Series XIII NORTH AMERICAN JOURNAL OF HOMOEOPATHY. Original Articles in Medicine. OUR COUGH REMEDIES.* By A. C. COWPERTHWAITE, M. D., Chicago, Ill. N considering the cough remedies of the Homoeopathic Materia Medica, I shall only mention those that are of most frequent use, and which experience has taught are most efficacious in the treatment of the variety of coughs most often met with in ordinary pracIt should be remembered, however, that our armamentarium. possesses a great number of remedies that may be curative in coughs presenting uncommon peculiarities. True, these coughs are often cured in a bungling sort of a way by remedies that while not well indicated partially cover the general pathogenesis or rather the general pathological state, according to crude ideas of reasoning. Such cures are never so prompt and perfect as are those brought about by the administration of the well-indicated remedy. There is no place where crude generalization works so poorly as in the treatment of coughs. It is unfortunate here, as elsewhere, that the repertory is fast falling into disuse, for it is only by a careful study of symptomatology that we can perform creditable cures. It is the physician who fails to appreciate this fact, or who is too careless or too lazy to put it in practice who soon comes to depend upon palliatives in the treatment of coughs, and vies with his allopathic neighbor in prescribing the various compounds and syrups put upon the market by manufacturing chemists, the effectual ingredient of all which is either morphine or codeine and chloroform. *Written especially for the NORTH AMERICAN. I would be glad to give brief indications for the use of the less commonly used remedies in cough, but their name is legion, and such a course would carry this paper far beyond a desirable length. Then, too, it must be borne in mind that while a remedy for cough. is usually selected from the character of the cough and the expectoration, yet this is not always the case, and not infrequently we are led to prescribe, especially the rarer cough remedies, on account of some peculiarity or symptom not apparently connected with the cough itself. At all times the concomitant symptoms must have great weight in the selection of the remedy. It is remarkable, however, how often we find that the remedy that covers the cough and expectoration also covers the associated symptoms. As an illustration take stannum. In a great majority of instances where we find the profuse expectoration of stannum we also find the characteristic sense of weakness in the chest. The same holds true of many other remedies, and seems to make more easy the work of an intelligent and conscientious prescriber. I shall, in a general way, mention remedies in the order of their comparative usefulness, or rather, of their frequency of administration, their pathogenesis being such that they more often correspond to the symptoms of the case, and for that reason are more often curative. Such an arrangement is purely arbitrary, as my opinion on this question may be no better than some other writer who might, on the same grounds, arrange the remedies in a decidedly different order. Many physicians become routinists in the prescribing for coughs, as well as for other conditions. I know of one, who almost invariably prescribes kali bich. for cough, regardless of indications. The same physician also always prescribes gels. for fever and merc. cor. for diarrhoea, and while distinguished in certain lines of medical and surgical work, considers it beneath his dignity to spend any time whatever in consulting symptomatology. If we would spend more time in the latter occupation there would be less need for the specialist, as homoeopathy is just as able to-day, as it has gloriously been in the past, to cure many of the diseases that are now almost immediately sentenced to the speculum and the knife, and that, too, by homoeopathic specialists, many of whom have only regard for the fee they expect to receive, and more of whom are ambitious to be accounted as "scientific," according as that word goes in the present age. Bryonia. Perhaps this remedy deserves that place, not so much because it is oftenest prescribed for cough, as for the fact that when indicated it usually comes in ahead of other remedies. It is often the first remedy indicated when an acute catarrhal condition is first localizing in the respiratory tract, and a cough is developing, which is usually dry and rough, with a little thin mucous expectoration and accompanied by considerable soreness of the chest. The cough is always worse in a warm room, especially on coming in from the cold air, and is worse from moving about. Bryonia is a remedy most useful after the violent general symptoms of an acute inflammation have begun to subside and localization with product formation is about to take place or has already just occurred. This holds true in other localities, but is especially applicable in respiratory inflammations, whether there be a tracheitis, bronchitis, pneumonial or pleurisy. In the latter the well-known stitching pains of bryonia causes it to be often indicated, and these pains may be present and assist in indicating bryonia when the pleura are not involved. This drug is unfortunate in being pretty nearly always handicapped in its good work by being prescribed in alternation with some other drug, notably aconite. The stage of usefulness for bryonia only begins when that of aconite et al. ends, and on the other hand, that of bryonia ends when that of phosphorus, et al begins. These various drugs follow each other well, and are complementary, but their alternation is neither scientifically or practically correct. Phosphorus. It is altogether likely that, in a general way, phosphorus deserves first place as a cough remedy. As has already been suggested, its sphere of usefulness usually begins after bryonia and similar remedies would cease to be indicated, whether in an advancing catarrhal condition ending in bronchitis, laryngitis, tracheitis or in a pneumonia. Phosphorus is never indicated early, but only after product formation is fully established. In the first-mentioned the cough is dry, caused by tickling in the trachea, some mucous expectoration, and accompanied by soreness, oppression and constriction of the chest, the latter being an important differentiating symptom. The cough is usually worse when the patient lies on the left side, worse from talking, laughing or reading, and contrary to bryonia, is better indoors and worse when going from warm to cold air. In pneumonia phosphorus is indicated where there is a dry cough with bloody mucus, or rust-colored expectoration, with violent oppression or tightness of the chest. It may also be useful in tuberculosis when the hollow, hacking cough is present. Kali Bichronicum.—This drug is frequently prescribed for and is of great value in subacute and chronic inflammations of the lower air passages, but is never of value in the early stages. The cough is usually dry, deep, rough, hoarse, and accompanied by a difficult, tough, stringy mucous expectoration. Kali is often needed for the hard, deep coughs that prevail after a common cold. While the tightness and constriction of phosphorus are not present, yet there is no element of looseness in the cough itself, wherein it differs from hepar sulphur. The cough is usually brought on by tickling in the trachea or at the bifurcation of the bronchi, and, according to clinical observations, is worse after eating, when undressing, and in the morning on walking, better after getting warm in bed and when exercising. The usefulness of kali in membranous croup, with symptoms characteristic of that disease, has led to its abuse in being empirically prescribed in all forms of croup in all stages, regardless of indications. It is usually only indicated in the later stages and when there is little or no fever. Hepar Sulphur.-This is the chief remedy for a loose cough. With the looseness there is some rattling, but not to the same extent as in ipecac or tartar emetic, where the air passages are so full of mucus that there is a constant rattling sound during inspiration and expiration, which is not present in hepar. Neither is there the same constant tendency to vomiting of mucus, oppression of breathing and cyanosis. For this reason it is rarely a remedy for whooping cough, but is chiefly indicated in laryngeal and bronchial coughs. It is often a remedy in croup, and was the number three of Bonninghausen's famous trio of croup remedies-aconite, spongia and hepar sulphur, which he prescribed in rotation (not alternation). In croup there is great hoarseness, whistling breathing, and hard, barking cough, accompanied by a rattling of mucus, the latter differentiating from spongia and kali bich., and the absence of a dry, hot skin from aconite, the hepar patient being usually moist. It follows spongia well, and is often the remedy after spongia has been. used. In hepar the cough is often brought on from being uncovered, or any portion of the body becoming cold. It is very characteristic that the hepar patient is very sensitive to cold air and has a tendency to easy and profuse perspiration. Rumex Crispus.-This remedy is of great value in coughs accompanying acute catarrh of the larynx or bronchi, or from laryngeo-tracheal irritation. The chief feature of the drug is that the cough is always produced by tickling in the throat-pit, and has invariably associated with it a raw sensation behind the sternum. Under such circumstances its effects are marvelous. The cough is |