Acute bronchitis, wet cough

Chapter 19

Acute bronchitis, wet cough Summary

Terrain in detail

Essence: A hyperparasympathetic spasmophilia of fragilized bronchi in response to an aggressor. Terrain: (1) Spasmophilia: Para > Alpha > Beta with (2) ENDO: Adrenal cortex insufficiency and central hyperthyroidism and hyperhistaminemia ➔ inflamed bronchi and (3)-Exocrine pancreatic and pituitary over-activity ➔ mucous (various qualities) resulting in (4) Spasmodic, wet cough.

Precritical terrain

Treatment goals Symptomatic: Anti-infectious, antiallergic, antispasmodic, antitussive, expectorant, mucolytic Terrain: ● ANS: ⇓ Para > Alpha, ⇑ Beta (resolve spasmophilia) ● CORTICO: ⇑: Adrenal cortex ● THYRO: ⇓ TRH (mast cell degranulation) ● Reduce excess production of secretions: ⇓ Exocrine pancreas solicitation ● Break up mucous: mucolytics ● DRAIN: 1-Pulmonary-Pancreatic axis, 2-Intestines, 3-Liver, 4-Skin (as indicated) ● DIET: Pancreas sparing

Sample treatment 1. Neuroendocrine-Infectious: 3 mL three times per day for 10–14  days (cf. Table  19.6): Inula helenium MT 30 mL, Fabiana imbricata MT 30 mL, Ribes nigrum GM 60 mL, Lavandula angustifolia EO 1.5 mL, Satureja montana EO 1 mL 2. Drainage: 3 mL three times per day for 10  days (cf. Table 19.7): Agrimonia eupatoria MT 60 mL, Plantago major MT 30 mL, Arctium lappa MT 30 mL, Eucalyptus smithii EO 2 mL 3. Antispasmodic cough topical essential oil blend: Eucalyptus spp. EO 8 drops, Lavandula angustifolia EO 4 drops, Cupressus sempervirens EO 3 drops + 1 TBSP carrier oil

The Theory of Endobiogeny. https://doi.org/10.1016/B978-0-12-816965-0.00019-6 © 2020 Elsevier Inc. All rights reserved.

There is, prior to the time of exposure to the inciting agent, a global hyperfunctioning of the terrain that targets and fragilizes the bronchi to maintain an increased oxygen requirement. The net effect is a local congestion and fragilization of the bronchi. 1. Endocrine: Hyperfunctioning a. Pituitary b. Thyroid: TSH, T4 c. Pancreas, Endocrine d. Adrenal cortex (lesser role) 2. ANS: Para, hyperfunctioning 3. Emunctory: a. Defense, oversolicited and taxed i. Exocrine pancreas ii. Spleen: Immunity b. Congestion i. Colon ii. Liver iii. Skin

Agent The agent in wet bronchitis is typically an allergen or virus, which provokes a supraphysiologic oxygen demand that is beyond the adaptation capability of the patient, further diminishing the already-fragilized buffering capacity. This neuroendocrine adaptation response will determine if the bronchitis is wet or dry (cf. Chapter  18: Acute Bronchitis, Dry).

Critical terrain 1. ANS: Hyper Para > Alpha, with spasmophilia: blocked or delayed beta 2. Pituitary: Oversolicited and inefficient in relaunching peripheral glands 3. Corticotropic: ACTH ≫ Cortisol, absolute cortisol typically insufficient to help resolve infection

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TABLE 19.1  Precritical and critical terrain symptoms and Biology of Functions correlations. Area

Finding

Terrain

BoF

Bronchus

Spasmodic cough: expiratory, wet

Para ≫ Alpha, spasmophilia

↑/↓ LMI + ↓ PMI

Para

Good sleeper, good eater, seldom cries, shy, introverted, sweats easily, eczema, prolonged expiratory phase

↑Para

N/A

Alpha

GERD, Gastritis, constipation, insomnia

↑Alpha

↑/↓ LMI

Thyro

Vivid dreams, nightmares

↑TRH

↑: Thyroid relaunching, Thyroid relaunching corr., HypothalamoMetabolic, TRH/TSH

Cortico

General fatigue, lassitude

Adrenal insufficiency

↓Cortisol, ↓Adrenal cortex, Cortisol:Adrenal cortex ratio < 2 regardless of absolute value

Pancreas, exocrine

Recurrent sinusitis, tonsillitis, eczema, mucus production with dairy/gluten, bloating, anus fissures

