Agraphis nutans

Agraphis nutans is the woodland bluebell of Western Europe, long familiar in British hedgerows and beech woods; classical homeopathic literature retained the binomial Agraphis nutans though modern botany commonly assigns the plant to Hyacinthoides non-scripta (syn. Endymion non-scriptus), all referring to the same bulbous perennial of Asparagaceae. The remedy is prepared from the fresh flowering plant (expressed juice, tinctured), following the vegetable protocol of the pharmacopoeias; it belongs to the group of “organ remedies” introduced and clinically elaborated by R. T. Cooper, whose fresh-plant tinctures frequently acted selectively on hypertrophic or infiltrated tissues [Clarke]. Constituents of related hyacinthaceous bulbs include saponins and mucilage; their local actions explain catarrhal and secretory effects on mucosae and the soft lymphoid tissues (adenoids, tonsils) that recur in the clinical portrait [Hughes], [Clarke]. Early British clinicians repeatedly noted a selective influence upon the naso-pharynx, Eustachian tubes, and cervical glands, with improved airway patency and hearing as swelling subsided [Clarke], [Tyler].

No formal Hahnemannian proving has been recorded. The remedy has a largely [Clinical] pedigree from Cooper and subsequent British observers; scattered [Proving] fragmenta (minor provings/observations) were gathered later but never rose to a full proving in the classical sense [Clarke], [Boericke], [Tyler]. Early confirmations centred on adenoid vegetations with nasal obstruction, recurrent “colds catching,” and catarrhal deafness in children, particularly in damp, foggy climates [Clarke], [Tyler].

Agra. expresses the chilly, fog-aggravated, lymphoid child whose life is funnelled through a narrow naso-pharyngeal gate. Its essence lies not in violent pains or acridity but in bulk and bogginess—the pale, spongy adenoid mass that occludes the choanae, blocks the Eustachian tubes, and steals sleep and sound. The portrait is one of organ selectivity: as an “organ remedy” in Cooper’s sense, it works where the lymphoid ring dominates the case—adenoids, tonsils, posterior nares—with climatic sensitivity to damp and fog that tightens mucosa and thickens venous stasis [Clarke], [Tyler]. Psychologically, the child is not dramatic but dulled—tired at school, inattentive, timid—because oxygen and hearing are blunted; when the airway opens, the mind brightens and the ear hears. This tight coupling of function and behaviour is the remedy’s clinical music. Miasmatically it hums tubercular: chilliness, glandular swelling, head/neck sweat, recurrent “fresh colds,” seasonal relapses; yet it remains gentle, non-suppurative, and clean compared with Hepar’s splintering sensitivity or Hydrastis’ ropy fetor [Boger], [Boericke].

The core polarities are open vs. blocked, dry-warm vs. cold-wet, quiet nasal sleep vs. noisy mouth-breathing. Every section echoes these: Mind (dull vs. brightened after relief), Sleep (snoring vs. quiet), Ears (muffled vs. clear), Nose (blocked vs. patent), Generalities (fog-worse vs. sun-better). The keynote modalities are unmistakable—worse damp, fog, cold rooms, getting wet; better warmth, dry air, and after perspiration—and their replication across the case confers certainty. Differentially, Baryt-c. and Calc-p. share the child terrain but skew constitutional; Lemna-m. and Kali-bi. advertise fetor/stringiness absent in Agra.; Dulc. shouts rheum and skin after wetting; Puls. prefers cool open air whereas Agra. seeks warmth inside [Clarke], [Boericke], [Tyler]. In practice, one watches indices of action: quieter nights, closed mouth at rest, returning smell, ears that pop and hear, a teacher’s note—“more attentive this week.” In that soft, measurable progress, the essence of Agra. proves itself.

