Dr. Amrit Kalsi Chief Medical Officer (H) Directorate of AYUSH (Homoeopathic Wing), Govt of NCT of Delhi In-charge Delhi Government Health Center, Jwalapuri

1. DIAGNOSTIC APPROACH TO MATERIA MEDICA
(DR. AMIT ARORA & DR. UDESH KUMAR)

2. Abstract: The Materia Medica is full of gems (i.e.
symptoms). Each symptom or a group of symptoms indicate
toward a diagnosis of a specific disease. My approach in this
article is to convert the symptomatic language of Materia
Medica into a diagnostic form, so as to show therapeutic
indications of that remedy. When in these common diagnostic
symptoms, the particular individual modalities are added;
they become the homoeopathic prescribing symptoms. In
this section we have describe some of drugs which consist of
symptoms related to chronic respiratory disorders like
Asthma, Chronic bronchitis, bronchiectasis, Allergic rhinitis,
sinusitis, chronic laryngitis and some cardiac conditions
giving rise to respiratory distress.

3. The cardinal symptoms of respiratory system are Cough, breathlessness, sputum and
sometimes pain in chest and haemoptysis. Some diagnoses related to different types of
cough are listed here:
•Dry or unproductive: Upper respiratory tract infection, bronchiogenic carcinoma,
smoker’s cough, bronchial asthma, psychogenic cough.
•Wet or productive: Bronchiectasis, fungal infections
•Paroxysmal: Asthma, cardiac failure.
•With wheezing: Asthma, chronic bronchitis, tropical eosinophilia
•Nocturnal: Asthma, post nasal drip in chronic sinusitis, reflux oesophagitis.
•In early hours of morning: Asthma, tropical eosinophilia.
•Winter episodes: Chronic bronchitis. 1
•Hacking (short, dry, irritating cough): in congestive conditions of pharynx and
upper respiratory passages, smoker’s cough.
•Cough related to exertion: Chronic bronchitis, Asthma, Bronchial carcinoma,
Interstitial lung disease, obesity, heart failure and valvular heart disease mainly mitral
stenosis and aortic regurgitation. .
•Cough related to meals: Hiatus hernia, oesophageal diverticula, trachea-oesophageal
fistula.
•Recent worsening in case of chronic cough: is a common presenting symptom of
bronchiogenic carcinoma.

4. Some drugs related to chronic respiratory
disorders along with the probable diagnosis
are:

5. 1. Ambra Grisea:
a) Violent cough is spasmodic paroxysms, with eructation (Allen) –
signifies reflex cough from reflex irritation of vagus, that is
cough due to distension of stomach, cough due to gastro-esophageal
reflux disorder.
b) Cough worse talking and reading aloud (Allen)– chronic
laryngitis.
c) Cough worse in presence of people (Boericke) - Psychogenic
cough

6. 2. Ammonium carbonicum: Ammonia has a specific action on mucous
membrane of respiratory organs, causes inflammation of bronchial mucous
membrane.
a) Stoppage of nose, mostly at night (Allen) – Chronic sinusitis, Nasal polyp,
hypertrophied nasal turbinates.
b) One of best remedy in emphysema (Allen)
c) Cough from tickling in throat as from dust (Allen) – Chronic laryngitis, cough
due to post-nasal drip in sinusitis.
d) Loses breath when falling asleep (Allen) – Asthma, Chronic heart failure,
Pulmonary oedema, sleep apnoea.
e) Dyspnoea with palpitation (Allen) - clinical diagnosis could be dyspnoea due
to valvular heart disease mainly mitral stenosis and aortic regurgitation.
f) Dyspnoea worse by exertion or on ascending few steps (Allen) – Grade I
dyspnoea, can occur in early stages of chronic bronchitis, Asthma, Bronchial
carcinoma, Interstitial lung disease, obesity, heart failure, valvular heart
disease, cardiomyopathy.

