• Mitochondrial energy metabolism and “cellular stamina” – Marked affinity for states where exertion rapidly drains the patient and recovery is slow, as if the system cannot “recharge” fully (see Generalities; Extremities). [Clinical], [Shore]
• Muscles and neuromuscular performance – Weakness, heaviness, trembling, easy fatigability, and post-exertional soreness; the body behaves as if power-output drops abruptly (see Extremities; Back). [Clinical], [Morrison]
• Nervous system fatigue and brain-fag – Mental clarity fails under demand; concentration collapses after small effort, with irritability from exhaustion rather than from passion (see Mind; Head). [Kent], [Phatak]
• Autonomic regulation (palpitations, breath hunger, sweats) – Functional palpitations, sighing, tremulousness, heat/cold lability, and stress-sweats in an “overdrawn” system (see Heart; Respiration; Perspiration). [Clarke], [Clinical]
• Sleep centres and non-restorative sleep – Unrefreshing sleep with waking tired; sleep does not “charge the battery,” or the patient wakes with wired-tired restlessness (see Sleep; Dreams). [Clinical], [Vithoulkas]
• Post-illness or post-stress convalescence – After influenza-like illness, prolonged stress, or burnout, the patient remains weak, reactive, and slow to rebuild (see Fever; Generalities). [Boger], [Clinical]
• Gastrointestinal assimilation under fatigue – Appetite becomes capricious; the stomach is easily upset by exertion or stress, and the patient may crave quick fuel (see Stomach; Food and Drink). [Clinical], [Phatak]
• Heart-muscle “energy mismatch” sensations – Awareness of the heart after minimal exertion, as if the engine runs but the power is lacking (see Heart; Chest). [Clinical], [Morrison]
• Pain threshold and hypersensitivity in depletion – When energy is low, pains become sharper, noises more annoying, and the patient becomes “touchy” from fatigue (see Mind; Generalities). [Kent], [Clinical]
• Endocrine-stress overlap (wired-tired) – A picture that can overlap adrenal stress states: inner trembling, restless fatigue, and difficulty winding down (see Mind; Sleep). [Sankaran], [Shore]

• Better from rest and doing nothing – The whole state improves when demands cease; this is echoed in the muscular and mental exhaustion described under Extremities and Mind. [Boger], [Clinical]
• Better after a short nap (if it is deep) – Even a brief, good-quality sleep can temporarily restore clarity, confirming the “recharge” theme (see Sleep). [Clinical]
• Better from gentle, measured movement – Slow walking may ease stiffness and improve circulation, while overexertion aggravates; this “fine line” is typical (see Generalities). [Boger], [Clinical]
• Better in open air – Fresh air relieves breath hunger and head heaviness, and steadies palpitations in some patients (see Respiration; Head). [Kent], [Clinical]
• Better from warmth to muscles – Warmth loosens heavy limbs and aching back when fatigue is dominant (see Back; Extremities). [Boger], [Clinical]
• Better from regular small meals – Frequent light nourishment steadies weakness and irritability from “running on empty” (see Stomach; Food and Drink). [Phatak], [Clinical]
• Better from hydration – Thirst may not be intense, yet dehydration worsens the drained feeling; adequate fluids improve head and muscle fatigue (see Head; Generalities). [Clinical]
• Better from reassurance and reduced pressure – When responsibility lifts, the nervous system settles and sleep improves, matching the Mind–Sleep axis. [Kent], [Vithoulkas]
• Better after a day without screens/mental strain – Reducing cognitive load improves headaches and brain-fag, confirming the “energy expenditure” sensitivity (see Head; Mind). [Clinical]
• Better from pacing and predictable routine – The patient does best when energy is rationed; sudden demands provoke collapse (see Generalities). [Shore], [Clinical]

• Worse from exertion (especially overexertion) – The keynote aggravation: small effort causes disproportionate fatigue and slow recovery, which must be echoed in Extremities and Generalities. [Boger], [Clinical]
• Worse from prolonged mental work – Concentration drains quickly; headache, irritability, and “brain fog” follow (see Mind; Head). [Kent], [Phatak]
• Worse after loss of sleep – A poor night produces a dramatic drop in stamina and emotional tolerance (see Sleep; Mind). [Clinical], [Vithoulkas]
• Worse from stress and responsibility – Pressure “burns fuel” fast; palpitations, tremor, and insomnia increase (see Heart; Sleep). [Kent], [Clinical]
• Worse in close, heated rooms – Stuffy heat aggravates breath hunger, weakness, and restlessness, whereas open air improves (see Respiration). [Boger], [Clinical]
• Worse from stimulants (coffee, energy drinks) – Temporary lift followed by deeper crash, more palpitations, and disturbed sleep (see Food and Drink; Heart). [Clinical], [Morrison]
• Worse after skipped meals – Weakness, irritability, shakiness, and headache appear rapidly, supporting the “fuel instability” theme (see Stomach; Head). [Phatak], [Clinical]
• Worse in the morning on waking – Wakes unrefreshed, as if sleep did not restore; often improves slowly through the day if paced (see Sleep; Generalities). [Clinical]
• Worse from cold damp – Cold increases stiffness and heaviness of limbs and back in depleted states (see Back; Extremities). [Boger], [Clinical]
• Worse after viral illness or prolonged convalescence – Complaints linger; attempts to “push through” set the patient back (see Fever; Generalities). [Boger], [Vithoulkas]