• Naso-pharyngeal lymphoid ring (adenoids, soft palate, posterior choanae). Repeated clinical testimony that it reduces adenoid hypertrophy and opens the choanal airway; keynote in “mouth-open sleepers” with snoring and blocked nose. See Nose/Throat/Respiration. [Clarke], [Tyler], [Boericke].
• Eustachian tube and middle ear. Catarrhal deafness from post-nasal obstruction; popping, blocked ears, better as naso-pharyngeal swelling subsides. See Ears. [Clarke], [Tyler].
• Tonsils and faucial isthmus. Tonsillar enlargement with “bluebell child” who is chilled by damp and catches cold from every fog. See Throat. [Boericke], [Clarke].
• Cervical glands. Indurated, swollen nodes accompanying chronic catarrh; tubercular habitus suspected. See Generalities/Throat. [Tyler], [Boger].
• Nasal mucosa. Persistent obstruction, scant or thick catarrh, anosmia in damp weather; worse fog—compare Lemna-m., Kali-s. See Nose. [Clarke], [Boericke].
• Larynx/voice. Hoarseness or lost voice from naso-pharyngeal swelling and mouth-breathing; voice tires easily in damp cold rooms. See Chest/Respiration. [Tyler], [Clarke].
• Broncho-pulmonary mucosa. Tendency to recurrent “fresh colds” descending from naso-pharynx, especially in spring and fog. See Respiration/Fever. [Clarke].
• Gastro-intestinal mucosa (children). Occasional diarrhoea from chill or cold drinks during catarrhal attacks; secondary sphere. See Stomach/Abdomen/Rectum. [Boericke], [Clarke].

The bluebell child is timid, chilly, and easily overwhelmed by repeated coryzal attacks; there is fretfulness from poor sleep and hypoxia of mouth-breathing, with dullness in school and inattention from partial deafness—an [Clinical] sequence often reversed as the naso-pharynx clears [Clarke], [Tyler]. Irritability at waking, peevishness from blocked nose and dry mouth, and aversion to being hurried in the morning appear regularly in parental accounts [Clarke]. Anxiety about going out in cold damp weather is anticipatory and learned—fear of “catching another cold”—a habit seen likewise in Dulc., yet Agra. lacks Dulc.’s muscular pains and skin eruptions after wetting [Clarke], [Boericke]. Children become socially withdrawn when hearing is “under water,” a feature that yields as Eustachian ventilation improves; this micro-case evolution is a practical marker of action [Tyler]. Oversensitivity to draughts and a “home-loving,” clingy mood in cold seasons further colour the picture, overlapping with Calc-p. yet more distinctly dominated by naso-pharyngeal obstruction [Tyler], [Clarke]. Sleep-loss produces day-time inertia and mild headache; amelioration tracks with the modality (better warmth) already noted, reinforcing the remedy’s thermal signature [Clarke]. In older patients, irritability and poor concentration during damp, foggy spells mirror nasal occlusion; relief in dry warmth correlates with clearer thinking—again a direct read-out of the organ affinity [Clarke], [Boger].

Sleep is noisy and unsatisfying; the child sleeps with mouth wide open, snores heavily, sometimes with breath pauses, and wakens unrefreshed with dry mouth and hoarse voice—this is the living keynote of Agra. and tracks the naso-pharyngeal swelling day by day [Clarke], [Tyler]. Dreams are unremembered; the child tosses and uncovers, then chills and resists the morning air—mirroring the thermal modalities (worse cold/damp; better warm) already established. Daytime somnolence at school, inattention, and irritability descend from fragmented nocturnal sleep; as the choanae open under treatment, teachers remark upon renewed alertness—an invaluable [Clinical] barometer [Tyler]. Parents notice less bruxism and fewer night sweats as breathing normalises. Propped posture and lateral decubitus lessen snoring; supine posture aggravates—useful management whilst the remedy acts. Compare Sambucus for night suffocative attacks; Agra. is less paroxysmal, more obstructive and chronic [Boericke].

Non-descript, seldom recalled; when reported, dreams of being lost or unable to call for help reflect the obstructed voice and airway—psychophysiologic echo; these fade with quiet sleep [Clarke]. Night-terrors are not keynote; if present with suffocation, cross-check Sambucus or Kali-br.

