Intro: Role of all health care systems needs to be established in the management of this incapacitating lung disease. Homoeopathy is a promising medical care system in the management of cases suffering from Interstitial Lung disease. An integrated medical approach can go a long way in the management of complications which are arising due to coronavirus. This article gives an overview on Pulmonary fibrosis and how it can be managed with homoeopathic medicines.

As the coronavirus continues to impact the world’s population, the impact that it is having on human lungs is devastating. Pulmonary fibrosis, the scarring or inflammation of the tissue around the air sacs of the lungs, which leads to fatigue and shortness of breath, is being reported in vast numbers of survivors. This is the condition that the physicians will have to deal with in the near future in many COVID-19 survivors.

While the vast majority of the almost 60 million people who have contracted the virus around the world have had only a mild or moderate infection, about 10% will develop severe Covid-19 pneumonia, and 5% will develop Acute Respiratory Distress Syndrome (ARDS), which works out to significant pulmonary involvement in several million individuals.

According to a study published in the Lancet (Comparison of the characteristics, morbidity, and mortality of COVID-19 and seasonal influenza: a nationwide, population-based retrospective cohort study) respiratory complications were more common in COVID-19 cases than in seasonal influenza. Similar to other studies, we found that pulmonary bacterial co-infections were infrequent in COVID-19, in contrast to what has been reported for influenza epidemics. However, in our study, the frequency of pulmonary bacterial co-infections was very similar for COVID-19 and influenza. It therefore seems that SARS-CoV-2 has a superior potential for respiratory pathogenicity, possibly by inducing upregulation of a small number of inflammatory mediators (including IL-6), and that respiratory complications are mainly responsible for the excess mortality observed in COVID-19. 

Role of all health care systems needs to be established in the management of this incapacitating lung disease. Homoeopathy is a promising medical care system in the management of cases suffering from Interstitial Lung disease. An integrated medical approach can go a long way in the management of complications which are arising due to coronavirus. This article gives an overview on Pulmonary fibrosis and how it can be managed with homoeopathic medicines.


  • Pulmonary fibrosis

    Pulmonary fibrosis is a lung disease that occurs when lung tissue becomes damaged and scarred. This thickened, stiff tissue makes it more difficult for your lungs to work properly. As pulmonary fibrosis worsens, you become progressively more short of breath. The scarring associated with pulmonary fibrosis can be caused by a multitude of factors. Lung fibrosis is one of the major complications in COVID -19. 
    Symptoms

    Signs and symptoms of pulmonary fibrosis may include:

    • Shortness of breath (dyspnea)
    • A dry cough
    • Fatigue
    • Unexplained weight loss
    • Aching muscles and joints
    • Widening and rounding of the tips of the fingers or toes (clubbing)
The course of pulmonary fibrosis — and the severity of symptoms — can vary considerably from person to person. Some people become ill very quickly with severe disease. Others have moderate symptoms that worsen more slowly, over months or years.
Some people may experience a rapid worsening of their symptoms (acute exacerbation), such as severe shortness of breath, that may last for several days to weeks. People who have acute exacerbations may be placed on a mechanical ventilator. Doctors may also prescribe antibiotics, corticosteroid medications or other medications to treat an acute exacerbation.

Causes

Pulmonary fibrosis scars and thickens the tissue around and between the air sacs (alveoli) in your lungs. This makes it more difficult for oxygen to pass into your bloodstream. The damage can be caused by many different factors — including long-term exposure to certain toxins, certain medical conditions, radiation therapy and some medications.
Occupational and environmental factors - Long-term exposure to a number of toxins and pollutants can damage your lungs. These include Silica dust, Asbestos fibers, Hard metal dusts, Coal dust, Grain dust, Bird and animal droppings
Radiation treatments - Some people who receive radiation therapy for lung or breast cancer show signs of lung damage months or sometimes years after the initial treatment. 

Medications - Many drugs can damage your lungs, especially medications such as Chemotherapy drugs, Heart medications, Some Anti-inflammatory drugs.

