Treatment of Upper Respiratory Infections with Septilin

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1 (Current Medical Practice (1958): (2), 10, ) Treatment of Upper Respiratory Infections with Septilin Gokhale, S.G., M.B.,B.S., Casualty Medical officer, Dr. Balabhai Nanavati Hospital, Vile Parle, Bombay, India, and Wakharia, P.V., M.B.,B.S., C.M.O., St. George Hospital, Bombay, India. What is known as Mahishakshi guggul is the oleo-gum-resin of the plant Balsamodendron mukul belonging to the forests of India. When fresh, the oleo-gum-resin of Balsamodendron is moist, viscid, fragrant and of a golden yellow colour; burns in fire, melts in the sun and forms a milky emulsions with hot water. Chemically it is constituted of a volatile oil, gum, resin and bitter principle. Pharmacologically the oleo-resin acts as an astringent and has mild anti-bacterial effect. It is haemopoietic and causes an increase of leucocytes in the blood and stimulates phagocytosis and thus increases the defence mechanism of the individual. It acts as a diaphoretic, stimulating expectorant and diuretic. It is a uterine stimulant, emmenogogue and increases menstrual flow at the commencement; but if the drug is persistently taken the menstruation is regulated as it exerts a regularising influence on the ovarian function. It is quite harmless and may be taken for a long time without any ill-effects. It sometimes produces an erythematous rash and rarely symptoms of kidney irritation appear but these rapidly disappear when the drug is omitted. Septilin is a compound preparation, the main ingredient of which is the oleo-resin of Balsamodendron Mukul. In Septilin the gum is separated and only the oleo-resin is used. Septilin contains: Balsamodendron mukul Vanda roxburghii Shankh bhasma Ext. Tinospora cordifolia Rubia cordifolia Phyuanthus emblica Moringa pterigosperma Pristimera indica 160 milligrams 64 milligrams 32 milligrams 50 milligrams 32 milligrams 16 milligrams 16 milligrams 8 milligrams The dose is 2 tablets three or four times a day. The manufacturers claim that Balsamodendron in Septilin reduces the oedema in the mucous membranes caused by irritating substances and also dries up the excessive mucous secretion. It has, however, no effect on the normal secretion of the mucous membranes. But they also warn that there is a feeling of relative dryness in the mucous membranes of the nose in patients who have chronic rhinorrhoea. The total effect of Septilin in otolaryngeal diseases is to give relief by drying up excessive secretion in the nostrils, eustachian tubes and maxillary or frontal sinuses. As Balsamodendron has anti-bacterial activity, infections of the sinuses are also reduced to a considerable extent.

2 The present study was undertaken at the Dhanrajgirji Hospital, Sholapur, over a period of 3 months from the end of September 1957, as a few earlier trials with Septilin had given encouraging results. In all 75 patients were treated with this drug. The average duration of treatment was 2-4 days. Thirty patients did not report again and therefore could not be followed up. Controlled studies were not made due to certain practical difficulties and routine laboratory investigations were not performed, because clinically the diagnosis was obvious. The response of patients to Septilin therapy in various respiratory infections is given below: Table 1 Disease No. of cases treated Good response Moderate response Poor response (1) Allergic Rhinitis (2) U.R.T.I (3) Common Cold (4) Acute Bronchitis 2 2 (5) Laryngitis 2 2 Response to treatment Details of the clinical conditions, dosage used and response obtained are shown in Table 2. Symptoms 1. Sneezing, watery from the nose about 10 sneezes in 20 minutes. 2. Sneezing, watery from the nose. 3. Headache, watery, sneezing. 4. Violent sneezing, watery 5. Sneezing early morning Periodic attacks every 10 days for the last 2 years 6. Sneezing, watery off and on for last 10 years. Table 2 Clinical findings and Duration Diagnosis 25 minutes Pale m.m. Watery. Inf. Terb. Hypertrophy. Allergic rhinitis. H/O such attacks for the last 4 yeas Repeated Pale m.m. Hypertrophied attacks off inf. Terbinate. Allergic and rhinitis practically every alternate day. 2 days Afebrile, pale m.m. Allergic rhinitis 1 day Afebrile, watery through nose, allergic rhinitis. Afebrile, hypertrophied terb., pale m.m. Allergic rhinitis. 2 days Afebrile, Watery, Allergic rhinitis 7. Pain in throat, dry 2 days Congested pharynx, temp. 99 F. Upper respiratory tract infection. 8. Sore throat, cough, nasal 2 days Congested pharynx, tonsils+, congested nasal mucosa, U.R.T.I. Treatment Hours in which response obtained. Secretion and sneezes completely stopped in 12 During of each attack before treatment used to be 2-3 days Good response in about 12 hours, no attack for months after 6 days' treatment. 1 q.d.s Good response in 48 hours sneezing and secretion stopped. Sneezing stopped in 24 hours, but watery continued after 96 hours' treatment. No sneezing attacks for about 20 days after 96 hours' treatment. No response at all in 72 hours' treatment. Good response in 48 Septilin Good response in 48

