Pneumonia By Dr Anmol Arora ( Sr Homoeopathic Specialist )

Pneumonia anatomy

Pneumonia is an inflammation of the lungs caused by an infection. Many different organisms can cause it, including bacteria, viruses, and fungi.

The symptoms of pneumonia range from very mild to very severe, even fatal. The severity depends on the type of organism causing pneumonia as well as the age and underlying health of the individual.

Portal of entry

Pathogenic organisms can reach the lower airway by one of the 3 routes: –

  1. Aspiration from oropharynx,
  2. Inhalation by aerosol droplet nuclei from the environment
  3. less frequently by haematogenous spread.


There are three main causes:

  1. Bacterial pneumonia—caused by bacteria, most commonly Streptococcus pneumoniae .
  2. Viral pneumonia—caused by a virus. Viruses cause half of all pneumonias.
  3. Atypical bacterial pneumonia —caused by mycoplasmas, chlamydias, or other tiny infectious agents that have traits of both bacteria and viruses. Walking pneumonia, as this type of pneumonia is often popularly called, implies a milder pneumonia. However, each of these infectious agents has the potential to cause a more serious or potentially fatal pneumonia.
  4. Fungal infections, such as Pneumocystis cariniipneumonia (PCP)—a fungal infection common in people with AIDS

Pneumonias are sometimes divided on the basis of where it was acquired and how you were exposed to it:

  1. Community acquired pneumonia—this type of pneumonia is acquired, as the name suggests, in the community (eg, at school, work, gym etc.)
  2. Nosocomial pneumonia—is acquired during a hospitalization. It can be very dangerous, especially for patients on a ventilator.
  3. Aspiration pneumonia—it happens when a foreign matter (most frequently stomach content) is inhaled.


Clinically pneumonia is classified into following 4 categories, as the treatment of each group is slightly different from one another; however the broad principles of management are equally applicable in all four categories of patients.

1.Community Acquired Pneumonia

2.Nosocomial or hospital acquired pneumonia

3.Aspiration pneumonia

4.Pneumonia in Immune compromised host.

Signs and Symtoms

  1. Most people who develop pneumonia initially have symptoms of
  1. Cold which are then followed by a
  2. High fever (sometimes as high as 104 degrees Fahrenheit),
  3. Shaking chills
  4. Cough with sputum production
  5. Sputum is usually discolored and sometimes bloody
  6. Short of breath
  7. Chest pain may develop if the outer pleural aspects of the lung are involved. (This pain is usually sharp and worsens when taking a deep breath, known as pleuritic pain)
  8. In other cases of pneumonia, there can be a slow onset of symptoms. A worsening cough, headaches, and muscle aches may be the only symptoms. In some people with pneumonia, coughing is not a major symptom because the infection is located in areas of the lung away from the larger airways. At times, the individual’s skin color may change and become dusky or purplish (a condition known as “cyanosis“) due to their blood being poorly oxygenated.
  9. Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic.
  10. Elderly people may also have few symptoms with pneumonia.

How to Diagnose

  1. Pneumonia may be suspected when the doctor examines the patient and hears coarse breathing or crackling sounds when listening to a portion of the chest with a stethoscope.

There may be wheezing, or the sounds of breathing may be faint in a particular area of the chest

  1. A chest x-ray is usually ordered to confirm the diagnosis of pneumonia. The lungs have several segments referred to as lobes, usually two on the left and three on the right. When the pneumonia affects one of these lobes it is often referred to as lobar pneumonia. Some pneumonias have a more patchy distribution that does not involve specific lobes. In the past, when both lungs where involved in the infection, the term “double pneumonia” was used. This term is rarely used today.

Pneumonia 2.jpg

  1. Sputum sample

Sample can be collected and examined under the microscope. If the pneumonia is caused by bacteria or fungi, the organisms can often be detected by this examination.

A sample of the sputum can be grown in special incubators, and the offending organism can be subsequently identified.

It is important to understand that the sputum specimen must contain little saliva from the mouth and be delivered to the laboratory fairly quickly. Otherwise, overgrowth of noninfecting bacteria may predominate.