Medical conditions - Lung damage can also result from a number of conditions, including, Dermatomyositis, Polymyositis, Mixed connective tissue disease, Systemic lupus erythematosus Rheumatoid arthritis, Sarcoidosis, Scleroderma, Pneumonia
COVID -19 – One of the most recent causes of lung fibrosis is the deadly virus coronavirus that’s been affected humanity now for over a year. 

  • Risk factors

    Factors that make you more susceptible to pulmonary fibrosis include:

    • Age. Although pulmonary fibrosis has been diagnosed in children and infants, the disorder is much more likely to affect middle-aged and older adults.
    • Sex. Idiopathic pulmonary fibrosis is more likely to affect men than women.
    • Smoking. Far more smokers and former smokers develop pulmonary fibrosis than do people who have never smoked. Pulmonary fibrosis can occur in patients with emphysema.
    • Certain occupations. You have an increased risk of developing pulmonary fibrosis if you work in mining, farming or construction or if you're exposed to pollutants known to damage your lungs.
    • Cancer treatments. Having radiation treatments to your chest or using certain chemotherapy drugs can increase your risk of pulmonary fibrosis.
    • Genetic factors. Some types of pulmonary fibrosis run in families, and genetic factors may be a component.
  • Complications

    Complications of pulmonary fibrosis may include:

    • High blood pressure in your lungs (pulmonary hypertension). Unlike systemic high blood pressure, this condition affects only the arteries in your lungs. It begins when the smallest arteries and capillaries are compressed by scar tissue, causing increased resistance to blood flow in your lungs.
    • This in turn raises pressure within the pulmonary arteries and the lower right heart chamber (right ventricle). Some forms of pulmonary hypertension are serious illnesses that become progressively worse and are sometimes fatal.
    • Right-sided heart failure (cor pulmonale). This serious condition occurs when your heart's lower right chamber (ventricle) has to pump harder than usual to move blood through partially blocked pulmonary arteries.
    • Respiratory failure. This is often the last stage of chronic lung disease. It occurs when blood oxygen levels fall dangerously low.
    • Lung cancer. Long-standing pulmonary fibrosis also increases your risk of developing lung cancer.
    • Lung complications. As pulmonary fibrosis progresses, it may lead to complications such as blood clots in the lungs, a collapsed lung or lung infections.

Homoeopathic Approach 

“The good physician treats the disease; The great physician treats the patient who has the disease”.  Homoeopathy is a system of medicine which treats the individual ant not the disease. The homoeopathic approach is always to take in the totality of the symptoms and prescribe on that totality considering the constitutional approach. Miasmatic analysis also needs to be made to prescribe an anti-miasmatic remedy. In cases with acute symptoms, many specific remedies are prescribed alongside to give relief to the patient from the present symptoms. There are many homoeopathic remedies that can be prescribed for treating acute pulmonary symptoms. Below are enlisted a few of them:

Arsenic album - Unable to lie down; fears suffocation. Air-passages constricted. Worse midnight. Burning in chest. Suffocative catarrh. Cough worse after midnight; worse lying on back. Expectoration scanty, frothy. Darting pain through upper third of right lung. Wheezing respiration. Burning heat all over. Cough dry, as from sulphur fumes; after drinking.
Aralia racemose - Dry cough coming on after first sleep, about middle of night. Asthma on lying down at night with spasmodic cough; worse after first sleep, with tickling in throat. Constriction of chest; feels as if a foreign body were in throat. Obstruction worse in spring. Hay-fever; frequent sneezing. Rawness and burning behind sternum.

Aspidosperma (Quebracho) MT helps in removing temporary obstruction to the oxidation of the blood by stimulating respiratory centres increasing oxidation and excretion of carbonic acid. It is also used in pulmonary stenosis, thrombosis of pulmonary artery and uraemic dyspnoea. It is an effective remedy in many cases of asthma. It stimulates the respiration centres and increases oxygen in the blood (lack of oxygen is the most common problem in lung fibrosis). Cardiac asthma. Want of breath during exertion is the guiding symptoms. 

