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Пневмония — основные препараты

Main remedies for early stage pneumonia

In the first days of the illness when the case is primarily represented by fever, chills and acute cough, we think of the following remedies, arranged in order of most rapid onset first:

Aconitum napellus
Sudden onset of a serious condition in normally robust patients.
Usually from exposure to cold, wind or sudden shocks.
High fever is the rule, almost always over 103  F.
Disposition: Restless, anxious or frightened. The patient classically has a strong fear of death or presentiment of death. Desires company. (This is not required for the remedy to be correct.)
Signs: Pulse bounding.
Face flushed. Hot, dry skin.
The pupils may be constricted.
Intense thirst for cold drinks.
Cough: Dry, painful cough in first hours.
Better: When sitting.
Expectoration: After the first few hours, the sputum becomes bloody: "Cherry red."
Location: Left sided pneumonia, especially the left upper lobe.
Sulphur is the main complementary to Aconite and often finishes the cure.

Belladonna
Sudden onset, also after exposure in robust persons.
High fever is the rule, almost always over 103Ю F.
Disposition: Rapidly develops delirium and vivid or scary hallucinations.
Signs: Bright red flushed face. Pulse bounding.
Burning hot face but cold feet and hands. Pupils dilated.
Photophobia. Dry mouth but generally thirstless. Desires lemonade.
Severe headache and throbbing.
Worse: Jarring. Motion. Cough.
Cough: Dry and painful cough. Head feels it will split open.
Worse: From motion. Lying on the right side.
Location: Mainly on the right side.

Bryonia alba
Slow onset beginning with an upper respiratory infection with malaise and sneezing. By the second day cracked lips, low grade fever. By the third or fourth day high fever and serious illness are apparent.
Disposition: Irritable. Averse to company, to being disturbed.
May have many business worries. In delirium asks to be taken home.
Signs: Dusky flush of the face.
Tongue coated white or yellow or especially dirty brown, chiefly in the center of the tongue.
General: Worse from heat; better in a cool room.
Thirst is extreme, especially for large amounts of cold water.
Symptoms aggravated at 9 PM.
Both pains and cough are aggravated by motion.
Cough: Intense pains with each cough; holds the chest.
Pleuritic pains.
Worse: Motion. Deep inspiration. Pants to avoid taking a deep breath which he knows will trigger a painful cough.
Expectoration: Dark or brown, sticky mucus which is difficult to expel.
Local: Left frontal headache extending to occiput.
Severe headache with stitching or bursting pains.
Worse: Cough. Movement.
Aching throughout muscles.
Worse: Motion. Jarring.
Location: Mainly right-sided pneumonia.

Chelidonium majus
Slow onset and often applies to later stages of pneumonia.
Disposition: Irritable and snappy.
Signs: Yellow hue to face and tongue.
General: Craving for warm drinks. Retains only warm drinks.
Worse: 4 AM or 4 PM.
Cough: Profuse expectoration. Cough better sitting or leaning forward. Mucus flies out of the mouth forcibly.
Local: Marked pain or stitches about the right scapula or shoulder area.
Right foot or hand cold with the left side normal.
Location: Right-sided pneumonia.

Ferrum phosphoricum
Develops more slowly, over one or two days.
High fever is the rule, almost always over 103Ю F.
Disposition: Prefers to be left alone.
There may be a surprising absence of symptoms besides the high fever.
Signs: Rapid pulse. Malar, circumscribed flush. Pallor about the mouth.
Some authors have described friction rub as a common finding.
General: Thirst extreme for cold drinks.
Cough: Incessant cough with irritation behind the sternum.
Worse: Cold, Drafts.
Expectoration: Blood streaked sputum in bright, red streaks.
Location: Right-sided pneumonia, especially the right upper lobe.

Ipecacuanha
Especially a remedy for children and infants. Onset over two to three days.
Fever is less high - (102Ю to 103Ю F).
Disposition: Irritable. Capricious. Cannot be pleased.
Signs: Flushed face. Sweats. Then followed by exhaustion and pallor.
Cyanosis, especially during the coughing paroxysm.
Tongue is generally clean, red and smooth.
Wheezing and marked dyspnea.
Cough: Suffocative episodes followed by violent paroxysm of cough accompanied by retching and vomiting.
Worse: 7 PM. Heat.
Better: Open air.
Expectoration: Stringy sputum sometimes with bright, red blood.
Location: Any.
Main remedy in bronchiolitis. Interstitial pneumonitis.

Veratrum viride
Sudden, rapid rise in fever to 104Ю F or more.
Disposition: Excited. Fearful.
Signs: Intense pulsation of whole body. Heart bounding and pulse rate inappropriately high - 140 or 150 beats per minute.
Pupils dilated.
Tongue yellow or with a bright red stripe down the center.
Cold perspiration on the forehead.
General: Profuse perspiration with beads of sweat covering the body.
Intense thirst.
Nausea and vomiting.
Cough: Difficult expectoration.