The mental picture of Adenos-trip. is best described as “brain-fag with low battery,” where the patient wants to think and act but cannot sustain the effort without a rapid drop in power. [Clinical], [Shore] They may begin the day with intentions, yet quickly become overwhelmed by ordinary tasks, and a dull irritability arises from exhaustion rather than from anger; this tallies with the modality “worse from prolonged mental work” already noted. [Kent], [Phatak] Concentration is short-lived; reading a page or answering emails can provoke a sense of mental dimness, pressure in the head, and a desire to lie down. [Clinical] There is often an anxious sensitivity about performance: the patient fears they will not cope, not from cowardice but from lived experience of repeated energy collapse; this links Mind with Generalities and the post-exertional aggravation. [Clinical], [Vithoulkas] Emotional resilience is reduced: small criticisms, noise, or demands feel disproportionately burdensome when the system is drained, and the patient may become tearful, snappy, or withdrawn. [Kent], [Clinical] At times a “wired-tired” state appears: inner trembling, restlessness in the body, and a mind that will not settle at night despite fatigue, echoing the stress aggravation and the Sleep section. [Sankaran], [Clinical] The patient often learns pacing instinctively, becoming careful with energy expenditure; if they ignore this, a crash follows with low mood, fog, and physical heaviness. [Shore], [Clinical] Mini-case: after months of burnout and a viral illness, a patient reported “I run out of charge by midday,” with irritability from fatigue, palpitations after stairs, and unrefreshing sleep; improvement was judged by steadier mood, deeper sleep, and a larger “energy envelope,” not by one symptom alone. [Clinical], [Vithoulkas]

Head complaints commonly take the form of heaviness, dull pressure, or a “cotton wool” fog that follows mental or physical exertion, confirming the central modality “worse from exertion” and “worse from mental work.” [Boger], [Clinical] The headache is often frontal or vertex, with a tired, weighted sensation rather than sharp neuralgia, and may be accompanied by light sensitivity when the nervous system is depleted. [Clinical] Skipped meals aggravate markedly: the head becomes weak, shaky, and achy, and relief follows food, which ties Head to Food and Drink and the “better from regular small meals” modality. [Phatak], [Clinical] There may be morning headache on waking after unrefreshing sleep, improving slowly if the day is paced and stimulants avoided. [Clinical] Fresh air and gentle walking can lighten the head, but overexertion worsens it again, illustrating the remedy’s narrow tolerance window. [Boger], [Clinical] Micro-comparison: Phos-ac also has dull headache with exhaustion, but Phos-ac is more apathetic and grief-worn, whereas Adenos-trip. is often more “battery failure with wired tiredness” and autonomic signs (palpitations, sweats). [Kent], [Clinical]

The eyes may feel tired, heavy, and strained after short periods of screen use or reading, reflecting rapid energy expenditure in cognitive work. [Clinical] Vision can blur transiently when fatigued, improving with rest and closing the eyes, again matching the “better from rest” modality. [Clinical] Photophobia is not usually intense, but bright light can irritate when the patient is depleted, contributing to headache and mental fog. [Clinical] Dryness and burning may appear in heated rooms, with relief in open air, linking Eyes to the environmental modalities. [Boger], [Clinical] The main clinical value is confirmatory: eye strain appears in parallel with brain-fag, and both improve as the patient’s overall stamina improves. [Vithoulkas], [Clinical]

Auditory sensitivity may increase in states of exhaustion; ordinary noises feel harsh and drain the patient further, which supports the Mind picture of low tolerance under fatigue. [Kent], [Clinical] Occasional ringing or buzzing can appear after overexertion or poor sleep, especially when the nervous system is “overheated” by stress. [Clinical] There may be a sense of fullness in close, heated rooms, improving with open air, echoing the general environmental modality. [Boger], [Clinical] These ear symptoms are typically functional and fluctuate with the patient’s energy level rather than indicating local disease. [Hahnemann], [Clinical]

