to be taken night and morning.
Bryonia alba
When there is frequent cough, with pains and soreness in the chest or pains under the ribs.
Dose. -As Arsenicum.
Ipecacuanha
If there is great tightness about the chest, or rattling in the chest from an accumulation of mucus, also in nocturnal paroxysms of suffocation.
Dose. -Three drops as Arsenicum.
Nux vomica
Where Arsenicum fails to relieve, and when the asthma is worse after a meal, or there is a short cough with difficult expectoration, and oppression in the lower part of the chest, the clothes feeling tight.
Dose. -As Arsenicum, or if a little relief has been obtained, one drop may be taken every six hours.

Accessory treatment
The patient should sponge the chest daily with cold water, take regular exercise in the open air, keep the surface of the body warm, and avoid damp, wet, and easterly winds. A careful diet should be observed – light, nourishing, and easy of digestion – with an absence of stimulants.

During the asthmatic attack:
Symptoms
A paroxysm of asthma may last from half an hour to two or three hours, and may come on without any assignable cause. There is a sense of constriction about the chest and urgent desire for fresh air, the patient elevates his shoulders and labours to draw in his breath, which enters slowly and with a wheezing sound. In severe cases, the face is flushed or livid, and expressive of anxiety, the eyes are prominent, while the skin gets cold and clammy. Exhaustion is frequently felt after a paroxysm, but good health is often enjoyed in the intervals between.

Medicinal treatment
Ipecacuanha
Should be first administered, if no exciting cause can be traced.
Dose. -Three drops every minutes to half an hour. See under Arsenicum in Asthma.
Aconitum napellus
If the exciting cause has been atmosphere, as fog, or cold, dry air.
Dose. -As Ipecacuanha.
Lobelia inflata
If, on the other hand, the stomach seems to have given the provocation.
Dose. -As Ipecacuanha.

Arsenicum album
May be given after three of four doses of Ipecacuanha, if relief has not been obtained.
Dose. -Two drops as Ipecacuanha.
Accessory treatment
Draw the patient near a large fire, and immerse the feet and legs in warm water, and if there is much pain about the chest, foment the part with hot flannels. Friction over the spine with oil or camphorated oil will frequently benefit; or the paroxysm may often be relieved by a cup of strong coffee, inhaling the steam from hot water, the fumes from burning brown paper, the vapour of spirits of camphor or ether, or by smoking stramonium leaves or tobacco.

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by John H.Clarke.

Paroxysms of difficult breathing, sometimes associated with disease of the heart or chronic bronchitis, and sometimes purely spasmodic, without any affection of the lungs or bronchi. Asthma is often hereditary, and may attack persons of all ages, but is more commonly met with in age than in youth. The paroxysms come on suddenly, often in the night, with a feeling of suffocation and desire to take a long breath. All the muscles of breathing are brought into play, the patient sits up, the head is thrown back, the breathing is laboured, whistling and rattling sounds are heard all over the chest the patient asks for the doors and windows to be thrown open. The face is pale or livid; eyes anxious or protruding; forehead covered with profuse cold sweat. An attack may be brought on by several causes-odours, smoke, dust, irregularity of diet, over-exertion, mental emotions, suppression of accustomed discharges.

Diagnosis.-The diseases likely to be mistaken for asthma are bronchitis, croup, and spasm of the larynx. From bronchitis it is distinguished by the rapid disappearance of the rattling and wheezing on the chest after an attack; by the sudden appearance and disappearance of the attack; and by the fact that the breathing is slow, wheezy, and prolonged, whilst in bronchitis it is hurried. In croup and laryngeal spasm the age of the patient helps to distinguish, children being more liable to these than to asthma; also the character of the breathing; in croup and spasm of the larynx the difficulty is in drawing in a breath, in asthma it is in expelling it.

General Treatment. Relief may be obtained during an attack by plunging the hands into hot water; by bandaging the arms above the elbows, commencing with the left. If the attack is induced by the smell of ipecacuanha, camphor or sweet nitre should be given to smell of; if by inhaling fumes of sulphur, pulsatilla is better. When attacks come on immediately after a meal, chewing a little ginger will relieve. Patients subject to asthma should wear woollen clothing, rub the skin well with a coarse wet towel, and take warm drinks. Those who have dusty occupations should wear respirators.

Medicines.-(To be given in the attack every fifteen minutes until symptoms improve, and then less frequently. In the intervals two or three times a day.)

Ipecac. 3.-

Feeling of constriction about the chest; panting, rattling in the windpipe, as if full of mucus, which seems to be moving up and down. Patient gasps anxiously for breath; face pale, hands and feet cold.

Nux vomica 3.-

When the attack occurs early in the morning; when induced by disorders of the stomach or indiscretions in eating or drinking.

Lobelia 3.-

With nausea and great depression of the heart.

Arsenicum 3.-

Most violent attacks, especially those occurring in consequence of suppressed catarrh, moaning, groaning, uneasy tossing about; in old people who are attacked whilst walking, who can breathe but the distress continues.

Arnica 3.-

When the attack is induced by exertion, speaking, or even blowing the nose; respiration laboured or oppressed, with shooting pains in chest.

Sambucus 3.-

Especially in children, attacks beginning in the night, sweat on throat and neck.

Pulsatilla 3. In blondes, and persons of mild disposition; breath seems to be impeded in lower part of chest, drowsiness, free expectoration.

Sulphur 6.-

In chronic cases; after suppressed eruptions; patients who suffer from skin affections; who have flushes of heat and fainty spells; sinking feeling at the pit of the stomach, worse in the forenoon. The asthma may be dry or accompanied with profuse yellow expectoration.

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