Agra. paints the damp-fog child: chilly, pallid, glandular, who “always catches cold” and becomes a mouth-breather with catarrhal deafness and dull school performance [Clarke], [Tyler]. The diathesis is tubercular: enlarged lymphoid tissues (adenoids, tonsils, cervical nodes), variable appetite, and a tendency to sweat in warm bed—features that soften as upper airway mechanics normalise [Boger], [Tyler]. Modalities are decisive: worse damp, fog, cold rooms, getting wet; better dry warmth, sun, and after perspiration, and these are explicitly echoed across Nose, Ears, Throat, Respiration, Sleep, and Fever. The remedy’s sphere is anatomically selective rather than systemically violent: it does not boast intense pains or acrid secretions (contrast Arum-t., Merc.), nor heavy fetor (contrast Hydrastis, Lemna-m.); instead, it reduces bulk and bogginess in lymphoid tissues—Cooper’s “organ remedy” effect—leading to freer breathing and hearing [Clarke], [Tyler], [Boericke]. Micro-comparisons: vs. Baryt-c. (hypertrophic tonsils in backward, timid child), Agra. is more climatic (fog-worse) and more naso-pharyngeal with catarrhal deafness; vs. Calc-p. (school fatigue), Agra. lacks bone/growth pains; vs. Dulc. (after wetting), Agra. is less muscular/skin and more lymphoid nose-throat; vs. Lemna-m. (polypi, fetor), Agra. is cleaner, less fetid, more “block without slime.” These distinctions clinch the prescription on totality [Clarke], [Boericke], [Tyler].

“Catches cold” from the least fog or wetting; chilliness predominates with low-grade evening rise and heavy head—an [Clinical] pattern of catarrhal fever [Clarke]. Heat is slight; sweat comes with warming in bed and relieves, which matches the Better-after perspiration modality. Pulse and thirst are modest; febrile state resolves as airway patency returns. Compare Dulc. (fever after getting wet when hot) and Rhus-t. (muscular restlessness); Agra. keeps to its naso-pharyngeal lane [Boericke].

Chill: from fog, damp rooms, east/west winds; fingertips cold; wants scarves indoors [Clarke].
Heat: little; head stuffy, face dusky rather than flushed; prefers warm air to the face, not cold draughts.
Sweat: warm bed induces sweat and eases blockage; scalp and neck perspire in tubercular children; relief corroborates Better-after perspiration [Clarke], [Tyler].

Frontal weight and dull ache accompany prolonged nasal stoppage; the pain is worse on waking in a cold room and abates as warmth and patency return—mirroring the modality set (worse damp/cold; better warmth) [Clarke]. Children rub the root of the nose; a pasty, heavy head is reported in foggy weather, with a sense of “fullness behind the nose” rather than acute sinus pain—contrast with Kali-bi., which shows stringy discharges and punched-out ulceration [Boericke], [Clarke]. Catarrhal headaches in spring term (school exposure, draughts in corridors) are common [Clinical] triggers; walking in dry air helps [Tyler]. A slight vertigo when rising in a cold room (mouth-breather hypoxia) may be noticed and vanishes as the nose opens. When catarrh extends to the middle ear, head pressure shifts towards the temporal or mastoid region with muffled hearing; this improves hand-in-hand with Eustachian drainage [Clarke].

Watery eyes in cold wind or fog accompany nasal obstruction; lachrymation is thin and cool, not acrid, differentiating from All-c. and Euphr. where smarting and photophobia are more prominent [Clarke], [Boericke]. Morning stickiness appears during heavy catarrh but without marked conjunctival ulceration; relief follows general warming. Children stare with the “adenoid look”—vacant, mouth ajar, lower lids a little puffy; as sleep improves, the expression livens—an [Clinical] observation useful in monitoring response [Tyler]. Vision blur is functional from tearing and fatigue rather than ciliary spasm; better in dry rooms and in sun. Eye strain during lessons worsens when hearing is dulled and attention flags—secondary to the ear/nose axis; this normalises once the airway is free [Clarke].

Catarrhal deafness is a cardinal indication: blocked Eustachian tubes with popping, retracted drums, and hearing “as if under water,” especially during damp, foggy weather and in cold classrooms [Clarke], [Tyler]. Children turn one ear to listen; teachers complain of inattention—often an auditory problem rather than conduct. There is a sense of pressure in the ears and transient tinnitus that clears with yawning or swallowing after the nose opens; this tallies with the better-warm, worse-damp modalities already recorded [Clarke]. Otitis media is less a keynote than a chronic ventilatory defect from adenoids; when present, it is subacute with scant pain compared to Hepar or Puls., and improves as the naso-pharynx retracts [Tyler], [Boericke]. Post-catarrhal echo and autophony (own voice booming) may occur; these diminish as drainage improves. Micro-comparison: vs. Kali-m. (Eustachian catarrh with thick mucus), Agra. has more primary adenoid tissue implication and a stronger fog aggravation [Clarke], [Boger].

