Pneumonia is an inflammation of the lung caused by infection with bacteria, viruses,

and other organisms. Pneumonia is usually triggered when a patient’s defense system is
weakened, most often by a simple viral upper respiratory tract infection or a case of
influenza. Such infections or other triggers do not cause pneumonia directly but they
alter the mucous blanket, thus encouraging bacterial growth. Other factors can also
make specific people susceptible to bacterial growth and pneumonia.
Bacteria are the most common causes of pneumonia, but these
infections can also be caused by other microbial organisms. It is
often impossible to identify the specific culprit. The most
common cause of pneumonia is the gram-positive bacterium
Streptococcus pneumoniae (also called S. pneumoniae or
pneumococcal pneumonia ). The most common gram-negative
species causing pneumonia is Haemophilus influenzae (generally
occurring in patients with chronic lung disease, older patients,
and alcoholics).
Atypical pneumonias are generally caused by tiny nonbacterial
organisms called Mycoplasma or Chlamydia pneumoniae and
produce mild symptoms with a dry cough. Viruses that can cause
or lead to pneumonia include influenza, respiratory syncytial
virus (RSV), herpes simplex virus, varicella-zoster (the cause of
chickenpox), and adenovirus.

General Symptoms.
The symptoms of bacterial pneumonia develop abruptly and may
include chest pain, fever, shaking, chills, shortness of breath, and
rapid breathing and heart beat.
Symptoms of pneumonia indicating a medical emergency include
high fever, a rapid heart rate, low blood pressure, bluish-skin, and
mental confusion.

Coughing up sputum containing pus or blood is an indication of

serious infection.

Severe abdominal pain may accompany pneumonia occurring in

the lower lobes of the lung.

In advanced cases, the patient’s skin may become bluish

(cyanotic), breathing may become labored and heavy, and the
patient may become confused.
Symptoms in the Elderly. It is important to note that older people
may have fewer or different symptoms than younger people have.
An elderly person who experiences even a minor cough and
weakness for more than a day should seek medical help. Some
may exhibit confusion, lethargy, and general deterioration.

Symptoms of Pneumonia Causes by Anaerobic Bacteria

People with pneumonia caused by anaerobic bacteria such as
Bacteroides, which can produce abscesses, often have prolonged
fever and productive cough, frequently showing blood in the
sputum, which indicates necrosis (tissue death) in the lung. About
a third of these patients experience weight loss.

Symptoms of Atypical Pneumonia

General Symptoms for Atypical Pneumonias. Atypical
nonbacterial pneumonia is most commonly caused by
Mycoplasma and usually appears in children and young adults.
Symptoms progress gradually, often beginning with general flu-
like symptoms, such as fatigue, fever, weakness, headache, nasal
discharge, sore throat, ear ache, and stomach and intestinal
distress.

Vague pain under and around the breast bone may occur, but the
severe chest pain associated with typical bacterial pneumonia is
uncommon.

Patients may experience a severe hacking cough, but it usually

does not produce sputum.
Symptoms of Legionnaire’s Disease. Symptoms of Legionnaire’s
disease usually evolve more rapidly and include high fever, a dry
cough, and shortness of breath, often accompanied by headache,
muscle pains, fatigue, gastrointestinal problems, and mental
confusion.

#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 vigour, 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.

#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.
#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,2nd 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.

#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.
#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. 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, 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.
#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.
#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 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.
#Sanguinaria. [Sang]
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.
#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.
#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 .
#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.
#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.