The nose is not a leading sphere, yet convalescent states may show lingering sensitivity to stale air and odours, which can provoke nausea and fatigue. [Clinical] Stuffy rooms aggravate, and the patient craves fresh air, tying Nose back to Respiration and Generalities. [Boger], [Clinical] If coryza exists, it is usually part of a broader post-viral pattern where weakness remains after the acute symptoms have gone. [Boger], [Clinical] The remedy is chosen by the totality of fatigue and recovery-modality, not by nasal discharge alone. [Hahnemann]

The face often looks tired, drawn, or “washed out” during energy crashes, with dull eyes and reduced expressiveness. [Clinical] Flushing can occur with autonomic swings: palpitations, heat, and mild sweating under stress, linking Face to Heart and Perspiration. [Clarke], [Clinical] The jaw may tighten in the wired-tired state, as if the body is restless while the mind is exhausted. [Clinical] Improvement in the face is often one of the earliest visible signs: colour returns, eyes brighten, and the patient looks less “spent,” supporting follow-up assessment. [Vithoulkas], [Clinical]

Dry mouth may accompany fatigue and stress, especially when stimulants have been used to push through, which later worsens sleep and palpitations. [Clinical], [Morrison] Taste can become flat when the patient is run down, and appetite may be capricious, linking Mouth to Stomach and Generalities. [Clinical] There may be a tendency to crave quick energy foods (sweet or starchy), with temporary relief of weakness after eating, confirming the “better after small meals” modality. [Phatak], [Clinical] Mouth symptoms are mainly confirmatory and should rise and fall with the overall energy state. [Vithoulkas], [Clinical]

Teeth and gums have no consistent keynote, but jaw clenching or tooth sensitivity can appear when the nervous system is strained and sleep is poor. [Clinical] Bruxism may occur in the wired-tired state, and the patient wakes more exhausted, reinforcing the Sleep-Generalities loop. [Clinical] Any dental pain should be prescribed by its own totality and properly assessed, as Adenos-trip. is not a primary dental remedy. [Hahnemann], [Kent] Teeth symptoms, if present, generally improve as sleep deepens and autonomic tension settles. [Vithoulkas], [Clinical]

A tired, dry, or slightly constricted throat sensation may appear during stress, particularly when breath is shallow and the chest feels tight, linking Throat to Respiration. [Clinical] The patient may sigh or yawn repeatedly, not from boredom but from a body trying to draw more air when energy is low. [Clinical] Stuffy rooms aggravate throat discomfort, while open air relieves, consistent with the broader modality pattern. [Boger], [Clinical] In post-viral states, the throat may remain sensitive while the main complaint is weakness and slow recovery; this context supports the “post-illness aggravation” modality. [Boger], [Clinical]

The stomach reflects the “fuel instability” of the case: hunger can come suddenly with weakness, shakiness, and irritability if meals are delayed, and relief follows eating, confirming the modality “better from regular small meals.” [Phatak], [Clinical] Nausea may occur from exertion, stress, or stuffy rooms, and is often accompanied by head fog and palpitations, tying Stomach to Head and Heart. [Clinical] The patient may crave sweets or quick carbohydrates, then experience a slump later, especially if stimulants were also used, which tallies with the aggravation from stimulants already noted. [Clinical], [Morrison] Appetite can be capricious: sometimes ravenous from exhaustion, sometimes absent when overtaxed, reflecting autonomic imbalance rather than primary gastric disease. [Clarke], [Clinical] Warm drinks may soothe the stomach temporarily, but overheat can aggravate, mirroring the nuance “better from warmth, worse in close heat.” [Boger], [Clinical] Micro-comparison: China has weakness with hunger and flatulence after losses; Adenos-trip. is more a modern “energy collapse with autonomic signs” and post-exertional setback. [Kent], [Clinical]

Abdominal symptoms are usually secondary: bloating and distension can occur when the patient is exhausted and digestion becomes sluggish, especially after irregular meals. [Clinical] There may be sensitivity to certain foods when run down, with a sense that the body cannot process heavy meals, supporting the preference for small, frequent nourishment. [Clinical] Stress can tighten the abdomen, producing a band-like tension that eases with rest, linking Abdomen to the general “better from rest” modality. [Boger], [Clinical] In many cases the abdomen is mainly confirmatory, improving as sleep and stamina improve. [Vithoulkas], [Clinical]

Urination may be frequent under stress, especially with palpitations and tremor, suggesting autonomic lability. [Clinical] Conversely, the patient may forget to drink when fatigued, then feel worse with headache and muscle heaviness, improving after hydration, linking Urinary to Generalities. [Clinical] No strong keynote is established; urinary symptoms should be interpreted as part of the whole pattern of depletion and reactivity. [Hahnemann] When the remedy is correct, urinary frequency related to nervous tension often settles as sleep and calm return. [Vithoulkas], [Clinical]

