Respiratory - Where diagnosis made the difference

Frances, Deborah

Medical Herbalism 03-31-97 9(1): 15-17

Like most practitioners, I treat a large number of patients with respiratory conditions. Whether the problem is a chronic one, as with asthma or emphysema, or more acute as in bronchitis or flu, the herbal cough formulas almost never fail to offer significant benefit in the healing process. I was therefore surprised when, in the following case, there was so little response to what seemed like such a well-chosen and vigorous herbal treatment program...until I got the diagnosis.

A 47-year-old female came to the clinic complaining of a cough that had been going on for three weeks. She had a history of one episode of pneumonia some years previously, which had been treated with antibiotics. Her cough was mostly loose, with expectoration easy at some times, and difficult at others. She felt a “wheezy rattling and rumbling” in her chest and a sensation of constriction. The cough was sometimes spasmodic, occasionally waking her at night. she had some coryza with a plugged sensation in her nose and plugged ears. She was afebrile, but did complain of aching muscles and back pain which she attributed to the stress of coughing.

On auscultation, her right lower to middle lung fields were wheezy and wet sounding, though lung sounds were not diminished and no obvious rales were heard. Examination of her ears revealed mild serous effusion [Ed: presence of fluid in the middle ear]. Her tonsils were a little enlarged but there was no redness in her throat. Occipital lymph nodes were mildly enlarged.

Suspecting a possible mycoplasma (“walking”) pneumonia, the appropriate lab work was ordered and the patient was sent for a chest X-ray. Spinal manipulation to her cervical and thoracic spine was performed to ensure optimal innervation to the respiratory organs and to relieve stress on the musculoskeletal system precipitated by three weeks of hard coughing.

In addition the following treatment plan was prescribed: (See formulas one, two and three on page sixteen). In addition, Vitamin C to be taken 1000 mg every 2 hours, and a mustard plaster was to be applied to the chest to increase circulation to the lungs.

The extra immune support, provided by the nutritional-herbal formula outlined above was added because of the concern that serious lung infection such as pneumonia was a likely possibility, given the patient’s lung sounds and previous history.

The herbs in the tea and tincture were chosen for their immune enhancing actions as well as their nutritive, expectorant, and soothing actions on the lungs. In addition, the grindelia, eriodictyon and thyme were added specifically for their anti-spasmodic action on the bronchial tree.
 

Copyright 2001 Paul Bergner    362

Medical Herbalism: Clinical Articles and Case Studies

On phone follow-up twenty-four hours later, the patient reported that she was not really much better. Though her cough was slightly more productive with the herbal formula, the change was minimal and she was not better in any other way. By this time, the chest X-ray results had come back reporting “findings more consistent with right lower lobe pneumonitis.” Blood work was negative for mycoplasma (“walking”) pneumonia and the differential white blood count was unremarkable for either bacterial of vital infection.

Since penumonitis is often a hypersensitivity response and blood work was negative for significant infection, she was started on quercitin, an anti-allergic flavonoid, at a dose of 500 mg three times a day, and a new tincture (formula four on page sixteen) was added to the one she was already taking:

The aim of this last formula was to address the inflammatory and allergic components of pneumonitis, while maintaining the immune enhancing and expectorant lung-nourishing qualities of the previous treatment.

Amni visagna (khella) was placed in the formula for its antiallergic properties as well as its ability to relieve bronchospasm, which was not responding as well as one would expect to the herbs in the first formulas (the tea and the tincture).

Urtica (nettles) was prescribed for its anti-allergic properties.

Achillea (yarrow) was added for its antiinflammatory properties and populus (poplar) was prescribed primarily for its anti-inflammatory and secondarily for its expectorant qualities. While the glycyrrhiza from the original formula contains phytosterols that are helpful in allergic and inflammatory conditions, it was clearly not enough in this case.

The original treatment plan, aimed at a presumably infectious lung condition did not fully address the real problem which was hypersensitivity and inflammation. Because the lungs were involved, the patient was left on the original tea and tincture when the new formula was added as their nutritive and antispasmodic properties were still indicated. The nutritional-herbal tablets were decreased to 2 tablets 4 times a day to support her immune system and address any minor infection that may have been present or threatening.

Two days later, I spoke with the patient again, and this time the response was more dramatic. The congestion in both her lungs and sinuses had cleared considerably, her ears were no longer plugged (serous otitis media is often an allergic symptom) her energy was much better, and her sleep was no longer disturbed by the cough.
 
 
 

Copyright 2001 Paul Bergner    363