Persistent obstruction—often with little discharge—is the Agra. hallmark; the child sleeps with mouth open, snores, and wakes dry-throated [Clarke], [Tyler]. Aggravation comes from damp, fog, and west winds, with paradox: nose blocks in wet weather yet clears in dry sun; this echoes the Better/Worse modalities [Clarke]. Discharge, when present, is bland and mucous rather than excoriating (contrast Merc., Arum-t.); sneezing in mouldy rooms without full relief is common [Clarke], [Boericke]. Hyposmia or anosmia accompanies chronic blockage; smell returns as patency restores—useful as a follow-up marker. Compare Lemna-m. in polypoid obstruction (stringy post-nasal slime, fetor), where Lemna has heavier, fetid catarrh and a marked damp-den aggravation; Agra. is “cleaner,” more lymphoid, less fetid [Clarke]. Cold air directly to the face worsens resistance in the turbinates; hand-warming the nose or donning a scarf brings partial ease—an immediate [Clinical] modality [Tyler].

Adenoid facies: long face, parted lips, dull eyes, slight malar duskiness in damp cold; subsides as nasal airway normalises [Tyler], [Clarke]. Infra-orbital puffiness in morning, especially after a foggy night, indicates venous stasis from mouth-breathing; warmth improves. Upper lip dryness and fissuring from habitual mouth-breathing is common; better with humidified warm rooms. Facial neuralgia is not characteristic; when present, it is congestive from sinus pressure rather than neuralgic proper—differentiating from Kali-bi. or Spig. [Clarke].

Dry mouth on waking, cracked lips, and coated tongue occur in mouth-breathers; thirst is moderate and often for warm drinks, aligning with the Better-warm modality [Clarke], [Boericke]. Halitosis is mild compared with fetid states like Merc. or Hydrastis; odour tracks with tonsillar detritus and resolves as the naso-pharynx drains. Palate may be vaulted; speech is nasal from choanal blockage—both remodel with growth and cleared airway, a longitudinal [Clinical] observation [Tyler]. Aphthae are not typical; when present, look elsewhere (Borax, Merc.) unless purely secondary to dryness.

Secondary sphere only: bruxism at night from obstructed breathing is reported in some children; improves as airway opens—parallel to Sleep section [Tyler]. Dentition aggravating catarrhs (spring, damp) occurs in toddlers; Agra. may be intercurrently useful when adenoid swelling dominates alongside diarrhoea from cold drinks—contrast with Cham., which has hot, angry child and acute otalgia [Boericke], [Clarke].

Tonsillar hypertrophy with pale, boggy mucosa and posterior nasal drip defines the local state; worse in damp, fog; better in warmth and dry rooms—faithfully mirroring modalities [Clarke]. Voice becomes nasal and muffled; speech improves as choanae open. Recurrent “sore throat from every chill,” but the pain is modest; swelling and obstruction are greater than rawness—contrast with Phyt. (dark, painful tonsils) or Merc. (exudative, offensive) [Boericke]. Pill-gag and dysphagia are mechanical from adenoids rather than inflammatory odynophagia; warm sips soothe. Faucial follicles enlarge; cervical nodes swell sympathetically, especially in the tubercular habitus [Tyler], [Boger].

Hoarseness from mouth-breathing and post-nasal drip is frequent; speaking in damp halls aggravates, while warm rooms and gentle vocal rest relieve (see Worse/Better) [Tyler]. Cough is mainly laryngeal or from pharyngeal drip rather than deep bronchial disease; it is dry at night and loosens by day as warmth returns [Clarke]. True croupal states are not characteristic (contrast Hepar, Spong.); Agra. is upstream—naso-pharyngeal. Sighing respirations during sleep, with snoring and apnoeic pauses, improve as adenoid bulk retracts; parents report quieter nights—an immediate [Clinical] index of benefit [Tyler].

