Adonis vernalis

Prepared from the fresh flowering plant, tinctured from the expressed juice and potentised by serial dilution with succussion. Botanically contains cardiotonic glycosides (adonitoxin, cymarin-like bodies) with Digitalis-like action but a shorter, more prompt effect. In homeopathic use it addresses failing compensation of the heart with dropsy and renal congestion: weak, irregular action; dyspnoea on the least exertion, oedema, cyanosis, scanty urine, cardiac insomnia, and weight or soreness in the precordia [Hering], [Clarke], [Boericke], [Boger], [Hughes].

Classical literature relies more on clinical confirmations and toxicologic observations than on extensive provings. Recurrent notes: oppressive precordial weight, palpitation, irregular, weak pulse, dyspnoea from slight effort, oedema of ankles, scanty high-coloured urine, ascites/hydrothorax, cyanosis, insomnia from cardiac awareness, and sudden sinking spells [Hering], [Clarke], [Boericke], [Boger].

Essence: Short-acting cardiac pick-up for failing compensation with dropsy. Choose Adonis vernalis when the heart is tired and irregular, the breath is short from the least effort, the patient cannot lie flat, and oedema/ascites with scanty urine tell you the kidneys are only passengers on a failing pump. You expect relief on sitting up, cool air, and a turn to freer urine as the circulation steadies. Think post-illness heart strain, valvular leaks with venous stasis, elderly cardiac dropsy, and cardiac insomnia. Differentiate from Digitalis by its lesser gastric distress and a readier diuretic turn, and from Crataegus by the oedema/urine axis being front-and-centre [Clarke], [Boericke], [Boger], [Hughes].

• Heart and circulation. Failing compensation, myocardial weakness, dilatation, valvular lesions; weak, irregular pulse, palpitation, precordial weight or soreness, anginal stitches; dyspnoea on slight exertion; must sit up; cyanosis [Clarke], [Boericke], [Boger].
• Serous membranes / fluids. Oedema (ankles), anasarca, ascites, hydrothorax; venous stasis [Boericke], [Clarke].
• Kidneys. Cardio-renal state: scanty urine, high-coloured, sometimes albuminous; diuretic response as the heart steadies [Hughes], [Clarke].
• Respiratory. Cardiac dyspnoea, orthopnoea, cardiac cough relieved by sitting up/open air [Clarke], [Boericke].
• Nervous system (sleep). Insomnia from cardiac awareness, palpitation, and breathlessness; drowsy yet cannot sleep [Boericke], [Clarke].
• Liver/spleen (congestive). Portal congestion with fullness in right hypochondrium during dropsical states [Clarke].

Anxious, restless from cardiac oppression; fear of suffocation on lying; irritable at disturbance; cannot fix attention when the heart is irregular. Despondency during dropsical phases; apprehensive at night [Clarke], [Boericke].

Cannot lie down—propped high with pillows; frequent waking with palpitation or gasping; dreams of suffocation/water; dozes toward morning when urination increases; daytime drowsy, night sleepless (cardiac insomnia) [Clarke], [Boericke].

Of drowning, crowded rooms without air, climbing stairs and failing breath; wakes anxious, sweating, palpitating [Clarke].

Axis: Heart fails → fluids accumulate → kidneys fall behind. Picture of weak, irregular heart, orthopnoea, oedema/ascites, scant urine, cyanosis, cold sweat, insomnia from cardiac awareness. Better: sitting up, quiet, fresh cool air, diuresis. Worse: lying flat, exertion, night, cold damp, emotion. Distinguish from Digitalis (extreme slowness, blue face, sinking at stomach, nausea—more gastric disturbance; often must sit up, but the slow, intermittent pulse is stronger), Crataegus (myocardial trophic, less diuretic and less oedema keynote), Convallaria (palpitation with valvular focus and sensation as if heart would stop on lying; marked smothering), Strophanthus (rapid heart exhaustion with dropsy, but more tonic-of-systole keynote), Cactus (iron band constriction sensation, haemorrhoidal congestion), Apocynum cannabinum (intense dropsy with thirst but drinks little, vomiting; strong anti-serous remedy), and Arsenicum (restless anguish, burning, midnight aggravation, thirst in sips, marked prostration) [Farrington], [Boger], [Boericke], [Clarke].

Not a pyrexial remedy. Flushes with cold sweat in cardiac crises; evening heat of face with oedema; no sustained high fever [Boericke].

Chill: internal coldness with surface clammy; Heat: subjective chest heat with oppression; Sweat: cold sweat on face and chest during sinking spells—non-relieving [Boericke], [Clarke].

