A Case of Cough & Voice Hoarseness - Homeopathic Phosphorus Embodied
Written By: Jessica Yacoub, HOM, RN, BScN
DEMOGRAPHIC INFORMATION
Age: 10
Gender: Female
Presenting Complaints: Feverish, painful dry cough, sore throat, hoarseness, lethargy, history of pneumonia and lingering coughs
HISTORY OF PRESENTING COMPLAINTS
The patient first developed a sore throat 1–2 days prior to consultation. Initially she appeared generally well with sustained energy. Over the next few days, symptoms progressed to cough and fever. Past medical history significant for pneumonia requiring hospitalization, making close monitoring essential. The child’s parent expressed concern for the child’s well-being, as the current symptoms somewhat resembled the previous serious infection. The child is also very prone to prolonged, lingering coughs, and symptoms generally appear more severe than those of her siblings. Current clinical diagnosis remains unknown.
The acute homeopathic case was evaluated thoroughly, and a complete symptom picture was obtained. The evaluation considered the physical, emotional, and mental spheres. With over 100 potential homeopathic remedies indicated for coughs, individualized case-taking is essential to understand the person’s unique experience and select the most appropriate remedy. We also will focus on symptomatology versus. the “disease” or “condition”.
HOMEOPATHIC CASE
Throat & Voice
• Sore throat began approximately 2 days prior
• Began clearing throat frequently yesterday
• Pain located centrally at the throat pit
• Refrains from speaking whenever possible, resorting to whispering if needed, talking worsens the throat pain**
Cough & Respiratory
• Development of a dry, deep, seal-like cough has developed today**
• Painful cough, attempts to suppress cough because coughing hurts the throat and sometimes the chest
• Deep, husky voice with hoarseness is now present**
• Rattling heard in chest during respiration without auscultation
• No wheezing
• Sensation of phlegm stuck in throat, difficulty expectorating
• One episode of vomiting after a coughing spell (after eating cold watermelon)**
Nasal
• Nose feels dry
• Dry, yellow-green crusts
General Symptoms
• Marked lethargy, fell asleep for a couple of hours**
• Craves ice-cold water but only small amounts frequently**
• Appetite reduced with only a strong desire for cold, refreshing foods such as popsicles, frozen fruits, fresh fruits**
• Feverish sensation, feels hot but chills easily, prefers blankets and covers
• Warm head and extremities (arms, hands, legs and feet) but toes cold
• No perspiration
• Desiring company, refused to sleep alone last night too**
• Sleep restless
Vitals
• SpO₂ 94%, Pulse 132 (vitals warrant close observation, see below for more)
** indicates standout symptoms that are especially intense or uniquely characteristic in the case.
HOMEOPATHIC ASSESSMENT
Key Symptoms for Case / Totality of Symptoms:
• Husky/hoarse voice with painful larynx worse on talking
• Dry, deep, barking cough
• Rattling mucus that is difficult to expectorate
• Strong craving for ice-cold drinks and cold, refreshing things
• Great desire for company
• Warm body to the touch, but chills easily, feels chilly
• Vomiting after cold ingesta
Rubrics (Homeopathic Symptoms) Considered for Case Assessment:
(1) Chest – pain – cough – during – agg.
(2) Cough – dry
(3) Cough – barking
(4) Larynx and Trachea – voice – hoarseness
(5) Throat – pain – cough – during – agg.
(6) Larynx and Trachea – voice – husky
(7) Stomach – vomiting – cough – during agg.
(8) Generals – food and drinks – fruit – desire
Homeopathic Repertorization of Symptom Totality Using Synthesis Repertory Software:
The top remedies to differentiate between and consider as per reperterization include: Phosphorus, Causticum & Sulphur. The case presented with several hallmark indicators pointing strongly to homeopathic phosphorus.
Supporting Symptoms for Phosphorus from Boericke Materia Medica:
• Hoarseness; worse evenings; Larynx very painful; Cannot talk on account of pain in larynx; Pain in throat on coughing.
• Hard, dry, tight, racking cough; Congestion of lungs.
• Better cold food; cold; open air; company.
