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Beyond Flat Earth Medicine - Homeopathic help for croup

Timothy R. Dooley, MD, NDHave you ever attempted to breathe through a straw? The smaller the straw, the harder it is to do, and the harder you try to breathe, the less effective your efforts become. This is very much like the situation in croup, a respiratory disease that is common in the fall and early winter.

Croup is an inflammation of the larynx and trachea, that is, the voice box and the passage below it into the lungs. This inflammation is usually caused by a viral infection and it is the swelling associated with the inflammation that gives rise to the usual symptoms. The swelling of the trachea causes its interior diameter to shrink until it becomes like breathing through a small straw. This effect is much more pronounced in children who have a smaller airway to begin with.

With this process in mind, it is easy to understand the symptoms associated with croup. In classic croup, the disease has a sudden onset. The child wakes in the night with a feeling of panic caused by the narrowed airway. The harder they struggle the harder it becomes to take a normal breath and the more the panic grows. Their voice is hoarse from the inflammation of the larynx, and the narrowed trachea gives rise to a barking, metallic cough. Sometimes the breathing itself is noisy for the same reasons.

What to do

The vast majority of croup attacks can be helped by a few simple measures. First, holding the child in a comforting way helps them feel secure and relax. Turn on the shower so that the bathroom gets steamy and then hold the child in that humid air (not in the shower itself). For the same reason, keeping a humidifier in the child's room during respiratory ailments can help attacks. Carrying the child in the cool night air often brings relief.

But what else? Conventional medicine has only hospital based treatments in the event of life threatening respiratory compromise and nothing else to offer for home use. Once again, homeopathy to the rescue.

The three most common homeopathic remedies for patients with croup are Aconite, Spongia, and Hepar sulph. There are actually a number of other remedies that might be indicated (such as Kali bichromicum, Lachesis, Phosphorus, and Bromium), but most cases of croup can be helped with just these first three remedies. Understanding when to use one over the others is a good lesson in basic homeopathic thinking that makes successful prescribing attainable.

The secret to success in homeopathic prescribing is to look at the whole patient, not just at the disease. The symptoms of the whole patient include the general symptoms (i.e., those symptoms which affect the person in general such as feeling hot or cold, restlessness, lethargy, appetite, etc.), the mental symptoms (such as irritability, weepiness, confusion, etc.), and the specific symptoms (the type of cough, discharges, etc.). Symptoms which are peculiar or unique are very important. An example of this might be a burning pain that feels relieved by hot applications. This is peculiar; normally such a patient would want cold applications to relieve the burning sensation.

Over time it becomes natural to examine the totality of the patient's symptoms and to recognize which symptoms are more important in guiding to a curative remedy. As the following examples of remedies that might be indicated in croup demonstrate, each remedy has specific characteristics and peculiarities that guide its use.


Aconite is an indispensable homeopathic remedy for acute illnesses. It is almost always prescribed on its general characteristics, that is, symptoms and properties of the patient as a whole. For Aconite these main general properties are sudden onset of symptoms, a feeling of anxious panic or fear of death, and great restlessness. This trio of symptoms makes Aconite a useful remedy for a wide range of acute illnesses of a sudden, violent nature. Add to these characteristics the fact that Aconite can cause (and cure) a hoarse, dry, barking cough, and you have a perfect picture of a patient with croup. In fact, Aconite so closely fits the picture of a classic croup attack that it is almost always the first remedy given during an acute attack. If you don't know what else to give to a patient during a croup attack, give Aconite.


Spongia is usually prescribed on its peculiar specific symptoms. This is in contrast to Aconite which is almost always prescribed on its general characteristics, so much so that it would be rare to prescribe Aconite for a patient who did not have anxious panic or restlessness. Spongia, however, is often indicated in a patient with croup because of the characteristic cough which it can cause and cure. This cough is hollow, barking, or croupy and is often worse if the patient takes cold drinks and better if the patient takes warm drinks or food. It is this combination of a barking dry cough that is worse from cold drinks and/or better from warm drinks that is peculiar and characteristic for Spongia. In addition, the respiratory passages are dry and the patient may wake with a fear of suffocation.

