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The Gleanings-IV, ENT-III-Throat, Larynx and Trachea

The Gleanings-IV ENT-III-Throat

EAR     NOSE   THROAT

Dr. M. A. USMANI

 

THROAT, LARYNX AND TRACHEA

 

[My remarks at the beginning of last (Nose) Chapter, apply here also, in letter and spirit. Miasmatic remedy should never be lost sight of. Sometimes it alone suffices to clear the whole, and non-responding, cases.

 

But in daily practice of acute cases of throat infections and inflammation, various remedies are indicated, according to their symptoms and modalities. But patients are not always available to detail their symptoms. Many times somebody comes to take their medicine. So you have to prescribe on the paucity of symptoms, and meager or no evidence. Same is the case with children; you examine their throat, if at all they allow you to do so; but they cannot relate their symptoms. The real test of a physician is how he fares in the large percentage of cases, and especially where he cannot get full data, and have no opportunity to personally examine the ailing parts. My sheet-anchor here is MERC. SOL. This is the remedy that can be prescribed for sore-throat without knowing anything else. In more than 80% of cases of this malady will be redressed by this ubiquitous and trusted agent.

 

Knowing the exciting cause is also very important. My unfailing tip here is that when the throat gets inflamed by taking something sour and acidic, give Belladonna. (Also sometimes, same complaint by cold drinks.) Belladonna is so specific for this cause, that I use it as a prophylactic for the patients who always get this inflammation by partaking of something intensely sour or cold cola drinks. In this way I avert many an imminent catastrophe.

 

Practical hints: always take something intensely sweet after taking something sour. Most effective examples are dry-dates, fresh dates. Chew one or two dates; those will clear your throat. If you are taking oranges, and you find one orange is very sweet, keep it to be taken last of all. If all the oranges seem to be sour, stop taking them and eat one banana after them, or some purely sweet fruit, if dates are not available. Tea with honey is also a good bet as a prophylactic; no less effective is tea with milk and salt. That will wash away the acid from the throat. I have given a lot of such tips in my series of blogs, under the caption: Vision of a Physician. E.g.

 

http://www.scribd.com/doc/49583804/Vision-of-a-Physician-How-not-to...

http://www.scribd.com/doc/49139190/Constipation-No-Disease

http://www.scribd.com/doc/49138405/HOW-NOT-TO-CONTRACT-FLU 

   

In the therapeutic of the throat, it is prudent to group remedies that are usually prescribed for its ailments. It is practical and sagacious to group them according to the groups of modalities. E.g., Bell., Merc., Hep. (for the eating or weather causes); then Lach., Phyt. Apis.(owing to amelioration from cold drinks); and  Nit.ac., Dol., Hep., KC., Arg.N.(for splinter-like pain); so on and so forth.  Dr. Usmani]

  

INTERNAL THROAT:

 

Sore Throat: Belladonna Group: Belladonna, Hep.Sulph., Merc.Sol., Sil., and Sulphur.  

When in spite of the exhibition of Belladonna, pus forms in the tonsils, as indicated by rigors and chills, and by sharp, lancinating pains, with throbbing, one should change from that remedy to Hep.Sulph. [On this state of infection, especially when the suppuration of the tonsils is threatened, the case should be commenced with this agent. [In the Chap. on Nose, we discussed Hep.Sulph. as suitable for the ripened catarrh, and quoted Dr. Farrington as saying that Hep. will spoil the case if given at the commencement of the catarrhal process. But in the beginning of suppuration this is the remedy. If such a case is commenced with Merc.Sol. the case will get worse, with undue pain. Ref. Dr. Jhar.  MAU] By the use of Hep.Sulph.one can even abort the purulent process, if used in appropriate potency.

Merc.Sol., the king of throat infection (and of Syphilis), has the loin’s share in the therapeutic of the throat. It should be given in all infections and inflammation of the throat and tonsils and larynx, if no other remedy is definitely indicated. In advanced suppurative stage it works miraculously by clearing all the dead tissues. Silicea

comes after Hep. if the latter could not effect clearance of  the puss. In such cases puss goes on forming and grows dark and foeted., and disagreeable to taste. If, even Sil. Fails, recourse should be had to Sulphur, (or to Flouric Acid).      (CMM p.414)

 

Sore Throat, Unbearable: Amygdalus Amara

The drug causes dark red inflammation of the fauces, uvula and tonsils, with sharp pains, causing considerable difficulty in swallowing; sometimes they are so severe as to make the patient cry out. In the light of these symptoms the drug can be used even for Diphtheria.It has in fact cured may cases of this disease.      (CMM  p. 414)

 

Sore Throat extending from Right to Left: Podo.