Beryllium metallicum - inflammation of the larynx with hoarseness, dyspnea which worsens at the slightest movement, dry, painful cough, aggravated when leaning back and from the cold, improved in a warm room. The cough is spasmodic, seeming to come from the sternum. No or very slight sputum with a sweet taste. A little hemoptysis may be present as well as a feeling of chest oppression when taking a breath, wheezing and crackles on auscultation.

Bryonia - Soreness in larynx and trachea. Hoarseness; worse in open air. Dry, hacking cough from irritation in upper trachea. Cough, dry, at night; must sit up; worse after eating or drinking, with vomiting, with stitches in chest, and expectoration of rust-colored sputa. Frequent desire to take a long breath; must expand lungs. Difficult, quick respiration; worse every movement; caused by stitches in chest. Cough, with feeling as if chest would fly to pieces; presses his head on sternum; must support chest. Croupous and pleuro-pneumonia. Expectoration brick shade, tough, and falls like lumps of jelly. Tough mucus in trachea, loosened only with much hawking. Coming into warm room excites cough (Nat carb). Heaviness beneath the sternum extending towards the right shoulder. Cough worse by going into warm room. Stitches in cardiac region. Angina pectoris (use tincture).

Cobalt - On taking a deep inspiration, stitches in the chest, soreness in the stomach and pain in the spleen.-Cough with soreness in the throat and rawness when hawking.-Stitches in anterior part of larynx.-Short hacking cough, with frequent eructation of a quantity of bright red blood, it feels as if it came from the larynx.-Raising of much thick, tough mucus mixed with a considerable quantity of bright red blood; with the sensation of fulness and pressive pain in the larynx, accompanied by a sensation of scratching and rawness, with occasional burning pains, and a disposition to keep the jaws closed tightly; these sensations are increased by pressure, empty deglutition and cold water.-Copious expectoration of frothy white mucus.

Drosera -Spasmodic, dry irritative cough, like whooping-cough, the paroxysms following each other very rapidly; can scarcely breathe; chokes. Cough very deep and hoarse; worse, after midnight; yellow expectoration, with bleeding from nose and mouth; retching. Deep, hoarse voice; hoarseness; laryngitis. Rough, scraping sensation deep in the fauces and soft palate. Sensation as if crumbs were in the throat, of feather in larynx. Laryngeal phthisis, with rapid emaciation. Harassing and titillating cough in children-not at all through the day, but commences as soon as the head touches the pillow at night. Clergyman's sore throat, with rough, scraping, dry sensation deep in the fauces; voice hoarse, deep, toneless, cracked, requires exertion to speak. Asthma when talking, with contraction of the throat at every word uttered.

Justicia adhatoda - Dry cough from sternal region all over chest. Hoarseness, larynx painful. Paroxysmal cough, with suffocative obstruction of respiration. Cough with sneezing. Severe dyspnoea with cough. Tightness across chest. Asthmatic attacks, cannot endure a close, warm room. Whooping-cough.

Phosphorus - Cough from tickling in throat; worse, cold air, reading, laughing, talking, from going from warm room into cold air. Sweetish taste while coughing. Hard, dry, tight, racking cough. Congestion of lungs. Burning pains, heat and oppression of chest. Tightness across chest; great weight on chest. Sharp stitches in chest; respiration quickened, oppressed. Much heat in chest. Pneumonia, with oppression; worse, lying on left side. Whole body trembles, with cough. Sputa rusty, blood-colored, or purulent. 

Rumex crispus - Tickling in throat-pit causes cough. Copious mucous discharge from nose and trachea. Dry, teasing cough, preventing sleep. Aggravated by pressure, talking, and especially by inspiring cool air and at night. Thin, watery, frothy expectoration by the mouthful: later, stringy and tough. Rawness of larynx and trachea. Soreness behind sternum, especially left side, in region of left shoulder. Raw pain under clavicle. Lump in throat.