Prescribing Patterns in The Current Influenza Epidemic
Prescribing Patterns in The Current Influenza Epidemic Over the past
Prescribing Patterns in The Current Influenza Epidemic
Over the past weeks I have found myself prescribing the same two remedies repeatedly as this influenza-like virus moves through the community, namely Arsenicum album and Phosphorus. While many cases initially present with a striking Belladonna picture, this rarely remains the dominant state. Instead, the picture often evolves quickly and requires a careful reassessment of the totality rather than persistence with the first apparent remedy.
Kate Howard RSHom
Homeopath and CHE Community Manager
These reflections are offered for professional colleagues and are based on direct clinical observation rather than theoretical epidemic analysis. They have reinforced, for me, the importance of remaining grounded in classical prescribing principles during acute epidemics.
The early Belladonna presentation
A significant number of cases begin abruptly with what looks like a classic Belladonna onset:
- Sudden start to symptoms
- Throbbing, pulsating headache
- Marked sensitivity to light
- High temperature with intense heat
- Generalised aches and pains
- Glassy eyes
- Hot skin with cold hands and feet
Belladonna is often considered at this stage and is helpful. However, in many cases the overall state either fails to fully respond or shifts within a short period. Reassessment of the developing totality has frequently led to Arsenicum album or Phosphorus.
The throat picture
Sore throats and tonsillitis-type presentations have been extremely common in this outbreak. On examination, many throats show marked redness, inflammation and pain on swallowing. Despite the intensity of the local pathology, the general symptoms often point away from a throat-focused prescription.
In a number of cases, the throat has been only one local expression of a much broader remedy picture.
Arsenicum album
In Arsenicum cases, the throat is typically burning and painful, but it sits alongside marked weakness, restlessness and anxiety. The patient often appears disproportionately unwell compared with the local throat findings.
Modalities for Arsenicum album:
- Worse after midnight
- Worse from cold, damp conditions
- Worse from movement
- Better from warmth
- Desire for small, frequent sips of water
Phosphorus
In Phosphorus cases, the throat is red, sore and sensitive, sometimes with hoarseness. There is often a sense of rawness rather than deep inflammation, and the throat symptoms are clearly secondary to the general emotional and physical state.
Modalities for Phosphorus:
- Worse in the evening
- Worse from cold air
- Better from warmth and company
- Strong thirst for large quantities of cold water
- Cough and symptoms aggravated by talking or exertion
Head and eye symptoms
Arsenicum album
Headaches are often accompanied by profound weakness. A particularly consistent feature has been streaming, stinging eye discharges with burning and irritation of the surrounding skin.
Modalities:
- Worse from motion or exertion
- Better from warmth and rest
- Burning pain in eyes and head
Phosphorus
Phosphorus headaches come with sensitivity to noise and light (like Belladonna), and emotional intensity. The eyes may be uncomfortable but lack the acrid, excoriating quality seen in Arsenicum.
Modalities:
- Worse from noise, light, and mental exertion
- Better from rest and reassurance
- Throbbing, pressing pains
Respiratory Symptoms
Respiratory symptoms have ranged from mild bronchial irritation to significant wheeze and breathlessness.
Arsenicum album
The Arsenicum chest picture has included:
- Wheezing and shortness of breath
- Anxiety around breathing
- Dry, hoarse cough
- Clear or scanty mucus
- Symptoms worse at night
Modalities:
- Worse at night and after midnight
- Worse from cold or damp air
- Better from warmth
Phosphorus
Phosphorus has been strongly indicated in cases with a rattly chest and thick mucus, where one might otherwise consider remedies such as Kali sulphuricum or Pulsatilla. What has differentiated Phosphorus has been the emotional state, with marked anxiety, fear of coughing and fear of choking, combined with a strong thirst for cold water.
Modalities:
- Worse in the evening and from cold air
- Worse from talking or exertion
- Better from warmth and company
- Strong thirst for cold water
Aches, weakness and general state
Both remedies present with influenza-type aches and significant weakness, but the quality differs.