Great dryness of throat, < from swallowing liquids; agg. in the morning with pains going into ear. Comp. Lyco.      (CMM, 455)

 

Sore Throat: Commencing on the Right side and passing to the Left, where it becomes fixed:    Lachesis   (T. K. Moor, Hom. Mag.May,1978), he also asserts that in Lach. first right tonsil is affected then the left generally. 

Enlarged Tonsils with Frequent Tonsillitis: Tuberculinum    “Always keep Tub. in mind when treating sore-throat with frequent tonsillitis, and enlarged tonsils.”           (T. K. Moor, ibid)

Pharyngitis with continued disposition to clear Throat: ArumDrac.

Pain sore, rough and tender.

Croup: Other remedies failing. Kaolin

 

Follicular pharyngitis, with Post-Nasal Catarrh: Kali-bi.

The follicles of the throat become hypertrophied and look like little tubercles on the pharyngeal walls. These are attended by a feeling of roughness and dryness of the throat, and sometimes by an accumulation of tenacious mucus. This is very tedious condition, and stubborn for treatment. Here, one should remember, Hep.S., Kali-Chlor. and Aesc.Hip, the latter resembles Kali-bivery closely, but lacks the tenacious, stringy mucus.

Kali-bi is also indicated in nasal catarrh. It produces at first dryness of the nasal passage, wit tickling in nose and sneezing, especially in open air.  The secretion of the nose is ropy and stringy, and often collects in the posterior nares; it may or may not be offensive. In catarrh of the posterior nares comp. Hydrastis, Spigelia, and Nat.S.  Nat.S hawks up salty mucus every morning. Kali-bi is also indicated in syphilitic sore throat and ozaena. Ulcers form on the fauces and tend to perforate. The surrounding mucous surface is coppery red color. In ozaena there are discharges from the nostrils or posterior nares consisting of plugs and clinkers, as they are sometimes called. Lumps of hard green mucusare hawked up from the posterior nares, particularly in the morning.     (CMM p.722)

 

Tonsillitis with Throbbing in Tonsils: Am.m

The throat is swollen so that the patient cannot open his mouth. The mouth and throat are filled with viscid phlegm, which the patient expels with great difficulty. Throbbing in tonsils is characteristic of Am-m.The faucial symptoms are so severe as to produce almost complete strangling.       (CMM p. 664)

 

Tonsillitis, Erysepelatus, Deep red: Apis Mel.

 

# Laryngitis, Hoarseness and Aphonia:

 

Arg. Nit.There is muco-purulent sputum, seeming to come from the posterior wall of the larynx. There is also marked hoarseness, sometimes total loss of voice. Singers frequently complain of a feeling as if there were something clogging the vocal organs.

 

Mangnum: is similar to Nitrate if Silver, causing laryngeal symptoms, particularly in anemic and tubercular patients. The hoarseness is usually worse in the morning, and grows better as they succeed in hawking up lumps of phlegm. The Mangnum patient has cough from loud reading with painful dryness and roughness of larynx. The cough is usually relieved by lying down.

 

Selenium:  it resembles with Arg.N.   Read next topic. (CMM p.609f.)

 

Paris Quadrifolia:Farrington says that it is a neglected drug in laryngeal affections. It is indicated when expectoration is mostly in the morning, and is tenacious and green.

 

Amm.Caust : Aphonia with Burning Rawness in Throat:

“One of the best remedies in whole Materia Medica.” (CMM)

 

Am.M.hoarseness and burning rawness in larynx.

 

Tip: Instantaneous Voice Recoverer: PopulusCandicans

Acute colds, especially when accompanied by a deep, hoarse voice, or even aphonia. Pharynx and larynx feel dry and the voice weak and toneless. Also coca.        (Boericke)  

 

# Hoarseness of Singers, Teachers and Orators:

 

Selenium: Particularly when the hoarseness appears as soon as when they begin to sing. Also when hoarseness appears after long use of voice. There is frequent necessity to clear the throat by reason of the accumulation of clear, starchy mucus. These symptoms point suspiciously towards incipient tuberculosis of larynx. Here Selenium is grouped with Arum-t., Spong., Caust., Carb.v., and Phosphorus.

Arum-t:Hoarseness of singers and orators, but is especially indicated when voice suddenly gives out during use. E.g. the patient is talking in a sort of monotone when the voice suddenly breaks and goes up to a higher key.

Causticum: Laryngeal catarrh in singers, with rough hoarse voice, associated tracheo-bronchial catarrh and rawness and burning under the sternum. D.D. Carbo-v: Caust. has hoarseness < morning, and C.V. in evening. Caust. < in cold weather, C.V.in a damp warm weather.

