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Dry Cough: Managing by Homoeopathy

By Dr. Subhash Chaudhary (Lecturer), Dr. Mohnish Ramjatan Yadav (PGT), Dr. D. Basu (Professor)
Department of Practice of Medicine, National Institute of Homoeopathy, Kolkata


A dry cough is most irritating for the patient as well as his accompanying persons. A dry cough has many causes, which range from simple upper respiratory tract infection that follows a cold to severe and life-threatening conditions include congestive heart failure and lung cancer. Management by homoeopathy could relieve the patient of the distress.

Dry cough is an extremely distressing problem. The physician should try to identify the cause, apart from homoeopathic prescription, as it may be an indicator of serious underlying disease.

Introduction
Cough is a very common clinical problem and is commonly accompanied by expectoration. Sometimes the expectoration is profuse and the clinician may suspect causes like bronchiectasis. Sometimes the amount of expectoration may be very scanty as in bronchitis or bronchial asthma; and may be encountered in smokers. There are cases where there is no expectoration at all. The term dry cough is loosely used for those cases of cough that have scanty or no expectoration. In the true sense, the term dry cough should be made applicable to those cases of cough in which there is no expectoration at all.

Search for Causes
If the homoeopathic physician wants to reach such a diagnosis apart from prescribing homoeopathy medicine as per homoeopathic philosophy and totality, then there are several possible causes to consider. Of these there are three very important causes.

  • Allergic diseases of respiratory tract including tropical pulmonary eosinophilia.
  • Disease of Pleura (pleurisy, pleural effusion etc.)
  • Upper respiratory tract problems. [But first the physician should find out whether the patient is taking any allopathic anti-hypertensive drug related to angiotensin pathway (either converting enzyme inhibitor or angiotensin blocker) as these drugs are known to produce such dry cough.]

    [There is a special point to consider in children. small children cannot bring up sputum. So even causes that should have expectoration may appear to be dry (without expectoration) in children.]

Brief Descriptions

  • Allergic diseases of respiratory tract including tropical pulmonary eosinophilia: Typical complaints include intermittent nasal congestion, itching, sneezing, clear rhinorrhea and conjunctival irritation. Symptoms increase with longer and higher levels of exposure to the responsible allergen. Patients may experience headaches, wheezing, and coughing, and may lose their sense of smell and taste. The problem is often more severe at night, which interferes with sleep, but can persist during the day. Chest radiograph and spirometry findings may be normal (tropical pulmonary eosinophilia may have military mottling), but in blood eosinophilia is found.

  • Disease of Pleura: The cause is related to irritation of the pleural surfaces Cardinal symptoms of dry pleurisy are cough and chest pain. Pain is exaggerated by deep breathing, coughing, and straining. The chest pain is generally localized, stitching in character which is aggravated by slightest motion, so the patient holds the chest with hand. There may be pleural rub or even friction fremitus.

  • Upper respiratory tract problems: Nasal congestion leads to post nasal drip this will then lead to irritation of the throat, which often feels like a “tickle” in the throat causing cough. Sometimes, just dry throat causes coughing. Dry air in the home or workplace, and especially when sleeping at night, air conditioning or a dry or dusty climate are all causes for dry throat.

    Some other causes which may have to be considered in some patients are:
  • Recurrent Laryngeal Nerve Paralysis with hoarseness and production of “bovine”/ “goose”/ “gander”/ “brassy” cough.

  • Impending Pulmonary Oedema before profuse pink, frothy, watery sputum will occur.

  • Interstitial Lung Diseases with exertional dyspnoea, haemoptysis and wheezing.

  • Gastroesophageal Reflux Disease with water brash, heartburn.

  • Otogenic Causes due to ear canal stimulation from wax impaction and cholesteatoma (Arnold’s ear-cough reflex).

  • Psychogenic causes will be considered in proper setting.

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