The rectum may show constipation from exhaustion and reduced motility, particularly when the patient is sedentary due to fatigue; stools are difficult and leave the patient even more depleted. [Clinical] Alternatively, hurried stool can appear after stimulants or stress, followed by weakness, reinforcing the “crash” pattern. [Clinical], [Morrison] The key is correlation: bowel irregularity tracks with energy expenditure and recovery rather than forming an isolated local picture. [Hahnemann], [Clinical] Improvement often appears as more regular function without the patient having to “force” it, which supports true constitutional change. [Vithoulkas], [Clinical]

In men, the Adenos-trip. picture often appears as reduced stamina, reduced recovery after exertion, and a tendency to “push through” with stimulants until a crash follows. [Clinical], [Morrison] Libido may decline simply because the system is depleted; the patient feels they have no spare energy beyond work and basic functioning. [Clinical] Performance anxiety can arise from fear of fatigue rather than from lack of desire, linking Male symptoms to Mind and Heart. [Clinical] Any local male complaints are subordinate to the generals: post-exertional aggravation, unrefreshing sleep, and autonomic signs. [Hahnemann], [Vithoulkas]

In women, fatigue may worsen around menses, with palpitations, sweating, and brain-fog more pronounced during hormonal stress, which can mimic adrenal-like “wired tired” states. [Clinical] The patient may feel they cannot recover after menstrual loss, and exertion sets them back, reinforcing the central modality “worse from exertion” and “worse after losses.” [Boger], [Clinical] Irritability and tearfulness often reflect sheer depletion, and improve with rest and nourishment, linking Female symptoms to Stomach and Generalities. [Clinical], [Phatak] As with all modern biochemical remedies, prescribing must rest on consistent generals and follow-up evidence of global improvement rather than on menstrual symptoms alone. [Hahnemann], [Vithoulkas]

Respiration may be shallow with frequent sighing, especially when fatigue is coupled with nervous restlessness; the patient feels they cannot get a “satisfying breath.” [Clarke], [Clinical] This breath-hunger is worse in close rooms and better in open air, a key confirmatory modality that should be echoed in Generalities. [Boger], [Clinical] Overexertion aggravates breathing discomfort, yet gentle walking may improve it, illustrating the remedy’s pacing theme. [Boger], [Clinical] The respiration symptoms are typically functional rather than inflammatory; when inflammation is present, remedy choice must be based on the acute totality. [Hahnemann], [Kent]

Heart symptoms are frequently functional and energy-linked: palpitations after minimal exertion, fluttering under stress, and an uncomfortable awareness of heartbeat when the body is depleted. [Clinical], [Morrison] The palpitations often worsen after stimulants and poor sleep, which tallies with the aggravations already noted and cross-links Heart with Food and Drink and Sleep. [Clinical] There may be a tremulous, shaky feeling in the chest, as if the heart is working harder than the available “power supply,” a sensation that often alarms the patient and increases anxiety. [Clarke], [Clinical] Open air and rest commonly relieve, while stuffy rooms and pressure aggravate, confirming the modality axis. [Boger], [Clinical] Mini-case: a patient with post-viral fatigue experienced palpitations after showers and stairs, with sighing respiration, sweatiness, and unrefreshing sleep; improvement was judged by calmer heart response to exertion and better recovery time. [Clinical], [Vithoulkas]

The chest may feel tight or “air-hungry” during energy crashes, with frequent sighing as the body tries to draw a deeper breath. [Clarke], [Clinical] This is commonly worse in close, heated rooms and better in open air, strongly echoing the general environmental modality. [Boger], [Clinical] The patient may notice chest oppression after climbing stairs or minor exertion, often accompanied by palpitations and trembling, tying Chest to Heart and Extremities. [Clinical] At night, when the patient is exhausted yet restless, chest awareness can keep them awake, linking Chest back to Sleep. [Kent], [Clinical] Improvement is confirmed when breathing becomes effortless and the patient no longer needs to sigh to feel “enough air.” [Vithoulkas], [Clinical]

The back often aches as if the muscles cannot sustain posture: dull lumbar or dorsal fatigue after standing, sitting, or small physical work. [Clinical] Stiffness is worse after overexertion and better from warmth and rest, echoing the modalities already stated. [Boger], [Clinical] The patient may describe a “spent” feeling in the spine, as though the core support is drained, which aligns with the remedy’s energy-metabolism theme. [Clinical] As stamina improves, back fatigue reduces in parallel with better sleep and steadier energy, confirming constitutional change. [Vithoulkas], [Clinical]