7. 3. Antimonium tartaricum :
a) Emphysema of aged (Boericke)
b) Bronchial tubes overloaded with mucus. Great rattling of mucus but little is
expectorated (Boericke)- Rattling cough is a natural response of bronchial
inflammation. The mucus is difficult to expectorate, due to
bronchoconstriction – this state can occur in asthma, chronic bronchitis,
bronchiectasis.
c) Face pale, cold, blue (if along with respiratory distress) (Allen) – This
indicates cyanosis with respiratory distress. The cause could be Atelectasia,
emphysema, lung fibrosis, complication of chronic bronchitis, acute episode in
chronic asthma
d) Antimonium tart acts upon the respiratory nerve centres (Burt) - Respiratory
nerve centres are present in medulla. So any condition which affects medulla
like haemorrhage or ischemia may lead to respiratory arrest and may require
mechanical ventilation. So in such cases this drug could be tried in case of
bronchial infections, when lungs get congested with mucus and patient is not
able to expectorate anything.

8. 4. Argentum Nitricum:
a) Chronic laryngitis of singers (Allen)
b) Vocal nodules (Boericke)
c) High notes causes cough, chronic hoarseness (Boericke)– Chronic laryngitis
5. Arsenicum album: Arsenic causes irritation in mucous membrane, and thus
causes cough – so it can be given in conditions like Allergic rhinitis, laryngitis,
nasobronchial allergy, asthma, bronchitis.
a) Breathing asthmatic; must sit or bend forward (Allen) – Moderate to severe
degree of asthma, where patient has difficulty to recline, but can breath in better
way while sitting and bending forward.
b) Unable to lie down, fear of suffocation (Allen, Boericke)– Asthma, Chronic
heart failure, Pulmonary oedema.
c) Expectoration frothy (Boericke)- Pulmonary oedema.
6. Arsenicum iodatum:
a) Thin, watery, irritating, excoriating discharge from anterior and posterior
nares. Sneezing. Hay fever. Irritation of nose with constant desire to sneeze
(Allen) – Allergic rhinitis
b) Chronic nasal catarrh, profuse, thick, yellow discharge (Allen) – Chronic
sinusitis.

9. 7. Aspidosperma:
a) Want of breath during exertion (Boericke)- Grade I dyspnoea, can occur in early
stages of chronic bronchitis, Asthma, Bronchial carcinoma, Interstitial lung disease,
obesity, heart failure, valvular heart disease, cardiomyopathy.
b) Stimulate respiratory center (Boericke)
8. Blatta orientalis: Indicated after arsenic when this is insufficient.
a) Asthma with bronchitis (Boericke)
b) Much pus like mucus (Boericke) –Bronchiectasis, chronic bronchitis
9. Calcarea carbonica: it causes increase secretion of mucus, so this remedy can be a
good remedy for sinusitis, hupertrophied nasal turbinates, chronic bronchitis,
bronchiectasis.
a) Stoppage of nose with foetid yellow discharge – Chronic sinusitis
b) Tickling cough troublesome at night, dry and free expectoration in morning
(Boericke)– Post nasal drip in sinusitis.
c) Tightness of chest worse going upstairs or slight ascent, must sit down - Grade I
dyspnoea, can occur in early stages of chronic bronchitis, Asthma, Bronchial
carcinoma, Interstitial lung disease, obesity, heart failure, valvular heart disease,
cardiomyopathy.

10. 10. Carbo vegetabilis:
a) Asthma dates from measles or pertusis of childhood (Allen)- As per a study in PubMed,
Sept 2012, Childhood infection and risk of Asthma, it states that Pertussis and measles
were associated with new-onset asthma after childhood. Pertusis was associated with
preadolescent incident asthma, while measles was associated with adolescent associated
asthma.
b) Persons who have never recovered from the effects of some previous illness (Boericke) –
COPD and bronchiectasis (which may occur after childhood infections like measles,
pertusis)
c) Asthma in aged with cyanosis (Boericke)
d) Imperfect oxidation. Body become blue (Boericke) – Respiratory conditions which are
associated with cyanosis are Atelectasia, emphysema, lung fibrosis, complication of
chronic bronchitis.
11. Digitalis:
a) Passive congestion of lung, giving bloody sputum due to failing myocardium (Boericke) –
this could be a feature of valvular heart disease (mitral stenosis) where pulmonary
congestion causes haemoptysis, left ventricular failure.
12. Cuprum metallicum:
a) Angina with asthma symptoms – it is a feature of cardiomyopathy, aortic stenosis.