Hepar sulph

It is both the general and peculiar characteristics for Hepar sulph which lead to its use in patients with croup, usually in the later stages of the disease. Patients who need this remedy are usually chilly; they just can't tolerate drafts or cold air. Emotionally they tend to be touchy and irritable. They often sweat easily. Their mucous discharges and expectoration tend to be thick and yellow. Their cough is choking, often barking, with rattling in the chest and is often brought on by breathing cold air.

A patient with croup may need all three of these remedies over a period of days as the disease goes through various stages. Aconite is usually needed initially when the attack is violent and sudden, Spongia may be needed a day or two later when the violence has abated and the cough is better with warm food or drinks. Hepar sulph often follows in the final stages where the mucus is thicker and yellow and the patient chilly.

Don't forget that none of these remedies are exclusively croup remedies. All three have been studied for their effects on the entire person and might be used in a wide variety of illnesses.


During an acute attack I usually recommend patients put a dose (2--4 pellets) of the remedy in a glass of water, stir, and sip on it as needed. Refill the glass and re-dose as needed. A common potency to use would be 30C, but I would not hesitate to use any available potency of the best indicated remedy. In less acute situations, a few pellets of 30C melted under the tongue about four times daily is usually adequate.

Possible dangers

The vast majority of the time, croup is a self-limiting and benign disease. My experience is that patients with this illness usually respond well to the simple measures and remedies outlined in this column. But anytime a patient, especially a child, is having respiratory problems, caution must be exercised. It is difficult to give exact parameters for which patients should go to the emergency room, but suffice to say that any patient having trouble breathing or becoming excessively fatigued from their illness needs a medical evaluation.

There is a closely related condition called epiglottitis which is a serious medical emergency. Unlike croup, this condition is uncommon but can often present with similar symptoms. A patient with this condition usually has a high fever, refuses to swallow due to pain (and therefore drools), and sits leaning forward to relieve the pain. They usually have noisy, raspy breathing. Any patient suspected of having epiglottitis needs an immediate medical evaluation.

Summary and other adjunct treatments

Calm the patient. Use steamy air and/or a walk in open air. Give plenty of fluids and stay well hydrated. Use a humidifier or vaporizer in the patient's room. Give an indicated homeopathic remedy. Seek medical evaluation if there is any suspicion of epiglottitis or trouble breathing. Consider massaging lobelia tincture on the chest. (This herbal tincture often helps relieve spasmodic croup.) Vitamin A, Vitamin C, and Zinc can help the immune system throw off the illness.

Editor Note:

The master German homeopath, Clemens von Bšnninghausen (1785--1864) treated enough croup that a product called "Bšnninghausen's Croup Powders" was marketed by several pharmacies. The product contained five small packets, each containing a dose of a remedy. The packets were numbered 1--5, and the instructions were to give packet number 1 when first signs of croup appeared, followed by the other packets if necessary, i.e., when the symptoms changed.

The powders were in this order: Aconite, Spongia, Hepar, Spongia, Hepar.

The late Dr. Maesimund Panos said that when any patient had a child, she would send to them an envelope with three remedies numbered 1--3 and instructions similar to those on the Bšnninghausen's Croup Powders. The remedies were Aconite, Spongia, and Hepar.

Dr. Panos told me that only in rare cases did a mother report that she had to give "number two," and in very rare cases, the condition progressed to where "number three" was needed.


About the author:

Dr. Timothy R. Dooley is a graduate of National College of Naturopathic Medicine as well as Oregon Health Sciences University School of Medicine. He practices homeopathy in San Diego, California, and teaches at the Southwest College of Naturopathic Medicine and Health Sciences. He is the author of the easy-to-read introductory book, Homeopathy: Beyond Flat Earth Medicine. The complete text can be read on-line at For more information, visit He can be reached at (619) 297-8641 or