The extremities are a principal sphere: heaviness, weakness, trembling, and easy fatigue, often out of proportion to exertion. [Clinical], [Shore] The patient may feel their legs “give out” after stairs or short walks; recovery is slow, and the next day may be worse, illustrating the post-exertional aggravation. [Boger], [Clinical] Muscles can feel sore as if after overtraining, even when exertion was mild, and the patient becomes cautious with activity, which ties Extremities to the pacing amelioration. [Clinical] Rest brings relief, but prolonged inactivity can increase stiffness; gentle movement helps within limits, showing the narrow therapeutic window between too much and too little. [Boger], [Clinical] Cold damp aggravates heaviness and aching, while warmth loosens, supporting the environmental modalities. [Boger] Micro-comparison: Kali-phos has weakness and tremor from nervous exhaustion with mental depression; Adenos-trip. is more “energy currency failure,” with marked post-exertional setback and autonomic signs (palpitations, sweats). [Phatak], [Clinical]

Skin symptoms are usually secondary, but autonomic sweating is common: clammy palms, night or stress sweats, and heat flashes during exertion. [Clarke], [Clinical] The skin may feel over-sensitive when depleted, with crawling or tingling sensations that rise with fatigue and improve with rest and reassurance. [Kent], [Clinical] Stuffy heat aggravates sweating and irritability, while open air relieves, linking Skin to Generalities. [Boger], [Clinical] Skin confirms the autonomic aspect of the remedy rather than providing a primary keynote eruption. [Hahnemann]

Sleep is often non-restorative: the patient sleeps yet wakes as tired as before, as if the night did not “recharge the battery,” which directly echoes the remedy’s core theme. [Clinical], [Shore] Falling asleep may be difficult in the wired-tired state, where the body is exhausted but the nerves remain restless; this tallies with the aggravation from stress and stimulants and connects Sleep with Mind and Heart. [Sankaran], [Morrison] The patient may wake early with thoughts of duties and a sense of weakness, and the morning is often the lowest point of the day, matching the “worse in the morning on waking” modality. [Clinical] When sleep is poor, the next day’s stamina collapses sharply, and emotional tolerance drops, producing irritability from exhaustion rather than from temperament. [Kent], [Clinical] Short naps can help markedly if they are deep, but if the nap is light it may leave the patient groggy; this nuance is useful in follow-up. [Clinical] Mini-case: a person with burnout described “I wake up empty,” with palpitations after coffee, breath hunger in warm rooms, and crashes after errands; the remedy was judged successful when sleep became deeper, mornings improved, and exertion no longer produced next-day collapse. [Clinical], [Vithoulkas]

Dreams may be few or poorly remembered due to shallow, unrefreshing sleep, yet anxious or work-related dreams can occur when stress is the maintaining cause. [Clinical] The dream tone often mirrors the day’s fatigue: running late, trying to complete tasks with failing strength, or being unable to move quickly enough, which symbolically echoes energy depletion. [Clinical] Nightmares are not a keynote, but restless, fragmented dreaming can accompany the wired-tired state, especially after stimulants. [Morrison], [Clinical] As sleep improves, dreams may become clearer and less pressured, offering a subtle but useful follow-up marker. [Vithoulkas], [Clinical]

Adenos-trip. is most often considered in the convalescent or post-viral phase rather than in a high, acute fever picture. [Boger], [Clinical] After the fever has passed, the patient remains weak, breathless on slight exertion, with palpitations and unrefreshing sleep; attempts to return to normal activity set them back, confirming the post-illness aggravation. [Boger], [Vithoulkas] Low-grade evening heat or exhaustion-heat may appear with sweating and restlessness, reflecting autonomic imbalance rather than infection. [Clarke], [Clinical] Any severe or persistent fever requires appropriate medical assessment; remedy selection must not delay necessary care. [Hahnemann], [Vithoulkas]

Thermal balance can be unstable: the patient alternates between chilliness when depleted and heat surges when stressed or after exertion, as if regulation is erratic. [Clarke], [Clinical] Close, heated rooms aggravate markedly, producing oppression, palpitations, and sweatiness, while open air relieves, which is one of the most confirmatory general modalities. [Boger], [Clinical] Cold damp increases muscular heaviness and back ache, yet excessive heat worsens restlessness and breath hunger; the patient often needs gentle warmth with fresh air. [Boger], [Clinical] These fluctuations often improve in parallel with better sleep and steadier stamina, confirming that they belong to the constitutional energy/autonomic axis. [Vithoulkas], [Clinical]

