• ACUTE BRONCHITIS

    Synonym: Bronchial Catarrh.

    Definition: Acute bronchitis is an Acute inflammation of mucous membrane of bronchial tubes characterized by fever, purulent expectoration and loud rhonchi.

    CLINICAL FEATURES
    Symptoms
    Onset acute.
    Fever.
    Cough
    Expectoration
    Initially
    Scanty, Difficult, Mucoid.
    Later on
    • Copious.
    • Easy.
    • Muco-purulent.
    Soreness
    . Behind sternum.
    . Worse coughing.
    – Tightness of chest.
    – Dyspnoea.
    – Wheezing.

    SIGNS
    – Temperature: 38°C-39°C.

    – On auscultation chest:

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    . Bilateral loud rhonchi, both inspiratow and expiratory.
    – Bilateral diffuse, coarse crepitations.

    ETIOLOGY (Cause of Acute bronchitis)
    Causative organism

    . Viral:
    – Haemophilus irifiuenzae.
    Bacterial:
    – Pneumococcus.
    – Staphylococcus aureus.
    Predisposing causes
    – General debility.
    – Preceding viral infections,
    – Lack of immunisation for
    • Measles.
    Pertussis.
    .Weather:
    Cold, damp weather.
    Dusty environment
    – Chronic mouth breathing.
    – Imrnuno-compromised subjects.
    – Subjects with
    . Congenital heart disease.
    . Mitral stenosis.
    – Age: children and young adults1

    COMPLICATIONS
    – Severe bronchospasm.

    – Chronic bronchitis.

    INVESTI GATIONS
    Blood

    – TLC: Leucocytosis.
    – DLC: Polymorphs raised.
    X-Ray chest
    – Increased pen-bronchial shadows.

    PROGNOSIS
    – Mild attack resolves in 7-10 days.

    – Slight morning cough persists for another week.
    – Severe attack lasts for 3-4 weeks.
    – Prognosis is good.

    MIASMATIC CLEAVAGE
    – Acute miasmatic disorder.

    THERAPEUTIC AIM
    – To cure.

    – To prevent complications.

    GENERAL MANAGEMENT
    – Bed rest.

    – Steam inhalation.
    – Avoid exposure to cold.
    – Well balanced, nutritious diet.

    HOMOEOPATHIC TREATMENT
    Early

    – Aconite.
    – Arsenicum album.
    – Bryonia Alb.
    – Blatta Orientalis.
    – Dulcamara.
    – Gelsemium.
    – Causticum.
    – Hepar Sulphunicum.
    – Justicea.
    – Ipecacuanha.
    – Late
    – Blatta orientalis.
    – Kali bichromicum.
    – Kali suiphuricum.
    – Mercurius solubilis.
    – Natrum sulphuricum.
    – Stannum metallicum.

    Reference to CCRII Annual report 2001-2002 related to the clinical research in:

    Disease related clinical research in bronchitis, following drugs have been identified as most

    effective from the assign list:
    – Senega.
    – Kali Iod.
    – Antimonium Iodatum.
    CCRH Observations in bronchitis; drugs evaluated are: Ammoniacum deroma, Antimonium iodatum, Eucalyptus globules, Justicea adhatoda, Kali iodatum, Lobelia inflata, Luffa operculata, Senega, Solanicum aceticum. The Senega and Kali iodatum and Antimonium iodatum were the most effective from the group assigned for bronchitis.

    Therapeutics

    Aconite: Suitable at the onset of the affection. Bronchitis, as a result of checked perspiration, exposure to cold drafts or dry, cold winds, a cold starts with a coryza, frequent sneezing, chilliness, restless sleep, full, hard pulse, and the characteristic mental state. This stage is a brief one.

    Gelsemium: Aconite is supplanted by Gelsemium. The restlessness is much less, with relative bradycardia, and drowsiness. Cold, with short and dry cough, the lungs are sore, and the breathing is somewhat oppressed.