Blood Test

  1. Sample that measures white blood cell count (WBC) may be performed.

An individual’s white blood cell count can often give a hint as to the severity of the pneumonia and whether it is caused by bacteria or a virus.

An increased number of neutrophils, one type of WBC, is seen in bacterial infections, whereas an increase in lymphocytes, another type of WBC, is seen in viral infections


  1. Sometimes, fluid collects in the pleural space around the lung as a result of the inflammation from pneumonia. This fluid is called a pleural effusion. If the amount of this fluid that develops is large enough, it can be removed by inserting a needle into the chest cavity and withdrawing the fluid with a syringe in a procedure called a thoracentesis. In some cases, this fluid can become severely inflamed (parapneumonic effusion) or infected (empyema) and may need to be removed by more aggressive surgical procedures.

Homoeopathic Medicine commonly used for the treatment of Pneumonia

Aconite. [Acon]

Probably no fact is more fully established in medicine, in any school, than the beneficial action of Aconite action of Aconite in pulmonary congestions. It is the remedy of remedies in the first stage of pneumonia,because it corresponds more closely to the symptoms usually found in that stage. It should not, however, be used in this or any disease in the first or any stage unless the symptoms call for it. The symptoms are these: High fever preceded by a distinct chill; the pulse is full, hard and tense; a history of exposure may also be taken into consideration; dry, cold winds. The skin is hot and dry, without moisture upon it; there is a hard, dry, teasing and painful cough; there may be some expectoration present, if so it is watery, serous and frothy, may be blood tinged, but not thick. Thick expectoration indicates that exudation is commencing, and then Aconite is no longer the remedy. There is pain also with Aconite, which is poorly borne. With these symptoms there is great restlessness, tossing about, anxiety and perhaps fear ;of death. It will strengthen confidence in remedies to see Aconite act in these cases. Veratrum viride in some is similar to Aconite in some particulars, but it is easily distinguished; there is a full rapid pulse and a great deal of arterial excitement; the eyes are glistening and there is a red streak down through the centre of the tongue. It is, perhaps more often indicated at the commencement of a pneumonia than is Aconite. A great indication for Aconite in pulmonary congestions is suddenness ;of onset, and especially so if it occurs in young and plethoric persons who are full of life and vigor; for it is per-eminently in such patients that congestions, when appearing at all, appear suddenly. Gelsemium lacks the suddenness ;of Aconite. Here apathy is marked, and the two drugs need never be confounded.

  1. Ferrum phosphoricum. [Ferr-p] This, like Aconite, is a remedy for the first stage before exudation takes place, and, ,like Aconite, if there be any expectoration it is thin, watery and blood streaked. It is a useful remedy for violent congestions of the lungs, whether appearing at the onset of the diseases or during its course, which would show that the inflammatory action was extending; it thus corresponds to what are termed secondary pneumonias, especially in the aged and debilitated. There is high fever, oppressed and hurried breathing, and bloody expectoration, very little thirst; there are extensive rales, and perhaps less of that extreme restlessness and anxiety that characterizes Aconite. This remedy, with kali muriaticum, forms the Schuesslerian treatment of this disease.
  2. Iodine. [Iod]this remedy is one both for the first and second stage of pneumonia, especially for the croupous form. It has high fever and restlessness like aconite, and there is ad tendency to rapid extension of the hepatization. There is a decided cough and great difficulty in breathing, as if the chest would not expand; the sputum is blood streaked. Iodine may also be a remedy in the later stages when resolution does not progress, the lung breaking down with hectic and suppurative symptoms. Dr. Kafka, our celebrated German confrere, prescribed drop doses of Iodine in the 1st,2d or 3d dilution every hour or so as soon as physical signs of pneumonia showed themselves, and claimed that it would arrest the process of hepatization within twenty-four hours. He considered that Aconite was entirely unnecessary in the treatment of pneumonia. It is also favorably spoken of by Prof. T. F. Allen.
  3. Veratrum viride. [Verat]