• Vomiting; water is thrown up as soon as it gets warm in the stomach.
• Chronic catarrh, with small hæmorrhages; handkerchief is always bloody. Epistaxis (nosebleeds). Gives rise to hemorrhages.
• Sudden prostration.
Initial Prescription (Nov 19)
Phosphorus 200CH 1 dry dose, followed by 1 teaspoon from liquid dilution every 30 minutes for 3 hours. Reassess at 3-4 hours.
o Given past pneumonia history as well as current vitals, close observation and clear instructions for follow-up were emphasized.
o Normal SpO₂ for children is 95–100% on room air, ideally 97% and above. Given the current respiratory symptoms, close monitoring is warranted.
o Normal resting heart rate is between 60 – 120 beats per minute for school aged children between 6–12 years old. Mild tachycardia is noted which can be present during infection and/ or dehydration.
o Advised to seek medical care at any time if needed, particularly if symptoms worsen or oxygen saturation drops.
Report & Response After 3-4 Hours of Beginning Remedy (Nov 19)
• Within minutes of the first dry dose, requested a popsicle, drink, and frozen peaches spontaneously, indicating improvement in appetite
• Later, desired and ate ½ yogurt
• Less lethargic throughout the day, able to go outside briefly, played a board game, multiple rounds with family, resting as needed
• New symptom: blood-tinged mucus when blowing nose (hemorrhagic tendencies are a confirmatory symptom for this remedy).
• No other changes to chief complaints.
Plan: All signs indicating increased vitality, predominately increased energy and appetite. In acutes, many times with the right homeopathic remedy you will see the energy, appetite or thirst improve before the physical or chief complaints begin to shift. Repeat 1 dose of Phos 200C before bed. Check-in next morning.
Follow-Up Day 1 (Nov 20)
General Symptoms:
• Afebrile
• No chills
• More energetic, smiling, interactive on video assessment
• Appetite increased, ate a full breakfast and both lunch and dinner in smaller amounts
• Slept independently overnight, restful sleep
Respiratory:
• Cough less deep and less “barky”
• Rattling no longer audible to the ear
• Cough still painful, but pain has improved slightly
• Still whispering with voice hoarseness
Plan: Parent reported overall improvement overnight of 40–50% since beginning the remedy late last afternoon. All signs indicating continued improvement. Phos 200C, 3 dry doses today, then reassess tomorrow.
Follow-Up Day 2 (Nov 21)
General Symptoms:
• Energy good, played games, decorated Christmas tree yesterday
• Improved appetite sustained today, but still not at baseline
• Two minor nosebleeds (one yesterday and once again this morning). Both were of short duration, small clots.
o Although this may appear as a “worsening” of the condition, all chief complaints as well as the child’s overall demeanour and vitality have continued to improve. The episodes were self-limiting and resolved quickly. From a homeopathic perspective, this aligns with a known Phosphorus tendency to hemorrhages and was not surprising following yesterday’s report of blood-tinged nasal discharge when blowing the nose. This developing symptom further supports that the chosen remedy was appropriate.
o Epistaxis (nosebleeds) can sometimes occur alongside cold / cough due to irritated nasal passages during acute infection. Inflamed, fragile blood vessels along with dry air, dryness of the mucous membranes, and mechanical stress from coughing or sneezing can make bleeding more likely.
o There are situations where epistaxis warrants prompt medical attention, such as prolonged bleeding despite pressure, frequent recurrence, accompanying symptoms like dizziness, weakness, or shortness of breath or during the use of any medications. None of these were present in this case. The two nosebleeds reported were self-limiting, short-lived, resolved quickly, and decreased in intensity over time.
• Sleep last night was restless, craved cold air, fan (another confirmatory symptom for this remedy, which is better cold, open air).
Respiratory:
• Cough persists but less harsh, does not sound like deep, seal bark
• Throat still painful but steadily continuing to improve since last report
• Craving ice-cold water continues
Vitals:
• SpO₂ 94%, Pulse 120
Plan: Watch and wait. Overall demeanour and chief symptoms are showing improvement, despite new symptom (epistaxis). Hydration was encouraged, and the client was advised to consume at least one full nutritious meal. A reassessment was scheduled for 4 hours later. Given the client’s vitals and the new onset of nosebleeds, close observation was recommended.