Over-solicited

↑/↓ Somatostatin

Spleen

Unfocused effort, fatigue, impaired adaptability, depressive tendency, recurrent infections

Splenic congestion

⇓ PMI

Liver

Poor immune response, loss of appetite especially in AM, chills

Hepatic congestion

⇑/⇓ LMI

Colon

Constipation, acne on buttocks

Colon congestion

⇓ Pelvic congestion

4. Thyrotropic: insufficient TSH-T4 response: abundant, thick mucous 5. Immune: Hyperimmunity 6. Emunctories: a. Exocrine pancreas i. Insufficient: abundant, thick, inspissated mucous ii. Hyperfunctioning: abundant, fluid mucous easy to expectorate b. Spleen and Liver: oversolicited, overtaxed, and congested c. Intestines: congested

Mechanisms Hypersecretory response with mucous that is excessive, ­inspissated, or both.

Result Expiratory, spasmodic wet cough.

History and BoF findings During acute bronchitis, typical symptoms of an irritable, spasmodic cough, with or without fever, of 10 or less days’ duration will be present. In a patient with known history of recurrent seasonal bronchitis, evaluate the precritical terrain in the preceding season to institute prophylaxis. Some

possible correlations between precritical symptoms and Biology of Functions are presented in Table 19.1.

Physical exam and BoF findings During presentation with acute wet bronchitis, the following may be observed on physical exam with some possible Biology of Functions correlations (Table 19.2).

Treatment During acute bronchitis, antibiotics should be avoided unless proven bacterial etiology in a fragilized patient. The general emphasis of treatment is listed in Table 19.3 in columns from left to right. The general approach is three-fold: 1. Symptomatic, localized to bronchi (Tables 19.3 and 19.7) 2. Neuroendocrine, in following order of emphasis (Table 19.4): a. Reduce Para and Alpha and reinstall beta sequencing b. Support global adrenal function, especially cortisol c. Regulate thyrotropic activity d. Oligoelements (discussed later) 3. Drainage (Table 19.5), in following order of emphasis: a. Pancreas-sparing diet b. Pancreato-Pulmonary axis c. Hepato-Splenic d. Intestines e. Skin (as indicated)

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TABLE 19.2  Critical terrain signs and Biology of Functions correlations. Area

Finding

Terrain

BoF

Bronchus

Spasmodic cough: expiratory, wet

Para ≫ Alpha

↑/↓ LMI

Beta delayed

↓ PMI

Chvostek

Spasmophilia

↑/↓ LMI + ↓ PMI

Brisk DTR, Clonus, Eyelid flutter on Glabella tap

⇑ TRH

⇑: Thyroid relaunching, Thyroid relaunching corr., HypothalamoMetabolic, TRH/TSH

Para

Moist, warm skin; constricted baseline pupil; iris rosette, abdominal bloating, sweating, increase salivation, lacrimation

Hyper Para

Thyro

Cold sensitivity (T3), heat intolerance (T4), weight loss, pruritis

Elevated peripheral thyroid activity

⇑ Thyroid, ⇑/nl Thyroid yield

Immune

Suprasternal notch: Tender on palpation

Thymus congested

⇑/Normal: IL-1, ↓ Genito-thyroid, ↑Evoked histamine

Pancreas

Tender, above umbilicus

Congestion: general

N/A

Tender, right of umbilicus

Over-solicitation: exocrine

⇑/⇓ Somatostatin

Tender, left of umbilicus

Over-solicitation: exocrine

N/A

Tender, superior-medial

Vascular hepatic congestion

⇑/⇓ LMI

Tender, inferior-lateral

Metabolic hepatic congestion

⇑/⇓ LMI

Tender: ACTH-F, TRH, TSH reflection points

Colon congestion

⇓: Pelvic congestion

Neuro

Liver

Colon

Key: DTR: Deep tendon reflex; LMI: Leukocyte mobilization index; PMI: Platelet mobilization index.

TABLE 19.3  Medicinal plants with polyvalent symptomatic actions. Plant

Antispasm

Agrimonia eupatoria

•

Decongestant/ pulm. drainer

Anti-inflam.

Anti-Allergic

Anti-infect.