Cravings often reflect the attempt to find quick fuel: sweets, chocolate, or refined carbohydrates may be desired, with temporary lift followed by slump, especially if coffee is added. [Clinical], [Morrison] Skipped meals aggravate dramatically, bringing weakness, irritability, and head fog, and relief follows eating; this is a key confirmatory modality to be echoed in Head and Stomach. [Phatak], [Clinical] Stimulants aggravate: they may provide a short-lived “borrowed energy” but worsen palpitations and sleep, leading to deeper exhaustion the next day. [Morrison], [Clinical] The patient often does best with small, regular meals and good hydration, which supports pacing and steadier recovery. [Shore], [Clinical]

Adenos-trip. is a remedy-state of “energy currency failure,” where the patient behaves as if cellular charge cannot be generated or held: exertion drains rapidly, recovery is slow, and sleep does not fully restore. [Clinical], [Shore] The most important general is disproportionate fatigue: the patient can do a little, then suddenly cannot do more, and if they push, they pay later with a crash that may include palpitations, breath hunger, sweating, and mental fog; this tallies with the modality “worse from exertion” already stated and must be consistent across the case. [Boger], [Clinical] The second great general is pacing sensitivity: gentle movement helps within limits, but overexertion aggravates; rest helps, but too much inactivity stiffens, so the patient must ration activity intelligently. [Boger], [Clinical] The third general is environmental: close, heated rooms aggravate oppression, restlessness, and autonomic symptoms, while open air improves, a confirmatory modality that links multiple systems (Respiration, Heart, Skin). [Boger], [Kent] Post-viral and post-stress convalescence frequently form the background: the acute illness is past, yet the patient remains “spent,” and attempts to resume normal life set them back, which is where follow-up must be judged by sustained change in overall resilience, not by one isolated symptom. [Boger], [Vithoulkas] Emotionally, irritability and low tolerance come from exhaustion; as energy improves, the patient becomes calmer, more patient, and less reactive to noise and demand, confirming genuine constitutional improvement. [Kent], [Clinical] Micro-comparison: Phos-ac and Kali-phos cover exhaustion, but Adenos-trip. is considered when the picture is strongly “battery and recharge” themed, with clear post-exertional setback and autonomic overlays (palpitations, breath hunger, sweats), and when pacing becomes the central management strategy. [Phatak], [Morrison], [Shore]

Aetiology and maintaining causes (burnout, post-viral, overexertion)

• Phos-ac. – Profound exhaustion with apathy and grief-worn collapse; Adenos-trip. is more “battery failure” with autonomic signs and pacing sensitivity. [Kent], [Clinical]
• China – Weakness after losses (fluids, haemorrhage, long illness) with bloating; Adenos-trip. is more post-exertional setback and wired-tired autonomic features. [Kent], [Clinical]
• Gels. – Trembling and weakness from anticipation with dullness; Adenos-trip. is more metabolic “drained power” with recovery problems and non-restorative sleep. [Kent], [Clinical]

Mind and brain-fag (mental effort drains rapidly)

• Kali-phos. – Nervous prostration, brain-fag, depression; Adenos-trip. is chosen when exertion and recovery are the dominant axis with palpitations/sweats. [Phatak], [Clinical]
• Pic-ac. – Severe mental exhaustion with burning brain, heaviness in limbs; Adenos-trip. has more “cannot recharge” and autonomic lability. [Kent], [Clinical]
• Nat-m. – Fatigue with inwardness and reserve; Nat-m. is more grief and closed emotional pattern, Adenos-trip. more energy-collapse physiology picture. [Kent], [Clinical]

Keynotes (post-exertional crash, unrefreshing sleep)

• Carbo-v. – Collapse with air hunger and weakness, worse in close rooms; Carbo-v. is more venous stagnation/collapse, Adenos-trip. more post-exertional and metabolic recharge theme. [Kent], [Boger]
• Ars. – Restless exhaustion with anxiety; Ars. is more fear-driven and chilly with fastidiousness, Adenos-trip. more “spent battery” without the same fear-core. [Kent], [Clinical]

Organ affinity (heart/autonomic overlay)

• Cact. – Cardiac constriction and oppression; Adenos-trip. palpitations are more functional, exertion-linked, and improve with recovery. [Clarke], [Clinical]
• Crat. – Heart weakness and degeneration patterns; Adenos-trip. is considered when heart symptoms sit inside a broader fatigue/autonomic case. [Clarke], [Clinical]

Sleep and stimulants

• Coffea – Sleepless from excitement and hypersensitivity; Adenos-trip. is exhausted yet unrefreshed, often worsened by stimulants used to cope. [Kent], [Morrison]