Arsenicum album shows collapse, exhaustion and restlessness, often with visible anxiety.
Phosphorus shows weakness alongside fearfulness and a strong need for reassurance.
Modalities for body symptoms:
- Arsenicum: worse after midnight, from movement, better from warmth
- Phosphorus: worse in the evening, from exertion, better from warmth and company
Gastrointestinal features and thirst
Digestive symptoms have been common and have often helped clarify remedy choice.
Arsenicum album
- Nausea or diarrhoea
- Burning sensations
- Desire for small, frequent sips of water
- Markedly reduced appetite
Phosphorus
- Strong thirst for large quantities of cold water
- Temporary relief from drinking
The contrast in thirst and digestive response alone has been decisive in several cases.
Differentiating Arsenicum album and Phosphorus (Based on Richard Pitt's Comparative Materia Medica)
Richard Pitt emphasises the importance of comparing remedies not only by physical signs but by their characteristic mental themes, temperaments, and remedy state dynamics. Key distinctions for these two remedies in acute and epidemic presentations are:
Mental and Emotional Themes
- Arsenicum album: Intense anxiety about health and survival, fear of worsening symptoms, restlessness, and a need for control. Fear often centers on death or loss of vitality.
- Phosphorus: Fear related to immediate vulnerability, heightened sensitivity to environment and people, and fear of coughing or choking. Anxiety is more about the present moment rather than existential concerns.
Physical Symptoms
Feature | Arsenicum album | Phosphorus |
Head | Throbbing, burning | Pressing, throbbing, worse from sensory overload |
Eyes | Streaming, stinging, burning | Irritated but not excoriating |
Throat | Burning pain, worse after midnight | Raw, sore, hoarse, worse in evening |
Chest | Wheezing, dry cough, worse at night | Rattly cough with thick mucus, worse in evening or with exertion |
Body | Aching, collapse, worse after midnight, better warmth | Weakness with fearfulness, worse with exertion, better warmth and company |
Thirst | Small sips frequently | Large quantities cold water |
Modalities | Worse from cold, damp, movement; better warmth | Worse from cold air, talking, exertion; better warmth, company |
Pitt encourages looking beyond isolated symptoms to the central theme of the remedy state, which allows differentiation even when some acute presentations overlap. In practice, these distinctions can guide classical prescribing and support appropriate remedy selection during epidemics.
Case observations
Case 1. Child. Arsenicum album
A child presented with a throbbing headache, high temperature, marked aches and weakness, and little interest in food. There was a clear desire for small sips of water. The eyes were streaming and stinging, and the throat was red and sore.
Arsenicum album 30C was prescribed, later followed by 200C as the case evolved, with a good clinical response.
Case 2. Adult. Arsenicum album
An adult with a history of pneumonia and bronchitis presented with wheezing, shortness of breath, anxiety, and a dry, hoarse cough with clear mucus.
Arsenicum album 30C led to a clear settling of the breathing and wheeze.
Case 3. Child. Phosphorus
A child presented with a rattly cough and thick mucus, which initially suggested remedies such as Kali sulphuricum or Pulsatilla. However, the child was extremely anxious, frightened of coughing and choking, and intensely thirsty for large amounts of water.
Phosphorus was prescribed and confirmed by the response.
Reflections on prescribing during epidemics
This outbreak has once again highlighted that epidemics do not require a different philosophy, only sharper observation.
The diagnostic label of the virus has been largely irrelevant. What has mattered is the individual patient and the totality they present at that moment. When approached in this way, remedies such as Arsenicum album and Phosphorus continue to show their depth and reliability, even within a shared epidemic context.
These cases have served as a timely reminder to treat what is in front of us, rather than what we expect to see.
Disclaimer
The content shared here is intended for informational purposes only and should not be considered a replacement for professional medical advice, diagnosis, or treatment from a qualified and licensed healthcare provider. The views and opinions expressed in this presentation are those of the presenter and do not necessarily represent those of CHE or any affiliated organizations.
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