Phosphorus
Symptoms rapidly develop (not so fast as Aconite or Belladonna),though also indicated in later stages of disease.
Fever quite high, over 102Ю F.
Disposition: Anxious, fearful and suffering. Strong need for company.
Signs: Hot, dry skin. Tongue coated white.
Face is twitching. Hands trembling.
General: Great thirst for cold drinks.
Chills easily. Aggravated by cold air.
Cough: Dry, tickling cough in the first days.
Loose cough with bright, red bloody expectoration.
Worse: Lying on the left side. Cold air.
Better: Cold drinks.
Anxious dyspnea; sits upright with head tilted backward.
Late stages with tormenting cough; chest burns with each cough.
Expectoration: Loose cough with bright, red bloody expectoration.
Marked expectoration following eating.
Local: Severe headache from each paroxysm of coughing.
Heaviness of the chest; as if a weight upon the chest.
Numbness of fingertips.
Location: Mainly in right lower lobar pneumonia.
Main remedies for advanced stage pneumonia
When the fever and acute symptoms have passed to some degree, the patient passes into an even more serious stage of illness. The following are some of the most important remedies to consider in later stages.

Arsenicum album
Later stages and collapsed states.
Disposition: At first restless and anxious with fear of death and desire for company. Later too exhausted to move and lies as if dead.
Once strength returns a little the restlessness begins anew.
Signs: Collapsed. Cold and prostrated. Rigors from slight drafts.
Tongue coated white; burning tongue. Offensive breath or sputum.
General: Chilly and desires warmth.
Worse: 12 to 1 AM.
Thirsty for sips of cold water.
Burning pains through whole respiratory tract.
Cough: Tight chest. Chest burns with each cough.
Worse: Lying; must sit up. Feels suffocated if lays flat.
Expectoration: Scant expectoration. Frothy sputum.
Location: Mainly right-sided pneumonia.
Often affecting the right upper lobe.

Kalium carbonicum
Later stages, generally the second day onward. Especially in children.
Disposition: Conscious but withdrawn as if all the energy is going into fighting the illness. Touchy. Desires company. Anxious.
Signs: Puffiness of the eyelids; swollen lids.
General: Thirsty, mainly room temperature liquids.
Chills. Worse from even a slight draft.
Cough: Suffocative cough with copious, cold perspiration.
Worse: 2 to 4 AM. Drafts. Lying on the right side.
Better: Sitting upright or even bent forward.
Sputum difficult to expectorate; must swallow the mucus.
Location: Right lower lobe (some authors mention left lower lobe).

Lycopodium clavatum
After the early stage has passed, especially on the third day or later.
Fever is less impressive, it may be high or not present at all.
Disposition: Anxious. Weak and even stuporous.
Signs: Brow furrowed. Flaring or fanning of alae nasi.
Froth at the corners of the mouth. Lips blue.
Tongue swollen and stiff and coated white.
Perspiration heavy and night sweats.
Cough: Hacking cough with no expectoration. Some cases have violent paroxysms of cough producing copious amounts of yellow mucus.
Worse: 4 to 8 PM. Lying on back.
Heavy chest; oppressed breathing.
Location: Right-sided pneumonia.

Sulphur
Later stages, generally the second day onward.
Disposition: Weary. Low-spirited. Complaining. Despair.
Fear of death.
Look dirty or greasy - don't want to change their clothing.
Signs: Red flush of face. Red lips and eyes injected. Greasy hair.
General: Dry mouth. Thirsty for cold drinks.
Chill easily but aggravated heat or aggravated heat and cold.
Heavy perspiration.
Cough: Pain in sternum with cough; pain extends to the back.
Worse: Night in bed. Talking.
Heavy chest.
Expectoration: Scant expectoration. Sputum yellow or green.
Location: Left-sided pneumonia (or right).

Other important remedies for advanced stage pneumonia

Antimonium tartaricum
Late stage pneumonia with collapse especially in infants and aged people.
Disposition: Irritable and peevish. Averse to being touched.
Miserable.
Signs: Lips cyanotic.
Sunken or gaunt features.
Cold sweat on face.
Flapping of the alae nasi.
Uses all accessory muscles; neck muscles strain with each inhalation.
Tongue coated thick and white.
Pulse weak and thready. Tremulous.
General: Chilly but aggravated by heat. Desires to be fanned.
Better: Sitting propped.
Thirsty for cold drinks (other times thirstless).
Loathing of food. Nausea.
Cough: Rattling chest. Weak, unproductive, wet sounding cough.
Better: Sitting.
Suffocative sensations. Even the blanket oppresses.
Expectoration: Whitish, purulent mucus.