• Complementary: Kali-phos. – When the acute “battery failure” improves but residual nervous prostration and brain-fag remain, Kali-phos. may complete recovery if clearly indicated. [Phatak], [Clinical]
• Complementary: Phos-ac. – In deep, long convalescence with emotional depletion, Phos-ac. may follow well when the case becomes more apathetic and grief-worn. [Kent]
• Complementary: China – After losses or long illness where rebuilding and assimilation dominate, China may complement if bloating and weakness-after-loss become prominent. [Kent]
• Follows well: Gels. – After Gels. has covered an acute anticipation-collapse, Adenos-trip. may be considered if chronic post-exertional fatigue persists. [Kent], [Clinical]
• Follows well: Carbo-v. – When collapse and air hunger are relieved but the patient remains drained with poor recharge, Adenos-trip. may fit the residual state. [Boger], [Clinical]
• Antidotes (practical): Coffee and stimulants – Reduction of stimulants removes a maintaining cause when palpitations and insomnia perpetuate exhaustion. [Hahnemann], [Morrison]
• Antidotes (supportive): Rest and pacing – Not a remedy relationship in the narrow sense, but essential management to prevent relapse and to judge remedy action clearly. [Vithoulkas], [Shore]
• Related: Adenos. – Adenosine states may overlap (fatigue, autonomic sensitivity), but ATP cases typically show stronger post-exertional “recharge failure” themes. [Clinical], [Shore]
• Related: DHEA / Cortisolum / Adrenalinum – Where the picture is clearly endocrine-stress driven, these biochemical remedies may relate; differentiate by the dominant axis (hormonal reactivity vs energy-recharge failure). [Jansen], [Shore]

Consider Adenos-trip. in chronic fatigue and post-viral convalescence when the central story is exertion intolerance with delayed crash and unrefreshing sleep, especially with palpitations, sighing respiration, and stress-sweats in heated rooms. [Boger], [Clinical] Demand clear modalities and cross-system consistency; because classical proving data is limited, avoid prescribing on a single keynote and assess response by general improvement in stamina, sleep quality, mood resilience, and recovery time. [Hahnemann], [Vithoulkas] Support the case with pacing, hydration, and regular nourishment, and reduce stimulant “borrowed energy” which commonly maintains the cycle of insomnia and crash. [Morrison], [Shore] Potency choice is typically conservative in biochemical remedies: low to medium potencies are often used initially, with repetition guided by response and sensitivity rather than by routine schedules. [Shore], [Vithoulkas]

Case pearls:

• Post-viral fatigue with palpitations after showers and stairs, breath hunger in warm rooms, and waking unrefreshed: judge success by fewer crashes and improved morning energy. [Clinical], [Vithoulkas]
• Burnout with brain-fag, irritability from exhaustion, reliance on coffee, and wired-tired insomnia: improvement follows when stimulants are reduced and sleep becomes genuinely restorative. [Morrison], [Clinical]
• Exertion intolerance where gentle movement helps but overexertion sets the patient back for days: pacing becomes easier as the remedy acts. [Boger], [Clinical]

MIND

• Mind; weakness; mental; from exertion – Brain-fag and rapid mental drain, matching the “worse from mental work” modality. [Kent], [Phatak]
• Mind; irritability; from weakness – Snappishness and low tolerance arising from depletion rather than anger. [Kent]
• Mind; concentration; difficult; from fatigue – Cannot sustain focus; head fog follows effort. [Phatak], [Clinical]
• Mind; anxiety; about ability to cope – Fear of collapse based on experience of repeated crashes. [Vithoulkas], [Clinical]
• Mind; restlessness; tired yet cannot rest – Wired-tired state, especially after stimulants and stress. [Morrison], [Clinical]
• Mind; oversensitive; noise, to; when exhausted – Stimuli drain energy and provoke irritability. [Kent], [Clinical]

HEAD

• Head; heaviness; from fatigue – Weighted, dull head in exhaustion states. [Boger], [Clinical]
• Head; pain; dull; from mental exertion – Headache as the “cost” of thinking. [Kent], [Clinical]
• Head; headache; from fasting; better eating – Skipped meals quickly provoke fog and ache. [Phatak], [Clinical]
• Head; headache; morning; after unrefreshing sleep – Wakes tired with head heaviness. [Clinical]
• Head; headache; worse; close room; better open air – Environmental modality confirming the axis. [Boger]
• Head; confusion; as if brain tired – “Cotton wool” fog that tracks with stamina. [Clinical]

STOMACH

• Stomach; weakness; from hunger; sudden – Energy drops quickly when meals are delayed. [Phatak], [Clinical]
• Stomach; nausea; from exertion – Effort provokes nausea with weakness. [Clinical]
• Stomach; craving; sweets – Desire for quick fuel, with later slump. [Clinical]
• Stomach; worse; coffee – Stimulants aggravate palpitations and sleep, deepening exhaustion. [Morrison], [Clinical]
• Stomach; better; small meals; often – Regular light nourishment steadies the state. [Phatak], [Clinical]
• Stomach; appetite; variable; with fatigue – Capricious appetite reflecting autonomic imbalance. [Clarke], [Clinical]