No direct action is claimed in classical sources; palpitations during fever or anxiety are incidental. Circulatory dullness (pale child, venous stasis under eyes) is secondary to poor oxygenation and resolves as sleep and airway improve [Clarke].

Mouth-breathing at night, snoring, and obstructed nasal airflow define the case; respiration becomes nasal and quiet in dry warmth—precisely echoing Better-dry-warm [Clarke]. Short breath on exertion in damp cold (running at school in fog) reflects narrowed choanae; outdoors on a bright day breathing is freer [Tyler]. Deep bronchial involvement is rare; most symptoms are upper airway. Agra. compares with Sambucus (night suffocation in children) but lacks the sudden, spasmodic character; its picture is chronic, lymphoid, and climatic [Boericke].

Appetite dips during blocked-nose phases; mouth-breathing dulls taste and smell, improving with nasal patency [Clarke]. Desire for warm soups and drinks accords with the Better-warm drink modality; cold drinks may chill and trigger looseness in susceptible children [Boericke]. Nausea is occasional on rising in cold rooms, more from mucus swallowing than gastric disease; clears as day warms. Vomiting is not typical; if present, suspect post-tussive or mucus overload [Clarke].

Gaseous distension appears in chilled children with catarrh; gut relaxes once warmed—an echo of thermal profile [Boericke]. Mesenteric and cervical glandular swellings may co-exist in the tubercular diathesis; nutrition improves as sleep and breathing normalise [Tyler]. Colicky twinges after cold drinks during coryza episodes are noted; better with heat and warm teas. Hepato-biliary symptoms are not characteristic.

Loose stools from cold drinks or after a wetting during a catarrhal spell are occasionally recorded in children, without tenesmus; better warmth and dry room quickly restore habit—contrast Dulc., which has more marked diarrhoea after getting chilled wet [Boericke], [Clarke]. Chronic constipation is not typical, though mouth-breathers may strain from poor fluid intake at night.

No keynote urinary sphere; increased frequency with chill is incidental. Enuresis may follow restless, obstructed sleep and disappears as snoring and mouth-breathing resolve—an [Clinical] consequence of improved sleep architecture [Tyler].

Desire for warm soups and drinks during coryza; aversion to cold fluids in chill phases; cold drinks may loosen stool in children, confirming the Worse-cold drinks modality [Boericke]. Appetite returns with smell/taste as obstruction clears [Clarke]. No strong idiosyncratic cravings recorded.

Not a leading sphere. Nasal obstruction-related fatigue may lessen libido in adults during fog spells; this is functional, resolving with respiratory improvement.

Catarrhal aggravations before menses in damp weather are noted in susceptible women; nasal blockage and hoarseness clear in warmth [Clarke]. Milkers and singers working in cold sheds report “tired voice” aligned with the same modalities [Tyler].

No strong keynotes; cervical and upper dorsal stiffness from mouth-open posture during sleep may be described by parents and improves as sleep normalises—again an [Clinical] corollary [Tyler].

Chill of hands and feet in damp rooms accompanies the general thermal state; warms slowly, aligning with Better-warmth [Boericke]. “Growing pains” are not specific; choose Calc-p., Rhus-t., or Dulc. on totality if they predominate.

Pallor with dusky infra-orbital shading, clammy in fog; sweats on scalp in warm bed—findings of the tubercular child but not decisive alone [Tyler]. Eruptions are not characteristic; eczema after wetting points rather to Dulc. [Boericke].

Aetiology / Climate

• Dulcamara — Catarrh after getting wet or chilled when hot; more muscular pains and cutaneous eruptions; Agra. is cleaner, lymphoid, fog-worse without the Dulc. rheumatic overlay [Boericke], [Clarke].
• Nat-s. — Damp-weather catarrh with bronchial tendency; greenish discharge; Agra. remains chiefly naso-pharyngeal with obstruction and deafness [Clarke], [Boger].
• Rhus-t. — Fog/rain aggravate but with restlessness and muscular stiffness; not primarily adenoid. Agra. targets lymphoid ring [Boericke].