4-Hour Reassessment on Day 2 (Nov 21)
• Craving for ice water resolved, now prefers room temperature fluids
• Voice has returned, hoarseness gone
• No longer whispering, talking readily
• Coughing more, but mucus now expectorating (a good response homeopathically)
• No further nosebleeds
• Tongue whitish/grey coating
• Vitals: SpO₂ 98%, Pulse 110
Plan: Symptoms and vitals continue to improve in just 4 hours (very good sign the remedy is still acting). Vitals normal. Oxygen saturation much better. Continue watchful waiting. Follow-up next day.
Follow-Up Day 3 (Nov 22)
• Continued improvement all day, resting as needed
• Slept peacefully last night with relaxed breathing
• Called up the stairs today to parent loudly, requesting a snack (strong, healthy voice), better appetite and thirst
• Cough continues to improve, less painful, throat does not hurt when coughing
• No mucus or bloody nose
• Vitals: SpO₂ 96%, Pulse 99
Plan: Decided on Phos 200C, 1 teaspoon dose, then watch and wait.
Follow-Up Day 4 (Nov 23)
• Energy sustained, resting as needed
• Appetite and thirst continue to improve back to baseline
• Cough improving, less intense
• All other symptoms resolved
• Vitals: SpO₂ 97%, afebrile
Plan: Continue to watch and wait.
Follow-Up Day 5 (Nov 24)
• All symptoms resolved except for a mild residual cough
• Cough significantly less harsh and dry, no rattling, no pain with coughing
• Child well overall and resting as needed
• No progression to bronchitis or pneumonia
• Vitals: SpO₂ 98%, Pulse mid 60s
Plan: Continue to observe. No further dosing required. Vitals now within normal range. Rest and nourishment encouraged to further support healing during the convalescence stage. Parent advised that a single water dose could be utilized if symptoms returned or healing significantly plateaued. Requested to follow-up as needed.
Outcome & Analysis
This case demonstrates a classic acute homeopathic Phosphorus presentation with some keynote symptoms including:
• Thirst for cold drinks and refreshing things
• Hoarse voice
• Painful larynx < (worse) talking
• Dry, deep, barking cough with rattling
• Desire for company
• Hemorrhagic tendencies (blood-tinged mucus, nosebleeds)
Final Assessment & Discussion of Case: The patient showed consistent, steady improvement within hours of the first dose and continued improving daily, with no relapse, no worsening of red-flag symptoms, and no development of bronchitis or pneumonia especially relevant given prior health history. This was a textbook Phosphorus acute respiratory case, treated successfully with timely dosing, close follow-up, and appropriate watchful waiting. It also illustrates three core principles of homeopathy:
Law of Similars: A substance that can produce certain symptoms in a healthy person can, in a highly diluted form (a homeopathically prepared medicine), stimulate healing in someone experiencing similar symptoms in illness.
Minimum Dose: Homeopathic remedies are highly diluted, leaving only the energetic essence of the substance. This subtle approach nudges the body toward balance without overwhelming it. Watchful waiting was applied at various points in the case to allow the vital force to respond naturally. Overall vitality of the patient is considered in dosing.
Single Remedy: Homeopathy emphasizes the use of one remedy at a time, chosen for the whole person based on symptom totality including the physical, emotional, and mental aspects, rather than prescribing multiple medications for different symptoms.
Disclaimer: This case is shared with the patient’s parental consent. All identifying information remains private and confidential. This case is intended for educational purposes only. It is not a substitute for professional homeopathic or medical care. The information provided should not be interpreted as medical advice, diagnosis, or treatment recommendations for any individual. Readers are encouraged to seek guidance from a qualified healthcare professional for any health concerns.
Copyright © [2025] Jessica Yacoub Homeopathy. All rights reserved. This content is the intellectual property of Jessica Yacoub Homeopathy. No part of this material may be reproduced, distributed, or transmitted in any form or by any means, including copying, screenshotting, or recording, without prior written permission. Unauthorized use is strictly prohibited.
