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Respiratory - Pleurisy case study

by Jill Stansbury

Medical Herbalism 01-31-96 7(4): 1, 5-6

Earlier this winter, a forty-seven year old woman came to see me complaining of a recent history of bacterial pneumonia, with a lingering cough and chest pain at the present time. She explained that she had developed a bad cold some six weeks earlier that had gone to her chest. She was diagnosed as having pneumonia 1 month ago, after a chest x-ray revealed significant congestion in the lungs. She was put on antibiotics, but responded only minimally, so that repeat courses of antibiotics had been given continually for the last month. A follow-up x-ray 1 week prior, revealed much of the congestion had cleared, with only the right bronchial region remaining congested. However, she was feeling worse, if anything. She described a tight, heavy, and burning sensation in her lungs, that was worse with any kind of motion, especially taking a deep breath. The least exertion, such as walking from one end of her house to the other was exhausting. She had driven herself to another doctor last week, but once there she became so weak she could not drive herself home and had to phone a friend. She consulted with me wishing to feel better, and wishing to avoid further antibiotics.

She had a temperature of 99 degrees F., and was pale and tired looking. She was breathing shallowly and was sitting and moving in such a way to prevent much movement of her rib cage. Through the stethoscope I could hear the high and low pitched squeaky sounds produced by friction of her lungs rubbing against her chest wall, and diagnosed her as having pleurisy. She felt as if there was mucous and blockage within her lungs, but coughing was so painful that was trying to avoid it.

I put together a 2 oz herbal tincture containing:

15 ml Asclepias tuberosa (Pleurisy root) for congestion in the lungs

15 ml Curcuma longa (Tumeric) as an antiinflammatory

10 ml Thymus vulgaris (Thyme) as a drying and warming decongestant and antispasmodic

12 ml Eriodictyon (Yerba santa) as a warming and stimulating expectorant

12 ml Glycyrrhiza (Licorice) as a demulcent and formula-balancer

I suggested she take this frequently, such as a dropperful every hour or two the first day, and then reduce the frequency to three or four hour intervals thereafter. Asclepias is an excellent consideration for cases of thick congestion within the lungs such as with pneumonia or lobar congestion as had been evidenced on this patient’s recent x-rays. Asclepias also has a warming energy and the early American eclectic physicians described it as being specific for pleuritis, and extensive mucous accumulations in the lungs such as with pneumonia. Hence the common name Pleurisy Root. Curcuma’s strong anti-oxidant and anti-inflammatory effects was aimed at quieting the inflammation in the pleural membranes of her lungs. Thyme is a strong antimicrobial agent and will decongest and relieve spasms of lung tissue. The Yerba santa is an antimicrobial expectorant with a warming and stimulating energy suitable for this old chronic condition with old mucous in the lungs. The licorice is soothing and antiinflammatory, and aimed at preventing harsh activity from any of the other botanicals in the formula. I also gave her an herbal tea containing:
Copyright 2001 Paul Bergner    364


    Medical Herbalism: Clinical Articles and Case Studies    

1 oz Mentha piperita (Mint leaves): Decongesting, antimicrobial, bronchodilating

1 oz Glycyrrhiza glabra (Licorice root shred): Demulcent, antiinflammatory, flavor

1 oz Urtica dioica (Nettle leaves): Nourishing, antiinflammatory

2 oz Verbascum thapsus (Mullein leaves): Demulcent, soothing, pain-relieving

2 oz Foeniculum vulgare (Fennel seed): bronchodilating, antimicrobial

1/2 oz Zingiber officinalis (Ginger powder): warming, stimulating, expectorating

1/2 oz Lobelia inflata (Indian Tobacco): bronchodilating, antispasmodic, stimulating

She was to prepare this by infusing 3 Tbl in 3 cups of water, and drink as much as possible continually, in small amounts, throughout the next several days.

I also suggested she apply some type of heat to her chest - as much as 3 times a day if she could manage it, and take a hot bath, morning and night for two days in addition. Since the problem was so chronic and drawn out, I wanted to stimulate her respiratory system with heat, and with the botanicals.

I recommended drinking some of the hot tea while in the bathtub. I often suggest that patients run a hot shower as a means of filling the bathtub. People are to leave the bathroom door closed, fill the tub with the shower on pure hot, and get the room as steamy and warm as possible. This warm humidity helps hydrate the respiratory passages, thin and loosen mucous, and calm and relax the tissues. I chose to this approach for this woman, since she was not coughing up mucous, and did not have moist sounding lungs. Her sensation was tight and burning, and her breathing sounded tight, squeaky, and dry. The moist phase of the lung congestion had been seen 1 month ago, so any mucous still lingering in her lungs was likely old and thick. Had this been an acute case of pneumonia, with abundant secretions, and a moist cough, we perhaps wouldn’t want to hydrate and stimulate to such an extreme, but use more drying and antimicrobial substances. After a month on antibiotics, I was seeking more of an anti-inflammatory and antispasmodic effect from the botanicals than a strong antimicrobial effect for this patient.

When treating pneumonia and pleurisy, frequent follow-up is ideal, so that if you don’t see improvements right away, you can do something different or additional promptly. I phoned the patient the following morning and she reported feeling “much better”. The intensity of the chest pain was improving and she was able to breath a bit more deeply. We spoke again two days later, and she was largely recovered. She was able to walk around her house, even up and down her stairs without breathing difficulty, and her energy was returning. She planned on returning to work shortly. I encouraged her to get a few more days rest to build herself back up, but people usually have a hard time giving themselves the luxury of following that advice.
Copyright 2001 Paul Bergner    365


    Medical Herbalism: Clinical Articles and Case Studies

Copyright 2001 Paul Bergner    366