Respiratory Problems

By Dr Russell Malcolm 

Problems  with the respiratory tract are the most common reason for patients  visiting their GPs. This is because our system of airways is a very  vulnerable interface with our environment. Consequently it is a way in  for viruses, bacteria, potential allergens, pollutants and irritants and  it is the primary location for the many illnesses associated with these  triggers.

Mammals have evolved many defence mechanisms to address these  airborne challenges. Our surface immunity is a very complex entity which  involves: agents that we secrete into the surface mucus; agents carried  in the lymphatic ducts, and agents borne by the blood supply. The  various specialised cells, antibodies and enzymes involved in these  processes also require a number of balancing mechanisms including our  ability to:

• invoke a fever on demand;

• generate a protective catarrh;

• preserve the physical movement of air and secretions;

• dynamically alter the balance between the regional perfusion of blood and the air flow into the alveolar sacs.

Fortunately, most respiratory problems  throughout life resolve themselves. Most viral colds and coughs are best  left untreated in the healthy person, because there is simply very  little that can be done to improve the “systems intelligence” that we  have evolved.

Viral infections

Sometimes a viral respiratory illness can linger on uncomfortably.  The symptoms are often a reflection of the virus itself, since different  respiratory viruses preferentially involve different tissues in the  respiratory tract. For example, the rhinovirus causes symptoms mainly in  the nose and sinuses, while the respiratory syncytial virus causes  symptoms in the nasopharynx and smallest branches of the airways,  penultimate to the alveoli in the lungs.

Patients who are overzealous with their  symptomatic drugs, who suppress their fever, or who are otherwise  compromised by a slow immune response, can develop problems with their  defence mechanisms. The more delayed or protracted the response is, the  more they are likely to get swollen lymph glands and persistent catarrh.

A “distracted” immune system will also fail to deal with changes in  the bacterial flora. This can result in secondary growths of  streptococcus, pneumococcus, haemophillus influenzae and other  organisms. These germs colonise the tonsils, middle ear and bronchi  where they can cause considerable local inflammation.

Those infections which provoke a tender swelling of the cervical neck  glands, often require acute remedies like Phytolacca decandra. After a  well-chosen remedy, the lymph glands become much more efficient and the  patient can usually then eradicate the primary infection without further  treatment.

Very few upper respiratory infections require antibiotics, even those  that are bacterial in origin, if they are quickly and expertly  prescribed for homeopathically. The first task is to provide the remedy  which most closely reflects the current physiological state and for this  you will need to consult a qualified practitioner. Depending on the  response, the primary treatment will be followed by a secondary  simillimum, or a potency of the infecting organism itself (nosode) – but  only once the primary acute symptoms are subsiding. The timing of  prescriptions is very important and depends on the “acuteness” of the  presentation, the “reactiveness” of the symptoms, the age of the patient  and the type of remedy used. Most acute illnesses require treatment  with plant remedies.

The timing of the remedy sequence depends on the illness stage. Most  viral illnesses progress through inflammatory, secretory, virus shedding  and resolution stages. Each stage may indicate a change of  prescription, particularly if there is a hitch in the patient’s natural  process of adaptation. Your homeopathic doctor will select remedies on  the basis of the prevailing symptoms, which tend to reflect  inefficiencies in the body’s efforts to compensate. The following is a  simple example of sequenced acute prescribing in viral croup.

Viral croup is a common condition in infancy. The renowned nineteenth  century homeopath, Clemens von Boenninghausen realised the phasic  nature of the condition and the prescribing implications of each stage  in the natural disease process. Boenninghausen’s croup powders  comprising Aconitum napellus, Hepar sulph calc and Spongia tosta were  given sequentially to effect the fastest recovery for each stage.

Influenza

There are several good studies available on the homeopathic treatment of  influenza. Some of these are rather overdue for updating and really  should be distributed to the homeopathic community at large (in time for  the next global pandemic).

Patients should be wary of taking paracetamol-based drugs for the  symptoms of flu as suppressing a fever can sometimes lead to further  complications.

In Europe and the United States Oscillococcinum is a popular  homeopathic medicine which can be bought over the counter for the  prevention and treatment of colds and flu. This product is not licensed  in the UK, but might be obtained with a doctor’s prescription.  Oscillococcinum is derived from the hearts and livers of wild ducks and  was employed in the treatment of influenza, long before it was known  that wild fowl are the main reservoir and carriers for influenza  pandemics. The identification of the acute homeopathic simillimum is,  nevertheless, of paramount importance.

