Chronic Bronchitis
1. PRELIMINARY DATA
- No.: 223/2026
- Patient's Name: PQR
- Address: Flat 1301, Topaz Residency, Pune.
- Occupation: Factory Supervisor (dust exposure, chemical fumes, long shifts)
- Religion: Hindu
- Date: 20/06/2026
- Age: 53 Years
- Sex: Male
- Education: Diploma in Mechanical
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Respiratory (bronchi & lungs) | Chronic productive cough with thick mucopurulent sputum, wheezing, breathlessness on exertion | < Cold damp weather, < Dust/fumes, < Night/morning, < Lying down, > Warm drinks, > Open air, since 15 years (worse last 6 years, spirometry shows obstructive pattern) | Chest tightness, fatigue, recurrent infections, irritability |
| General | Heaviness in chest | < After meals | Anxiety about breathlessness, low mood |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Recurrent chest colds in childhood; smoking 15 cig/day for 20 years (quit 5 years ago); suppressed eczema with ointments; frequent antibiotics for bronchitis exacerbations; occupational dust exposure.
- Family History: Father has chronic bronchitis & COPD. Mother has asthma. Brother has allergic rhinitis.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Normal
- Desires: Warm drinks (+++), Spicy food (+)
- Aversions: Cold food/drinks
- Thirst: Moderate
- Elimination:
- Urine: Normal
- Stool: Regular
- Perspiration: Profuse on upper body, sour
- Sleep: Disturbed by cough; wakes coughing
- Thermal State: Chilly patient (cannot tolerate cold air/fan)
B. Reactions - Physical Factors
- Weather: Aggravation in cold damp/winter
- Position: Better sitting up
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Irritable, impatient, worried
- Anxiety: About worsening breathlessness, job loss
- Fear: Fear of suffocation, fear dependency
- Dreams: Suffocation, falling, work failure
- Other: Suppressed frustration, feels restricted
6. PHYSICAL GENERAL EXAMINATION
- Wt: 78 kg | Ht: 170 cm | Temp: 98.6°F
- RR: 20/min | Pulse: 86 bpm | B.P.: 140/88 mmHg
- Face: Flushed, anxious
- Tongue: Coated
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Respiratory: Prolonged expiration, bilateral wheeze, rhonchi, barrel chest
- CVS: S1, S2 Normal
- GIT: Normal
- Musculoskeletal: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Irritability, anxiety about breathlessness, fear suffocation (Grade 3)
- Physical General: Chilly, desire warm drinks, sour sweat, productive cough (Grade 3)
- Particular: Chronic bronchitis with mucopurulent sputum, wheezing, < cold/dust/night, > warm drinks/sitting (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic obstructive respiratory disease with strong Mental Generals (irritability, fears) and Physical Generals (thermal, desires, sweat) dominating; Kent suits respiration rubrics for chronic bronchitis.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Irritability and impatience
- Anxiety about breathlessness
- Fear suffocation
- Desire warm drinks
- Chilly patient
- Profuse sour perspiration
- Cough chronic productive mucopurulent
- Wheezing breathlessness
- < Cold damp, night, dust
-
Warm drinks, sitting up
- Family respiratory history
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Irritability | Mind; IRRITABILITY | 57 |
| 2 | Anxiety health | Mind; ANXIETY; health, about | 6 |
| 3 | Fear suffocation | Mind; FEAR; suffocation, of | 47 |
| 4 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 5 | Respiration asthmatic chronic | Respiration; ASTHMATIC; chronic | 763 |
| 6 | Cough mucopurulent | Cough; MUCOUS; purulent | 807 |
| 7 | Chilly | Generalities; COLD; agg. | 1348 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Kali Carbonicum | 7/7 | 22 |
| 2 | Antimonium Tartaricum | 6/7 | 18 |
| 3 | Hepar Sulphuris | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Wheezing, irritability, chilly | Mucopurulent sputum, chronic cough | Family respiratory issues | Destructive fear suffocation |
Dominant Miasm: Psora-Sycotic
14. FINAL STEPS
- Provisional Diagnosis: Chronic Bronchitis
- Differentiation of Remedies: Compared Kali carb with Ant tart. Ant tart has more rattling cough, chilly, drowsiness; Kali carb matches chronic bronchitis with stitching pains, chilly, anxiety/irritability, desire warm drinks, sour sweat, < cold damp/night, > warm drinks. Hepar more for acute suppuration.
- Selection of Remedy (Materia Medica): Kali Carbonicum matches chronic bronchitis with productive cough, wheezing, chilly patient, anxiety/irritability, desire warm drinks, < cold damp/night (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic respiratory miasmatic case, sensitive constitution)
- Actual Prescription:
- Kali Carbonicum 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 15/07/2026 | Cough reduced 60%, sputum thinner & less, breathlessness milder | Placebo | Avoid dust/fumes, steam inhalation, warm clothing |
| 15/11/2026 | Minimal cough, no exacerbations, spirometry improved, energy better | Placebo | Continue avoidance of triggers, breathing exercises |