    Veratrum viride: It suits violent cases, temperature is high, pulse; full, hard, rapid, with great heat of the body. No anxiety and no restlessness.

    Belladonna: Bronchitis with a violent fever, with short, dry, continual, distressing cough, worse at night and on lying down. The breathing is irregular and hurried, no expectoration, or, if present, it is bldodstreaked. Fullness in chest. The skin is hot and moist (D/D; not dry like Aconite or Veratrum viride). Can not sleep, but dozes in semiconscious state and starts frequently.

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    Bryonia Alb: Cough is very severe and dry, hurts head and distant parts of the body. Patient presses the hands on the sides of the chest while coughing to relieve the pain. There iš great pressure over the sternum, dyspnoea. The cough is provoked from the irritatiOn in the larger bronchi, and the hacking causes sore spots in the trachea and chest. Stitching pains in the sides. The cougif is aggravated by coming into a warm room from the cold air.

    Phosphorus: Sub-acute cases of bronchitis, most suitable in delicate, tall, slender, overgrown persons. There is a paroxysmal cough with pain under the sternum. Suffocative pressure in the upper part of the chest with constriction of the larynx, hoarseness. On auscultation; mucous raies. Expectoration; mucoid, bloody or puruient, salty or sweetish taste. Tendency is toward pneumonia. Cough is worse after meals and going into open air, any use of the voice.

    Hepar Sulphur: Subacute cases; when the cough begins to loosen and becomes rattling, fatiguing and choking. On auscultaation; medium crepitus present.

    Mercurius: Roughness and soreness from the fauces down through the middle of the chest, a dry, raw very exhausting cough. Sputum watery, saliva-like, or yellow and muco-puruient. Fever with alternate chill and heat, desire for cold drinks, which aggravate the cough. Sweat without relief.

    Kali Bichromicum: Sub-acute bronchitis. Cough with tough, tenacious, glutinous expectoration, it can be, drawn out in long strings. Cough is worse towards morning , the tightness seems to be at the epigastrium.

    Antimonium Tartaricum: Remedy is most suitable for old people. On auscultation coarse crepitus all over the chest. Cough sounds loose, but no phlegm is raised. In children the cough is infrequent, and the child becomes drowsy, the respiration is superficial, requiring labored efforts of the respiratory muscles, and vomiting of food and mucus may be present.

    Ipecacuanha: Bronchitis in children. On auscultation coarse crepitations. Much coughing, but the child can raise little phlegm causing large accumulation of mucus. Spasmodic cough, nausea and vomiting.

    Baryta Carbonica: Loud rattling in the chest, but the patient cannot raise.

    Ammonium Causticum: Copious accumulation of mucus in the lungs with incessant cough.

    Antimonium Iodatum: Yellow, muco-purulentxpectoration.

    Antinionium Arsenicosum: Most useful remedy and corresponds to capillary bronchitis.

    Sulphur: Chronic bronchitis. Catarrh of the bronchial mucous membranes is accompanied with loud rales, a persistent, profuse, thick, muco purulent expectoration and attended by suffocative attacks.

    Balsam Peruvianurn: Bronchial catarrh, with oud raies and profuse muco-purulent, thick, reamy expectoration.

    Bacillinum: Suits especially to individuals who are constantly catching cold. Frequent elapses of bronchitis.

    Carbo Vegetabilis: Bronchitis of old people with profuse, yellow, foetid expectoration, yspnoea, much rattling in the chest, and burning.

    Senega: Irritating cough and the phlegm is adhesive with a pressing pain in the chest, when spiring, moving or coughing.

    Lachesis: Cough comes on when the patient about to drop of to sleep.

    Arsenicum Album: Cough with violent dyspnoea.
    Sicilla: Obstinate chronic bronchitis; cough with stitches in the chest, expectoration transparent or muco-purulent.

    Dulcamara: Bronchial catarrhs of old people with a very free greenish expectoration, worse from change of weather to cold and wet.

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