Avoiding formulaic treatments

There is a tendency for some people to prescribe Belladonna for  every fever, when in fact the patient really needs Datura stramonium or  Duboisinum, or Solanum dulcamara, or Baptisia tinctora, or China  officinalis, or Ferrum phosphoricum. Inadequate differentiation by the  prescriber, or the unfocused use of homeopathy simultaneously with  symptomatic drugs and antibiotics, are common causes of failure in  homeopathy.

One of the most obvious abuses is the overuse of Bryonia alba for  coughs. Bryonia is a highly complex remedy with very clear guiding  respiratory symptoms.

Only a very small number of patients with persistent cough actually  respond properly to this remedy (ie those who reflect the Bryonia  “state”). Some manufacturers provide Bryonia in a cough linctus. The  syrups and linctuses to which it is added can themselves offer some  comfort, but I find Bryonia tends actively to block the response to well  prescribed remedies, so I would never use it at the same time as  expertly chosen remedies.

The issue of over-prescribing

It could be argued that over-prescribing is a modern-day problem for  children, who are unable to make informed choices about their own  treatment. Many children have never worked through a viral respiratory  infection without concurrent exposure to paracetamol, ephedrine or  antibiotics. We do not yet know whether drug-mediated alterations of  acute physiology or immunology in our child population might be  implicated in the markedly increased incidence of childhood asthma and  glue ear in recent years. Regardless of whether there are long-term  health consequences to pharmacological meddling during acute childhood  illnesses, it is possible that millions of pounds are wasted on  symptomatic drugs which are needlessly administered for self-limiting  conditions.

Respiratory microflora

One of the most important determinants of health in the respiratory  tract is the state of our microflora. Our bodies are host to many  millions of micro­organisms which are in symbiotic relationships with  each other and with us. There has been a tendency in the past to regard  our microflora as an irrelevant or incidental group of passengers.  Increasingly we are aware that the constituent nature of this microflora  is important to our health.

If our passenger organisms belong to groups that don’t release toxins  or evoke inflammation, their presence can significantly inhibit the  growth of those that can. The microflora of the respiratory tract  changes during an infection, mainly because their physical and immune  environment changes as the sufferer’s body tries to inhibit the agent  causing the disease. When left to itself the flora will usually revert  back to a stable healthy state after the infection has been resolved.

However, when an infection has been prolonged because the patient is  debilitated or subjected to the over­prescribing of symptomatic drugs,  the microflora can evolve to a less healthy state. Groups of less  welcome organisms can overgrow and provoke persistent inflammation and  catarrh. Sometimes persistence of the primary pathogen is responsible,  and homeopathically this might warrant potencies of whatever nosode is  relevant.

However, the residual disturbances in the respiratory microflora are  usually made up of various aerobic bacteria. Many of these are generally  regarded as harmless by bacteriologists, since they are often isolated  from healthy people. When certain subspecies over-colonise, however,  they cause problems which can persist long after the primary infection  and antibiotic treatments are over. Your practitioner may feel they  require a more complex nosode. Sycotic co is one of the most useful  homeopathic nosodes for persisting post-infective catarrh in the ears,  nose, sinuses or lower airways. Sometimes potencies of Morbillinum  (measles) is indicated in children who develop glue ear after measles or  measles vaccination.

Chronic bronchitis

Bronchitis is an inflammation of the airways, which is often  characterised by having a relapsing or “acute on chronic” pattern.  Although each acute flare-up seemingly responds to antibiotics, there is  often a progressive change in the microflora. This is often attended by  excessive secretions and persisting inflammatory change. Smoking and  exposure to environmental irritants often compounds or perpetuates the  problem.

When the perpetuating causes are left untreated, patients tend to  develop increasingly frequent infections, attended with low-grade  relapsing fevers. Longstanding inflammation can ultimately give rise to  more serious cardio-respiratory complications. The cycles of infection  can often be broken by using Chininum sulph, Morgan pure, Bacillinum and  those remedies which alter the secretory environment. Homeopathic  remedies can also be nebulised under medical guidance and this can be a  particularly effective mode of remedy administration during acute  attacks.

In the medium term, patients should be treated between the acute  episodes. This can involve a wide range of remedies depending on the  individual circumstances. In chronic cases, there is nothing in  homeopathy that can fully redress the effects of smoking. Patients with  chronic relapsing respiratory problems must stop smoking completely. The  psychological aspects of the tobacco addiction may be amenable to  homeopathic treatment early in the withdrawal process.

Asthma

There is a tendency to think of asthma as a definitive diagnosis,  when in fact it is a spectrum of conditions, in which the principle  symptom is transient constriction of the small airways. The reason for  this physiological phenomenon can be allergic, infective, physiological  and/or psycho-neuro­endocrine. This essentially means that the systems  which mediate these unstable reactions in the lungs have a network of  causes.