Carbo vegetabilis
Late stages of pneumonia with collapse.
Disposition: Apathetic or even comatose.
Signs: Face or lips blue. Cold breath.
Face is puffy, bloated and mottled.
Cold perspiration, especially on the forehead.
General: Cold but averse to being covered.
Wants to be fanned. Wants open air.
Cannot lie flat.
Cough: Paroxysm of cough.
Worse: Lying flat.
Better: Sitting.
Expectoration: Copious, difficult expectoration and retching.
Local: Chest feels heavy, as if a weight.
Burning in chest with each cough.
Weak chest with much rattling.

Kalium iodatum
First remedy to be thought of in cases with repeated pneumonia.
Disposition: Irritable. Jesting.
Signs: Swelling of the eyelids. Night sweats.
General: Restless and warm-blooded.
Worse: Heat. Warm rooms. Night, especially from 2 to 5 am.
Better: Open air.
Cough: Cough with pains extending through to the back.
Worse: Night.
Better: Sitting.
Expectoration: Thick, green, salty expectoration.
Mucus seems to come from deep in the chest.
Location: Right-sided pneumonia.

Laurocerasus
Lingering pneumonia; patient is failing or shows no sign of recovery.
Disposition: Apathetic. Stuporous.
Signs: Cyanosis of lips, face, fingernails.
General: Horribly chilly, as if the body generates no heat at all.
Short of breath with slight exertion. Markedly weak.
Chest feels weak on talking aloud (Stann).
Unable even to sit without breathlessness; must lie down.
Gasping respiration, verging on respiratory arrest.
Cough: Paroxysms of cough with mild mucus or blood tinged sputum.
Worse: 2 PM. Lying (opposite of dyspnea). Better: Sitting.
Expectoration: Mucus with points of bright red blood.

Pulsatilla pratensis
Pneumonia with loose, productive cough.
Disposition: Weepy and anxious; desires company and affection.
Signs: Red, flushed face.
Tongue coated thick white.
General: Great heat and desire for cold. Also mixed with chills.
Great sense of oppression and desire for open air.
Thirstless, often despite dry mouth.
Marked dyspnea and desire to be propped-up in bed.
Cough: Loose cough with easy production of mucus.
Violent, gagging cough with a feeling of something tearing loose.
Copious expectoration in morning on rising.
Expectoration: Green or yellow-green, juicy mucus.
Tenacious, yellow, bloody sputum (in advanced cases).
Bitter or salty, offensive expectoration.
Local: Begins with coryza or otitis.

Rhus toxicodendron
Later stages of pneumonia.
Disposition: Restless. Anxious. Stuporous with muttering.
Signs: Red tip to the tongue. Dry tongue. Perspiration on whole body except the head.
General: Physical restlessness and great aching.
Worse: Cold, damp weather or from getting wet.
Sudden chills and fever in paroxysms.
Cough: Worse: Cold. When the chills come on.
Expectoration: Thick sputum, may be "rusty" with old blood.

Senega
Pneumonia especially in elderly or in those with chronic chest troubles.
Appearance: Hot, flushed, sweaty face, especially when coughing.
Face may be bluish, cyanotic.
Lies propped up in bed or wants to sit upright.
General: Marked oppression of chest and dyspnea.
Cough: Hard, racking, irritated cough with difficult expectoration.
Worse: Cold. Lying. Open air or drafts. Change of temperature.
Cough ends in sneezing.
Expectoration: White or transparent viscid, stringy mucus.
Unable to cough out mucus, must swallow it.
Local: Marked hoarseness and scraping from larynx.
Rattling chest (Ant-T).
Soreness and tenderness of the chest wall, especially left side.

Stannum metallicum
Late stages and in the recovery phase.
Disposition: Sad and depleted.
Signs: Trembling with weakness. Marked night sweats.
General: Great, prolonged weakness.
Worse: Speaking, from slight exertion - even walking to the toilet exhausts him.
Cough: Paroxysms of cough, worse from speaking.
Sputum is thick and has a peculiar salty or sweetish taste.
Hollow sensation in the chest; must hold the chest when he coughs.
Weak feeling in chest, worse from the effort of speaking.
Expectoration: Easy expectoration, does not struggle to raise it.
Salty or sickly sweet taste. Yellow, green, or gray offensive sputum.
Other important remedies to consider: Ammoniacum, Arnica, Calcarea Carbonica, Hepar Sulphur, Iodum, Kali Bichromicum, Kali Sulphuricum, Lachesis, Lobelia, Mercurius, Natrum Sulphuricum, Sanguinaria, Silica, Spongia, Thuja, Tuberculinum.

 

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