Mind/Child Type

• Baryt-c. — Timid child, big tonsils, delayed development; Agra. more climatic and Eustachian; Baryt. has marked shyness and glandular induration globally [Kent], [Clarke].
• Calc-p. — School fatigue, growing pains; Agra. has catarrhal deafness and fog aggravation; Calc-p. wants eggs, has bone themes [Tyler].

Keynotes: Naso-pharynx / Polyps

• Lemna-m. — Nasal polypi, fetor, thick catarrh, worse in damp basements; Agra. less fetid, more lymphoid blockage [Clarke].
• Kali-bi. — Stringy, adherent mucus, sinus pains, punched-out ulcers; Agra. has obstruction > discharge and cleaner mucosa [Boericke].
• Hydrastis — Thick, ropy catarrh, rawness, marked fetor; Agra. blockage with mild catarrh and climatic modalities [Clarke].

Organ Affinity: Ears

• Kali-m. — Eustachian catarrh with tenacious mucus; Agra. combines tube catarrh with adenoid source and fog-worse keynote [Boger], [Clarke].
• Puls. — Thick bland discharge, shifting symptoms, tearful child; Agra. has stronger climate modality and adenoids; Puls. is better in open cool air (opposite thermal feel) [Clarke].

Modalities: Thermal / Season

• Psorinum — Chilly, wants warm clothing, catches cold easily, offensive discharges; Agra. is less offensive, more local lymphoid [Kent], [Clarke].
• Hepar-s. — Chilliness and croupy tendency, great sensitivity, suppuration; Agra. lacks the violent laryngeal sensitivity and splinter pains [Boericke].

Glandular / Tubercular Diathesis

• Tuberculinum — Recurrent catarrhs, tired child, restlessness and change-seeking; Agra. is local, climatic, and sedate; Tub. is broader constitutional miasmatic support [Clarke], [Tyler].
• Silicea — Recurrent ENT infections with sweat of head; more suppurative tendency and fragility; Agra. is boggy-lymphoid without pus theme [Boericke], [Tyler].

• Complementary: Baryt-c. — Shared tonsillar/adenoid terrain; Baryt. for constitutional glandular induration; Agra. for climatic lymphoid bogginess [Clarke], [Kent].
• Complementary: Calc-p. — Builds the school-child constitution whilst Agra. opens the airway; alternating use on indications [Tyler].
• Complementary: Kali-m. — Eustachian catarrh synergy; Agra. removes adenoid source, Kali-m. resolves tube mucus [Boger].
• Complementary: Lemna-m. — Polypoid obstruction partnership; Lemna for fetor/slime, Agra. for lymphoid bogginess [Clarke].
• Complementary: Tuberculinum — Intercurrent in relapsing tubercular diathesis when colds recur despite local improvement [Tyler].
• Follows well: Dulc. in acute chill-from-wetting once the state settles into chronic obstruction [Boericke].
• Follows well: Hydrastis after thick catarrh when obstruction persists without fetor [Clarke].
• Precedes well: Puls. when thick bland discharge ensues after the airway opens [Clarke].
• Antidotes: Warmth and dry air (modal), gentle steam inhalations (supportive) may relieve aggravation while remedy acts [Clarke].
• Compatible: Nat-s., Kali-s. in damp-weather bronchial drift; select on sputum quality [Boger].
• Cautions/Inimical: None distinctly recorded in classical sources; relationships are practical and organ-based rather than doctrinal [Boericke], [Clarke].

• Indications. Chronic adenoid hypertrophy with mouth-breathing, snoring, catarrhal deafness, and fog-weather aggravations—especially in pale, chilly, tubercular children [Clarke], [Tyler].
• Potency & repetition. 6C–30C in chronic hypertrophy given once daily or on alternate days; 200C as a weekly dose in relapsing catarrhal seasons; ascend cautiously on response. Several British authors favoured intercurrent dosing through damp months [Tyler], [Boericke].
• Intercurrents/adjuncts. Combine constitutionals (Calc-p., Baryt-c., Tub.) on totality; hygienic measures—dry, warm bedroom, nasal saline, and avoiding foggy late-evening exposure—support the remedy’s action [Clarke], [Tyler].
• Monitoring. Track sleep sound, mouth-closure, snore index, smell return, and hearing/attention at school; these are reliable clinical endpoints for Agra.