Genetic factors underlie the asthmatic tendency in many cases. An  increased incidence of asthma has also been identified in children of  mothers who have used paracetamol frequently (most days or every day) in  the last trimester of pregnancy. Children brought up in very clean  environments are also at increased risk. In particular, the early  exposure of children to mycobacteria has been shown to lower the  incidence of asthma.

Good monitoring is vital in the treatment of asthma. A homeopathic  doctor will establish whether the presentation is predominantly  allergy-mediated, infective or systemic. Various blood tests and  skin-prick allergy testing can be helpful in establishing this.  Responses to heat, cold, humidity, exercise, stress, menstrual cycles,  drugs, inhalants, sleep/waking cycles and seasons all have significance,  both in determining the category of asthma and in terms of the  treatment programme.

Homeopathic treatment can be highly successful for asthmatic  patients. Nevertheless, no one should forget that a severe acute attack  can be fatal. There is no room for complacency. Both the monitoring and  treatment process has to dovetail in a responsible and consistent way  with established orthodox guidelines for good practice.

Those asthmatics who are affected in September, as the weather gets  colder, often have a demonstrable allergy to house dust mite. As heating  devices are turned up in the autumn, much morehouse dust is borne by  the resulting convection, to be inhaled by the sufferer. This allergic  challenge can be compounded by viral challenges that prevail at this  time of the year. Regular doses of homeopathic house dust mite in  August, in combination with household measures to reduce exposure, can  help to prevent autumn aggravations.

Pneumonia

One of the most common misapprehensions concerning homeopathy  relates to its potential in serious illness. Many people mistakenly  assume that this gentle therapy is only effective in mild conditions.  Before the advent of antibiotics, the Royal London Homoeopathic Hospital  received patients suffering from severe infections, on transfer from  other hospitals in the city where there was no possibility for active  treatment.

Case records from the beginning of the 20th century make interesting  reading. They contain details of patients who recovered, under  homeopathic treatment, from pneumonias and other severe infections. It  is important to remember, however, that, among the successes, there are  also a number of patients treated at the beginning of the 20th century,  who died and who would probably have survived with modern intensive  care.

The converse irony is that today, after years of over-prescribing,  increasing numbers of our antibiotics are becoming ineffective, with the  emergence of resistant bacterial strains. We can onlyhope that  prejudice will not prevent the medical community from tapping into a  long neglected homeopathic knowledge base, for the sake of these  patients.

In severe acute cases a doctor’s primary responsibility is to the  safety of the patient. Miss S presented acutely with a severe chest  infection and bronchospasm on a Friday afternoon. She was severely  breathless at rest and virtually unable to speak. This patient did not  want hospital admission. We insisted, however, that she demonstrate an  unequivocal remedy response within 30 minutes, or emergency hospital  admission would be arranged for her. Her air entry began to improve  rapidly following homeopathic Squilla maritima and she returned home  with a remedy sequence and strict instructions to call for help if the  improvement was not maintained. By the time of her review, on the  following Monday, she was markedly improved. She was completely free of  respiratory signs and symptoms by the end of that week.

An integrated approach

Today’s medical homeopaths have access to many investigative  technologies that were unknown to their predecessors and these can  profoundly influence the homeopathic approach. These investigations  allow the homeopathic physician to select the correct nosode, for  example, or a remedy with the best known affinities for the tissue or  organ involved.

Mr S had aspergillus, a fungal mass in his right lung which caused  chronic suppuration. In this condition there is both an infective  component and an allergic component, since the fungus produces spores  which generate an allergic response resulting in “asthmatic spasm” of  the airways and the trapping of infected secretions. In Mr S the  homeopathic treatment was completely dependant on the accuracy of his  diagnosis. Three doses of homeopathic Pneumonia air Aspergillus 30c,  caused a very rapid dilatation of his bronchioles and the release of  enormous quantities of infected material, pus and dead tissue. The  respiratory physicians, who shared his care, were astounded by the  changes in his X-ray appearance and lung-function tests.

There is a great potential for the increasing integration of  homeopathy in the management of respiratory illness. Much of this  potential is gradually becoming realised in our educational programmes,  where a pragmatic approach to the teaching of therapeutics will  increasingly enable doctors to treat acute cases responsibly and  homeopathically and thus prevent a great deal of chronic illness.

Russell Malcolm MB ChB FFHom is a former Director of Education at the  Royal London Homeopathic Hospital, he continues to contribute to homeopathic education, both in the UK and internationally.