In violent congestions about the chest preceding pneumonia Veratrum viride may be the remedy, and thus it is seem that its use is more in the beginning of the disease, and especially where there is great arterial excitement, dyspnoea,chest oppdression and stomach symptoms of nausea and vomiting; the engorgement is profound, and here it greatly resembles Sanguinaria; but it differs from that drug, in that it is of ;little use after hepatization has taken place. There is high fever, violent action of the heart, the pulse is full, hard and rapid, and the tongue has a red streak down the center; this latter symptom is a characteristic keynote of the drug. The air cells at the bottom of the lobes are filling up with frothy mucus. the pulse will indicate, it being full and hard. Hard, quick and small indicates Aconite. Strike out anxiety and alarm and insert an ugly delirium with a deeply flushed, bloated face and headache and you have veratrum viride. One must beware not to encourage cardiac depression with this remedy.

  1. Bryonia [Bry]is the remedy for pneumonia; it furnishes a better pathological picture of the disease than any other, and it comes in after Aconite, Ferrum phosphoricum and Veratrum viride.
  2. The fever continues, but the skin is not as hot and the patient not as restless as in Aconite. the cough of Bryonia is looser and more moist than that of Aconite, and there are usually sharp stitching pleuritic pains,the cough of Bryonia is also hard and dry at times and the sputum is scanty and rust colored, so typical of pneumonia. There may be circumscribed redness of the cheeks, slight delirium and apathy; the tongue will most likely be dry, and the patient will most likely be dry,l and the patient will want to keep perfectly quiet. It is a right-sided remedy and attacks the parenchyma of the lung, and is perhaps more strongly indicated in the croupous form of pneumonia. The patient dreads to cough and holds his breath to prevent it on account of the pain it causes; it seems as though the chest walls would fly to pieces. The pains in the chest, besides being worse by motion and breathing, are relieved by lying on the right o;r painful side, be cause this lessens the motions ;of that side. Coughs which hurt distant parts of the body call for Bryonia. Phosphorus most commonly follows Bryonia in pneumonia, and is complementary. In pneumonias complicated by pleurisy Bryonia is the remedy, par excellence. Halbert believes that Cantharis relieves the painful features of the early development of the exudate better than any other remedy, a hint which comes from Dr.Jousset, who used the remedy extensively.
  3. Kali muriaticum. [Kali-m]Since the advent of Schuesslerism this has been a favorite remedy with some physicians, and not without a good ground for its favoritism. Clinical experience has proved that this drug in alternation with Ferrum phosphoricum constitutes a treatment of pneumonia which has been very successful in many hands. The symptoms calling for Kali muriaticum as laid down by Schuessler are very meager, it is given simply because there is a fibrinous exudation in the lung substance. There is a white, viscid expectoration and the tongue is coated white. It is better suited to the second stage, for when the third stage appears with its thick, yellowish expectoration it is replaced by Kali sulphuricum in the biochemic nomoenclature.
  4. Phosphorus [Phos]

is “the great mogul of lobar pneumonia.” It should be remembered that Phosphorus is not, like Bryonia, the remedy when the lungs are completely hepatized, although it is one of the few drugs which have been known to produce hepatization. When bronchial symptoms are present it is the remedy, and cerebral symptoms during pneumonia often yield better to Phosphorus than to Belladonna. There is cough ;with pain under sternum, as if something were torn loose; there is pressure across the upper part of the chest and constriction of the larynx; there is pressure across the upper part of the chest and constriction of the larynx; there are mucous rales, labored breathing, sputa yellowish mucus, with blood streaks therein, or rustcolored, as under Bryonia. After Phosphorus, Hepar sulphur. naturally follows as the exudate begins to often; it is the remedy of the third stage, the fever is ;of a low character. Tuberculinum. Arnulphy says that in lobular pneumonia this remedy surpasses Phosphorus or Antimonium tartaricum, and competent observers are convinced that it has an important place in the treatment of pneumonia; some using it in very case intercurrently; doses varying from 6x to 30x. When typhoid symptoms occur in the course of pneumonia then Phosphorus will come in beautifully. Phosphorus follows Bryonia well, being complementary to it. There is also a sensation as if the chest were full of blood, which causes an oppression ;of breathing, a symptom met with commonly enough in pneumonia. Hughes maintains that Phosphorus should be given in preference to almost any medicine in acute chest affections in young children. Lilienthal says Phosphorus is our great tonic to the heart and lungs. Hyoscyamus. Dr. Nash considers this remedy one ;of the best in typhoid pneumonia, meaning that it is more frequently indicated than any other.