NOTE:Since Causticum has special reference for laryngo-trachial area it requires special mention to determine its real importance. Dr. Farrington beautifully explains it. So I quote: the aphonia of Causticum is an illustration of its paralytic effects (on vocal organs). This may or may not be catarrhal. It is associated with great weakness of the laryngeal muscle, which seems to refuse action. This is often the case in phthisis or laryngeal weakness, whether of a tubercular nature or not. The paralytic tendency is further revealed in cough. The patient is unable to expectorate. The sputum is raised to a certain level and then slips back. (comp. Arn., Dros., Kali.c., Sep.) The remedy also has this characteristic symptom: ‘the patient cannot cough deep enough to raise the sputum.’ Another characteristic symptom: ‘rawness and burning down the throat and trachea, feeling as if these parts were denuded, and hoarseness < in morning.’ Accumulation of mucus in fauces and larynx. The sputum often tastes greasy and soapy. Drinking cold water relieves the cough. Pain in the small of back on coughing is also characteristic; and also the spurting of urine on coughing. (Also found under Nat.m., Puls., Phos., apis., Scilla.)

D.D. Phosphorus: Phos. has evening <; Caust. morning. Phos. has extreme soreness of the voice box; coughing and talking causes soreness in larynx, and hence the patient avoids them. Relief from cold drinksis found only in Caust.   (CMM p.732)

D.D. Carbo.v:Carbo.v. is more similar to Caust. Here you can make no serious mistakes, says Farrington, because both drugs follow each other well. So giving one for the other causes no injury, only a delay in cure.  Both remedies have this rawness and soreness down the throat; both have hoarseness, Carb.v. < evening, Caust. morning. The former is indicated after the exposure to damp weathe, and the latter,after dry,cold, severe winter weather.                (ibid. p. 733)

 

In case of singers, ministers, public speakers and auctioneers, Graph., Rhus-t., Sel., and Arum-tcan be compared in voice giving way under stress.

 

In cases where Causticum fails in chronic hoarseness, worse in morning and evening, Sulphuris all sufficient remedy.

 

Still another kind of cough for which one can give Caust. is one which improves up to a certain point and then remains stationary, getting neither better nor worse.      (ibid. p. 733)

 

Eup-per:Very similar to Causticum in that it causes hoarseness with soreness in larynx., trachea, and bronchial tubes, < in morning. Both remedies are indicated in influenza with aching all over body, but Eup-p has more soreness than burning and rawness in chest, and apt to be associated with aching all over body.  (ibid)

 

Irritable Throat of Singers: Tendency to get hoarse: Wyethia

 

Aphonia from exposure to cold: Cina

 

Aphonia in professional singers: Argentum Met.

 

Boericke’s Tip: When Baryta Carb. stops responding to the remedy, needs doses of Psorinum (10m).

 

Feeling of Lump in right side of Throat: Variolinum

 

Follicular Pharyngitis: with constant hemming to clear throat.  Wyethia

 

Follicular Pharyngitis: with cough and sore throat, depending on hepatic disorders, Aesc. Hip.

 

Laryngopathy with Tubercular Basis;  Drosera

 

Failure of Voice after Public Speaking: Ferr. Pic.

 

# INTERNAL THROAT, Pathologic:

 

Enlarged Tonsils and Adenoids: Agraph. N.

 

Adenoids in Tubercular Patients: Tub. Bov.

(Kent, Lesser Writings)

Enlargement of Adenoids: with stoppage pf nose. (A specific), Tubercul.

 

Condylomata on Vocal Cord: Arg. N.

In addition there may be loss of voice, tumefaction of mucous membranes round about the vocal cord, and paresis of vocal cord. (Kent, P. 135)

 

EXTERNAL THROAT:

 

GOITER , Exophthalmic : Pilocarp. (Jabo.)

Increased heart action, pulsation of arteries, tremors and nervousness, heat and sweating, bronchial irritation.      (Boericke)

 

GOITER , Exophthalmic : Ephedra

Eyes feel protruded out, tumultuous action of the heart.

 

Exophthalmic Goiter, with hemorrhoidal bleeding: Lycopus Virg.

Toxic goiter, pre-operative stage.   (Boericke)

 

GOITER , Exophthalmic : with tubercular history. Dros.

 

GOITER , Exophthalmic : following emotional stress. Nat. M.

 

GOITER : when Iodine fails. Brom.

 

GOITER: at puberty. Calc. Iod.

 

GOITER , Non-Toxic and Obesity: also Exophthalmic. Fuc. Ves.

Thyroid enlargement in obese subjects. Obstinate constipation.

 

 

GOITER , Toxic, with Cardiac symptoms: Cactus

“cactus is pulseless, panting and prostrated, melancholy and taciturn; sad and ill-humored. Fear of death. Screams with pain; anxiety. (Boericke)

 

 

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