•

•

•

•c

Arctium lappa Cupressus sempervirensa

•

Eucalyptus ssp.a

•

•

•

•

•

•

•

•

•

• •

•

Matricaria recuctita Inula helenium Plantago major

Emollients

•

Glycyrrhiza glabra Lavandula angustifoliaa

Mucolytic/ expectorant

•

•

•

•

•

•

•

•

•

•

•

•

•

c

•

•

b

Malva sylvestris Viola tricolor a

•c

•

Can be diffused or nebulized as an essential oil. Parasympathomimetic: use at regulating doses in wet, hyper-para bronchitis. Indirect decongestant.

b c

•

•

148 SECTION | C Assessment and treatment of common disorders

TABLE 19.4  Medicinal plants for neuroendocrine regulation. Axis

Primary

Other

⇓: Para > Alpha

Thymus vulgaris EO, Lavandula angustifolia EO

Matricaria recuctita MT

⇑: Beta

Satureja montana EO

Cinnamomum zeylanicum EO

Relaunch Pituitary

Inula helenicum MT

Rhodiola rosea MT, Quercus pedunculata GM

⇓: TRH

Fabiana imbricata MT

Leonurus cardiaca MT

⇑: Adrenal cortex

Ribes nigrum GM, Quercus pedunculata GM

Satureja montana EO, Eleutherococcus senticosus MT

Key: EO: Essential oil, GM: Gemmomacerate, MT: mother tincture.

TABLE 19.5  Medicinal plants for drainage. Plant

Pancr.-Pulm

Agrimonia eupatoria Plantago major

Liver

Intestines

•

•

•

•

•

•

•

•

Ceanothus americanus

Hepato-Splenic

Skin

•

Viola tricolor

•

Key: Pancr.-Pulm: Pancreatic-Pulmonary axis.

Exemplary prescriptions Based on an Endobiogenic approach to wet bronchitis, a number of prescriptions can be derived. 1. Neuroendocrine: 3–4 mL three times per day 10– 14 days (Table 19.6): Inula helenium MT 30 mL, Fabiana imbricata MT 30 mL, Ribes nigrum GM 60 mL, Lavandula angustifolia EO 1.5 mL, Satureja montana EO 1 mL 2. Drainage: 3 mL three times per day for 10 days (Table 19.7): Agrimonia eupatoria MT 60 mL, Plantago major MT 30 mL, Arctium lappa MT 30 mL, Eucalyptus smithii EO 2 mL 3. Topical antispasmodic: Apply up to every hour for relief of cough:

Eucalyptus spp. EO 8 drops, Lavandula angustifolia EO 4 drops, Cupressus sempervirens EO 3 drops + 1 TBSP carrier oil; Instructions: (a) Mix carrier oil and EOs in glass bowl, (b) Apply with friction rub in circular and up/down motions for 3–4 min, (c) Cover chest with a shirt or blanket, then heated pad or towel; Alternative: Diffuse undiluted essential oils within 2 feet (0.6 m). 4. Oligoelements: (a) Spasmodic Cough: Magnesium oligo: 1–2 droppers every 4 h for first three days; (b) Inflammation: Selenium: 1–2 droppers every 4 h for first three days 5. Diet: Pancreas sparing, favor root vegetables: turnip, black radish, yams, and, juices of carrot, quince, chervil, cabbage, lettuce, mulberry, apple, and turnip.

TABLE 19.6  Neuroendocrine-infection prescription. Herb

Amount and form

Replacements and alternatives

Inula helenium

30 mL MT

Rhodiola rosea MT 15 mL + Quercus pedunculata GM 15 mL

Fabiana imbricata

30 mL MT

Leonurus cardiaca MT, Lycopus europaeus MT

Ribes nigrum

60 mL GM

Quercus pedunculata GM, Glycyrrhiza glabra MT

Lavandula angustifolia

1.5 mL EO

Eucalyptus ssp. EO 1.5 mL

Satureja montana

1 mL EO

Thymus vulgaris EO 0.5 mL + Cinnamomum zeylanicum EO 0.5 mL

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TABLE 19.7  Drainage prescription. Herb

Amount and form

Replacements and Alternatives

Agrimonia eupatoria

60 mL MT

Arctium lappa MT 30 mL + Plantago major MT 30 mL

Plantago major

30 mL MT

Agrimonia eupatoria MT 30 mL

Arctium lappa

30 mL MT

Viola tricolor MT 15 mL, Agrimonia eupatoria MT 15 mL

Eucalyptus smithii

2 mL EO

Eucalyptus globulus (unrectified) EO 2 mL