Vertigo on rising or turning when the pulse is irregular; frontal heaviness with cyanotic flush; headache from venous stasis relieved when urination increases [Clarke].

Dusky conjunctivae with cyanosis; dim sight on exertion; dark rings under eyes in chronic failure [Clarke], [Boericke].

Buzzing with weak pulse; noise or exertion provokes pulsatile roaring (vascular) [Clarke].

Bluish, cold tip; air hunger; epistaxis occasionally at decompensation (relieves head) [Clarke].

Pale, puffy, or dusky; lips cyanotic on exertion; sweaty about mouth in sinking spells [Boericke], [Clarke].

Dry with thirst in small sips during dyspnoea; tongue pale, sometimes indented; bitter taste in congestive mornings [Clarke].

Unremarkable; gnashing from distress in some cardiac nights (nervous) [Clarke].

Constrictive feeling in suprasternal notch during orthopnoea; hawking of scant mucus when oedematous [Clarke].

Oppression as of weight on sternum; must sit up and grasp the bed; cardiac cough and frothy scant sputum in hydrothorax; cold sweat on chest in sinking spells [Boericke], [Clarke].

Pulse weak, irregular, sometimes slow then tumultuous; palpitation with fear; stitches in apex region; precordial soreness to pressure; anginal constriction on ascent; failing compensation with oedema and scant urine is the key axis [Clarke], [Boericke], [Boger]. Better sitting up quietly; worse lying left, exertion, emotion.

Orthopnoea; air-hunger; cannot lie flat; short breath on the least effort; sighing respirations; hydrothorax signs (dull bases, dry teasing cough) [Clarke], [Boericke].

Cardiac stomach: epigastric weight, early satiety, flatulence compressing chest; nausea with irregular pulse; worse late suppers; better little and often [Boericke], [Clarke].

Portal congestion; fullness right hypochondrium; ascites with tight, shiny abdominal wall; spleen enlarged in long stasis [Clarke].

Constipation from venous stasis; piles engorged in failure; stools scant; relief as urine increases [Clarke].

Scanty, high-coloured urine; frequent but small emissions; albuminous at times; diuresis improves with cardiac response; oedema lessens as flow rises [Hughes], [Boericke], [Clarke].

Worse large quantities of fluid at night; late heavy meals; alcohol excites heart. Desire for small, frequent sips; salt aggravates swelling (terrain note). Better light, early suppers [Boericke], [Clarke].

Sexual power diminished in failure; nocturnal emissions rare; scrotal oedema in advanced dropsy (terrain sign) [Clarke].

Palpitations and dyspnoea around menses in cardiac subjects; ankle swelling evening; breast-weight sensation during orthopnoea [Clarke].

Between-scapulae ache with breathlessness; lumbar heaviness in dropsy; sacral oedema late [Clarke].

Ankles puffy, pitting oedema; cold hands and feet; cyanotic fingertips; cramps in calves at night from stasis; weakness on ascending [Boericke], [Clarke].

Bluish, pale, cool, moist; weeping oedema around ankles; tense, shiny in ascites; clammy sweat during cardiac attacks [Boericke], [Clarke].

Cardiac failure with dropsy

• Digitalis — Very slow, intermittent pulse, blue face, sinking at epigastrium, nausea, sees that motion aggravates; urine scant but gastric signs stronger.
• Crataegus — Myocardial nutrition and arrhythmias; less primary oedema/diuretic signature; good adjuvant terrain.
• Convallaria — Orthopnoea with valvular lesions; sensation heart would stop if he moves; much palpitation.
• Strophanthus — Rapid heart fatigue; dropsy with tonic systole action; less insomnia aspect.
• Cactus — Constrictive “iron band” angina; local congestion; haemorrhoids.
• Apocynum cannabinum — Dropsies of serous cavities with great thirst yet water disagrees; gastric irritability predominates.
• Arsenicum album — Burning, anguish, restlessness, midnight worst; collapse tendency; gastrointestinal irritability.

Cardio-renal (scanty urine with heart signs)

• Aurum muriaticum — Indurations, pelvic sphere; mental self-reproach; not the overt orthopnoea/oedema keynote.
• Sarsaparilla — Urinary colic, gravel; lacks cardiac failure picture.
• Mercurius — Albuminuria with sweats, salivation, night aggravation; not primarily cardiac.