3 9. Cough, cold, fever 3 days Tonsils+, Pharynx congested red streaks visible, temp. 100 F. U.R.T.I. 10. Headache, cold, sore throat. 11. Cough, cold, headache, sore throat. 3 days Throat congested, nose congested, +.U.R.T.I. 2 days Tonsils+, throat congested, nasal +, temp. 100 F. U.R.T.I. 12. " " " with temp. 99 F. 13. Dry cough, cold, malaise, sore throat. Had repeated attacks off and on. 14. Malaise, body-ache, sore throat, cold in head. 15. Headache, malaise, nasal 3 days Watery nasal, throat congested, nasal m.m. congested, temp. 99 F. 2 days Mucous. Throat, nose, pharynx congested. Temp. 100 F. Upper respiratory tract infection. 12 hours Mucous through nose, congested mucosa, afebrile, common cold. Septilin 1 Septilin 1 Good response in 72 Good response in 72 Only slight cough persisted after 96 hours' treatment. Nasal stopped in 48 hours; cough completely disappeared in 96 Cough and nasal stopped in 96 No further attack for a month and half. No response at all in 96 Good response in 36 Secretions completely stopped. 16. Discharge through nose. 24 hours " " Good response in Cold in head, mucous through nose 12 hours " " Secretions stopped in Nasal, headache. 12 hours Congested nasal mucosa, nasal, common cold. " Good response in Thick nasal, stuffiness in nose. 2 days " " Moderate response in 24 hours, complete in " " " " Good response in Malaise, nasal " " " Secretions completely stopped in 72 Good response. 22. Nasal 3 days " " Discharge completely stopped in Nasal, head cold, malaise 2 days Congested nasal mucosa, nasal, common cold. No response in Discharge through nose, headache 1 day " " Complete relief in Nasal 2 days Common cold with typhoid. " Secretions stopped in " " Cold with pulmonary T.B. " Complete relief in 48 Anti-T. B. treatment also given. 27. Nasal 2 days Cold with pulmonary T.B. Complete relief in " 3 days " " " 29. Nasal Off and on after every Common cold " Complete relief in 48

4 28 days 30. Nasal 3 days Tenderness over rt. " No response in 96 mucopurulent, Headache, Maxillary sinus, temp. fever. 100 F. Common cold with mild sinusitis 31. Headache, nasal. 2 days Common cold " No response in " 1 day " " Secretion stopped in 24 Complete relief in Repeated attacks " ' " Complete relief in 24 Used to last 5-6 days before. 34. Severe headache, profuse nasal 1 day Severe attack of common cold " No response in Headache, thick mucous 36. Nasal, headache, malaise " Common cold " Secretions stopped in 24 The patient complained of severe drying up of nose. 2 days " " Complete relief in " 1 day " " Complete relief in " 2 days " " Complete relief in " " " " Disappeared in 8 tablets. 40. " 3 days " " Only moderate relief in Headache, malaise, cough, fever 42. Cough with expectoration, fever, malaise, body-ache. 43. Cough, Cold, hoarseness of voice 2 days Rhonchi in chest both side. Temp. 101 F. 2 days Rhonchi chest both sides. Temp F. 3 days; Congested throat, attacks very congestion of vocal frequent, cords, acute laryngitis. postinfluenzal. " No response in 72 " No response in 72 " Voice improved in " 3 days " " Moderate relief in 48 Voice completely normal in 8 days. 45. " 2 days " " Voice completely normal in 72 CONCLUSION 1. Septilin (The Himalaya Drug Co.) has a place in the treatment of mild upper respiratory infections particularly in common cold, allergic rhinitis, pharyngitis, etc. It was found useful in about 75 per cent of cases and nasal usually stopped in 48 The drug appears to exert some antirhinitic effect leading to drying up of nasal secretions. It was interesting to note that one of the patients actually complained of burning sensation in and drying up of the nose. Common cold was usually controlled in two or three days. 2. The drug has not been found useful in lower respiratory infections such as acute bronchitis. 3. We also tried the drug in 3 cases of recurrent external styes and obtained very good response. ACKNOWLEDGEMENTS Our thanks are due to: (1) The Himalaya Drug Co., who made a large stock of Septilin available for clinical trials. (2) Dr. (Major) V.D. Kirpekar, M.S., F.I.C.S., Surgeon and Dr. M.G. Pradhan, M.D., M.R.C.P., Physician, at this hospital under whose guidance the work has been carried out.

5 (3) Dr. B.V. Mulay, M.S. (Bom.) Chief Medical Officer, Dhanrajgiriji Hospital for allowing the use of the hospital records. REFERENCES The Indian Practitioner, 1955, 8, 825-G. Krishna Murty. Chopra's I.D. of I. PP-228 and 289 Therapeutic notes. The Advance of Medicine 1956, 5, 314. Observations on Rumalaya K.R. Krishna Murthi, L.I.M.

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