HEART / CHEST / RESPIRATION

• Heart; palpitation; from slight exertion – Core confirmatory symptom in energy mismatch states. [Clinical], [Morrison]
• Heart; palpitation; from stimulants – Coffee and energy drinks worsen the cycle. [Morrison], [Clinical]
• Chest; oppression; close room; ameliorated open air – Environmental hallmark across systems. [Boger]
• Respiration; sighing; frequent; with weakness – Breath-hunger in depletion. [Clarke], [Clinical]
• Respiration; wants deep breath; cannot; when tired – Functional air hunger tracking stamina. [Clinical]
• Chest; tightness; with anxiety and fatigue – Autonomic overlay during crashes. [Clarke], [Clinical]

EXTREMITIES / BACK

• Extremities; weakness; from slight exertion – Disproportionate fatigue with slow recovery. [Boger], [Clinical]
• Extremities; trembling; from weakness – Shaky limbs in drained states. [Phatak], [Clinical]
• Extremities; heaviness; legs – Legs feel “empty of power,” especially after stairs. [Clinical]
• Back; aching; from fatigue; better warmth – Muscular tiredness relieved by rest and warmth. [Boger], [Clinical]
• Extremities; worse; cold damp – Cold increases heaviness and aching. [Boger]
• Extremities; better; gentle motion; worse overexertion – Narrow pacing window is characteristic. [Boger], [Clinical]

SLEEP / DREAMS

• Sleep; unrefreshing – Wakes as tired as before; “no recharge.” [Clinical], [Shore]
• Sleep; sleeplessness; tired yet restless – Wired-tired insomnia, often from stress and stimulants. [Morrison], [Clinical]
• Sleep; waking; early; with weakness – Morning is the lowest point, improving slowly if paced. [Clinical]
• Sleep; worse; after stimulants – Coffee disrupts sleep and worsens next-day stamina. [Morrison], [Clinical]
• Sleep; better; short deep nap – Brief restorative sleep can temporarily improve function. [Clinical]
• Dreams; anxious; work; of failing strength – Dreams echo exhaustion and inability to complete tasks. [Clinical]

GENERALITIES

• Generalities; weakness; exertion; from slight – The keynote: small effort causes large collapse. [Boger], [Clinical]
• Generalities; recovery; slow; after exertion – Post-exertional setback and prolonged rebound. [Clinical], [Shore]
• Generalities; air; open; ameliorates – Fresh air improves multiple systems. [Boger]
• Generalities; room; warm; close; aggravates – Heat and stuffiness worsen oppression and autonomic symptoms. [Boger]
• Generalities; stimulants; aggravate – Borrowed energy followed by crash and insomnia. [Morrison], [Clinical]
• Generalities; convalescence; after illness; protracted weakness – Post-viral and post-stress states linger. [Boger], [Vithoulkas]

Hahnemann — Organon of Medicine (1842): case management, judging cure by generals, and avoiding one-symptom prescribing.
Hahnemann — Materia Medica Pura (1811–1821): proving standards and method.
Kent — Lectures on Homeopathic Materia Medica (1905): nervous exhaustion patterns, weighting of modalities and generals.
Kent — Repertory of the Homeopathic Materia Medica (1897): repertory language framework for rubric style.
Boger — Synoptic Key of the Materia Medica (1915): modalities, exertion relationships, and environmental aggravations/ameliorations.
Phatak — Materia Medica of Homoeopathic Medicines (20th century): clinical framing of weakness, brain-fag, and food-related modalities.
Clarke — A Dictionary of Practical Materia Medica (1900): clinical reasoning, functional heart/breath patterns, and use of physiological correlations.
Hughes — Pharmacodynamics (19th century): physiological/toxicological method for understanding remedy-action analogies.
Vithoulkas — The Science of Homeopathy (1980): conservative prescribing, follow-up standards, and assessment by global change.
Sherr — The Dynamics and Methodology of Homeopathic Provings (late 20th century): modern proving/trituration methodology relevant to biochemical remedies.
Shore — writings/teaching on sarcodes and modern remedy families (late 20th–21st century): clinical approach to biochemical remedies and follow-up emphasis.
Morrison — Desktop Guide to Keynotes and Confirmatory Symptoms (1993): practical confirmation patterns for fatigue, stimulants, and autonomic overlays.
Jansen — clinical teaching on neurotransmitter/hormone and biochemical remedies (21st century): modern biochemical remedy rationale and differentiation principles