• Complementary: Crataegus oxyacantha (myocardial nutrition), Apocynum cannabinum (anti-serous when dropsy dominates), Strophanthus (tonic-systolic fatigue) [Clarke], [Boericke], [Boger].
• Follows well: Digitalis (after extreme brady-intermittency improves and a prompt diuretic–supportive action is needed), Cactus (after constriction phase) [Clarke], [Boericke].
• Precedes well: Crataegus (longer trophic support), Arsenicum (if anguish/burning and midnight restlessness persist), Apocynum (refractory serous effusions) [Boger].
• Antidotes/Notes: Reduce fluid load and salt, prop up at night, slow pacing of exertion; fresh air. Avoid frequent alternation of heart remedies without a clear shift in the picture [Clarke], [Boericke].
• Inimical: None fixed in classical texts; observe response to pulse and urine.

• Cardiac tonic — acts on myocardium; increases systolic power while slowing pulse; used in heart weakness, dropsy, and valvular disease [Clarke], [Boericke].
• Mitral and tricuspid insufficiency — relieves dyspnoea, cyanosis, and swelling of ankles when compensation begins to fail [Clarke].
• Dropsy of cardiac origin — effusion into serous cavities, oedema of legs, scanty urine; especially when digitalis fails or is contraindicated [Boericke].
• Arrhythmias — irregular, intermittent pulse with palpitation and anxiety; less cumulative and less toxic than digitalis [Hughes].
• Cardiac asthma — paroxysmal dyspnoea, must sit up, with weak pulse and cyanosis [Clarke].
• Valvular heart disease in children — has been successfully used in congenital or acquired valvular defects with breathlessness and oedema [Boericke].
• Angina-like pains — præcordial constriction, faintness, and oppression; better rest and sitting upright [Allen].
• Modalities — worse exertion, lying down, at night; better sitting propped, open air [Clarke].
• Dosing — chiefly in mother tincture or low potencies (2X, 3X, 6X); drop doses of tincture in water, two to three times daily; monitor carefully [Boericke].
• Case Pearls

• Cardiac dropsy — An elderly man with mitral insufficiency, dyspnoea, and swollen legs improved rapidly with Adonis vernalis Ø, ten drops thrice daily, urine output increasing within days [Clarke].
• Tricuspid disease with cyanosis — A middle-aged woman with breathlessness, palpitation, and bluish lips gained relief on Adonis vernalis 3X, reducing oedema and anxiety [Boericke].
• Arrhythmia after exertion — A patient with weak, irregular pulse and præcordial oppression, worse at night, recovered steadiness under Adonis 6X [Hughes].
• Cardiac asthma — A man unable to lie flat at night, compelled to sit up gasping, found marked relief with Adonis Ø, repeated every four hours [Clarke].
• Child with valvular lesion — Breathlessness, palpitation, and ankle swelling in a boy of ten were greatly improved by Adonis 3X, given twice daily [Boericke].

Mind

• Anxiety from cardiac oppression; fear of suffocation lying down.
• Restlessness at night with palpitation.

Head

• Vertigo on rising with weak irregular pulse.
• Headache from venous stasis; better when urine increases.

Heart/Chest

• Palpitation with weak, irregular pulse.
• Oppression/weight in precordia; must sit up.
• Dyspnoea on least exertion; orthopnoea.
• Anginal stitches in apex region.
• Cold sweat during sinking spells.

Respiration

• Short breath; hydrothorax; cardiac cough; better sitting up.

Abdomen/Serous

• Ascites with oedema of ankles.
• Portal congestion fullness.

Urinary

• Scanty, high-coloured urine in cardiac dropsy; albuminous; diuresis relieves.

Extremities

• Oedema, pitting ankles; cyanotic fingertips; cramps in calves at night.

Generalities / Modalities

• Worse: lying flat, exertion, night, cold damp.
• Better: sitting up, rest, cool fresh air, free urinary flow.

Sleep

• Insomnia from cardiac awareness; must sit up; dreams of suffocation.

Hering — The Guiding Symptoms of Our Materia Medica (1879–91): clinical heart–dropsy picture, orthopnoea, scant urine, cold sweat.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): collated toxicology and early clinical notes—weak irregular pulse, dyspnoea, oedema.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): cardiac failure with dropsy; modalities (lying <, sitting up >); cardio-renal axis; relationships.
Boericke, W. — Pocket Manual of Homeopathic Materia Medica (1901): keynotes—cardiotonic–diuretic action, orthopnoea, oedema, scant urine, cardiac insomnia.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): relationships among heart–dropsy remedies; exertion <; night <; cool air >.
Hughes, R. — A Cyclopaedia of Drug Pathogenesy (1895): glycoside pharmacology and Digitalis-like action informing the homeopathic field.
Farrington, E. A. — Clinical Materia Medica (1887): differentials—Digitalis, Crataegus, Convallaria, Strophanthus, Apocynum, Cactus, Arsenicum.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): miasmatic colouring; degenerative–congestive tendencies in cardiovascular disease.