11. 13. Dulcumara:
a) Winter cough, dry, teasing (Boericke) - Chronic bronchitis.
14. Eucalyptus globulus:
a) Ethmoid and frontal sinusitis (Boericke)
b) Profuse expectoration of offensive muco-pus. Foetid form of bronchitis,
bronchial dilatation and emphysema – Chronic bronchitis, emphysema,
bronchiectasis.
15. Eriodictyon: Asthma, chronic bronchitis, bronchial secretion gives relief
(Boericke).
16. Grindelia Robusta:
a) Asthmatic and bronchitis patients (Boericke)
b) Mucus difficult to detach (Boericke) – Asthma
c) Efficacious remedy for wheezing and oppression (Boericke)– Chronic
bronchitis, asthma, interstitial lung diseases
d) Asthma relieved by expectoration (Boericke)
e) Weak heart and respiration (Boericke) – Cardiomyopathy
f) Cannot breath when lying down (Boericke) - Asthma, Chronic heart failure,
Pulmonary oedema, sleep apnoea.

12. 17. Lobelia inflate:
a) Dyspnoea from constriction in chest, worse from any exertion –
Asthma, chronic bronchitis.
b) Senile emphysema.
18. Pothos: Asthmatic complaint from inhaling dust – Atopic asthma
19. Sanguinaria:
a) Cough of gastric disorder, relieved by eructation – Reflex cough due to
GERD
b) Asthma with stomach disorders- it may be due to tropical eosinophilia,
which can be presented in various forms, respiratory form
(commonest), alimentary form
20. Syphilinum: Asthma in summers (Boericke)
21. Aralia, Naja: Asthma preceded bycoryza

13. Miscellaneous: Most of asthma attacks occur between midnight to 4 Am. The
bronchial muscle tone is regulated by sympathetic and parasympathetic nervous
system. The sympathetic nervous system regulates body function when the person
is active while during the day and parasympathetic system during the night when
person relax. During sleep, the blood circulation decrease, pulse rate, respiratory
rate decreases and activity of adrenal glands also decreases. The reasons why
asthma attacks during this time are
The activity of vagi cause constriction of bronchial muscles.
Decrease in production of adrenalin in night. As adrenalin helps in
bronchodilation.
Decrease in cortisone production by adrenal cortex. Cortisone helps in
bronchodilation.
Levels of these two substances (cortisone and adrenalin) are lowest between
midnight and 4AM, making it more likely you will experience asthmatic symptoms
during these times.
Specific allergens such as pollens predispose asthmatic attack. Much pollen is
released early in the morning, shortly after dawn. This could also be the reason
why asthmatic attacks occur in early morning.

14. BIBILIOGRAPHY
1. Boericke,W,2006, New Manual of Homoeopathic Materia Medica and
repertory, 9th edition, B Jain Publishers Pvt Ltd, New delhi
2. Allen H.C., 2002, Keynotes and characteristicks with comparisions, Reprint
editin, A.B. publications, Kolkata.
3. Burt W.H., 2013, Physiological Materia Medica, 3rd edition, B Jain Publishers
Pvt Ltd, New delhi
4. Savill’s system of medicine, 1998, 14th edition, CBS publishers and
distributors, New delhi
5. Davidson’s Principal and Practice of medicine, 1999, 18th edition, churchil
livingstone
6. Golwala, Medicine for Students, 2003, 20th edition, published by Dr. A.F.
Golwala, Express court, Backbar reclamation, chruchgate, Mumbai
7. Mathew K. George, Preparation manual for undergradulates, 2001, B.I.
Churchil Livingstone Pvt Ltd, ND
8. www.ncbi.nlm.nih.gov/m/pubmed/22459783/
9. www.lung.org/associations/states/colorado/asthma/Asthma.html

15. Presented by
1.Dr. Amit Arora (SMO), Dte of AYUSH, Gnct of Delhi
2.Dr. Udesh Kumar (SMO), Dte of AYUSH, Gnct of Delhi