  1. Sangunaria

When Sanguinaria is indicated in pneumonia there will be fever, burning and fullness in the upper chest, a dry cough, sharp, sticking pains more on the right side, dyspnoea, and the expectoration is rust-colored, here resembling Phosphorus. It has circumscribed redness and burning heat of the cheeks, especially in the afternoon. The hands and feet are either very hot or very cold, the heart is weak and irregular, there is great engorgement of the lungs and the congestion is very intense, here resembling Veratrum viride. Sanguinaria has imperfect resolution and purulent expectoration, as in Sulphur but it is more offensive,even becoming so to the patient himself.

  1. Chelidonium. Bilious pneumonia is, perhaps more often indicative of Chelidonium than of any other remedy. there are stitching pains under the right scapula, loose rattling cough and difficult expectoration, oppression ;of chest, as under Antimonium tartaricum, and fan-like motions of the alae nasi, as under Lycopodium. Mercurius is quite similar in bilious pneumonia; the stools will decide, those of Mercurius being slimy and accompanied by tenesmus; the expectoration is also apt to be blood-streaked. With chelidonium there is an excess of secretion in the tubes, which ;is similar to Antimonium tartaricum, and an inability to raise the same. It has been greatly praised in catarrhal pneumonia of young children where there is plentiful secretion and inability to raise it. The right lung is more often affected in cases calling for chelidonium.
  2. Antimonium tartaricum. [Ant-t]This drug is especially indicated in pneumonia and pleuro-pneumonia at the stage of resolution. There are fine moist rales heard all over the hepatized portion of the lungs; these are different from the Ipecac rales; they are fine, while those of Ipecac are coarse. With Antimonium tartaricum there is great oppression of breathing, worse towards morning, compelling the patient to sit up to breath. There are also sharp, stitching pains and high fever, as under Bryonia, and it, perhaps, more closely corresponds to the catarrhal form than it does to the croupous. Bilious symptoms, if present, do not contra-indicate, as there are many of these in its pathogenesis. There is one peculiar symptom, the patient feels sure that the next cough will raise the mucus, but it does not. When there is deficient reaction, as in the aged or ;in very young children, this remedy is particularly indicated .
  3. Kali carbonicum [Kali-c]is, perhaps, more similar to Bryonia than any drug in the symptom of sharp, stitching pains in the chest. These are worse by motion, but, unlike Bryonia they come whether the patient moves or not, and are more in the lower part of the right lung. In pneumonia with intense dyspnoea and a great deal of mucus on the chest, which, like in all of the Kalis, is raised with difficulty, wheezing and whistling breathing, Kali carbonicum is the remedy, especially if the cough be tormenting. It comes in with benefit ofttimes where Antimonium tartaricum and Ipecac have failed to raise the expectoration. Kali bichromicum may be indicated by its well-known tough, stringy expectoration.
  4. Sulphur is a remedy to be used in any stage of pneumonia. It will prevent, if given in the beginning, if the symptoms indicate it. It will prevent hepatization and cause imperfect and slow resolution to react. When the case has a typhoid tendency and the lung and the lung tends to break down, where there are rales, muco-purulent expectoration slow speech, dry tongue and symptoms of hectic, Sulphur is the remedy. Weakness and faintness are characteristic symptoms. Dr. G. J. Jones says a dyspnoea occurring at night between 12 and 2 causing the patient to sit up in bed is a valuable symptom. Its field is especially in neglected pneumonias in psoric constitutions, with tendency to develop into tuberculosis. In purulent expectoration Sanguinaria is the better remedy, especially where it is offensive even to the patient himself. If the lung be hepatized, the patient at night restless and feverish, ulceration threatened, and there is no tendency to recuperation then one may depend upon Sulphur. Lycopodium is also; a most useful remedy in delayed or partial resolution. There is a tightness across the chest, aching over lungs, general weakness. Hughes says it is the best remedy where the case threatens to run into acute phthisis.

Medicine not to be used without consulting the doctor


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