Case pearls (ultra-concise):

• Mouth-open sleeper with fog-aggravated catarrhal deafness; Agra. 200C weekly → quiet nasal sleep in a fortnight [Tyler].
• Pale boy, adenoid facies, worse west winds; Agra. 30C daily through spring → hearing improved; teacher noted attention restored [Clarke].
• Relapsing obstruction after every wetting; Agra. followed by Tub. intercurrent reduced seasonality [Tyler].
• Polypoid obstruction with fetor failed on Agra. until Lemna-m. addressed slime; Agra. then maintained patency [Clarke].

Mind

• Mind, dullness, from deficient sleep (mouth-breathing); marks functional clouding in Agra. children [Clarke].
• Aversion to going out, damp weather; anticipatory aggravation pattern [Clarke].
• Irritability, morning, on waking with obstructed nose; tracks airway state [Tyler].
• Inattention, children, from catarrhal deafness; improves as Eustachian clears [Clarke].
• Anxiety about health, fear of “catching cold”; learned climate fear [Clarke].
• Indifference at school during catarrh; reversible with treatment [Tyler].

Head

• Headache, frontal, morning on waking, with nasal obstruction; relieved by warmth [Clarke].
• Heaviness of head, damp weather, fog; climatic signature [Clarke].
• Pain, root of nose, pressure, with sneezing; lymphoid congestion sign [Boericke].
• Vertigo on rising in cold room, catarrhal; functional hypoxia [Clarke].
• Sinus, pressure without fetor; differentiates from Kali-bi. [Boericke].

Nose

• Obstruction, chronic, adenoids; keynote of Agra. [Clarke].
• Coryza, damp weather, fog, worse west winds; classic modality [Clarke], [Tyler].
• Anosmia with obstruction; smell returns as patency improves [Clarke].
• Sneezing in mouldy rooms, no relief; environmental sensitivity [Clarke].
• Mouth-breathing, children; sleep index symptom [Tyler].
• Snoring, children, from nasal blockage; improves under remedy [Clarke].

Throat

• Tonsils, enlarged, pale, boggy; Agra. tissue quality [Boericke].
• Post-nasal catarrh, obstruction greater than discharge; lymphoid keynote [Clarke].
• Hoarseness from mouth-breathing; resolves with nasal patency [Tyler].
• Cervical glands, swollen with chronic catarrh; tubercular tinge [Boger].
• Dysphagia, mechanical from adenoids; eased by warm drinks [Boericke].

Ears

• Deafness, catarrhal, Eustachian blockage, children; chief indication [Clarke], [Tyler].
• Ear, obstruction, popping on swallowing; ventilation improves with remedy [Clarke].
• Autophony in catarrh; clears as tubes open [Tyler].
• Otitis media, subacute, fog-worse; less pain than Hepar [Boericke].
• Hearing, worse in damp; better in dry warmth [Clarke].

Respiration / Sleep

• Respiration, mouth-breathing, children; central sign [Clarke].
• Snoring, children, adenoids; tracking outcome [Tyler].
• Suffocation, tendency in sleep, mechanical; improved by head high [Clarke].
• Sleep, unrefreshing from nasal obstruction; functional fatigue [Tyler].
• Position, better propped; practical management rubric [Clarke].

Generalities / Weather

• Weather, foggy, aggravates; stamp of the remedy [Clarke], [Tyler].
• Cold, damp, aggravates; chief modality [Boericke].
• Warmth, dry, ameliorates; matches airway improvement [Clarke].
• Tendency to take cold from least exposure; tubercular habitus [Boger].
• Perspiration, after, ameliorates; correlates with nasal opening [Clarke].

Gastro-intestinal (secondary)

• Diarrhoea, children, from cold drinks during coryza; occasional but characteristic nuance [Boericke].
• Appetite diminished with blocked nose; taste/smell dulled [Clarke].
• Thirst for warm drinks in chill phases; thermal alignment [Boericke].

Clarke — A Dictionary of Practical Materia Medica (1900): clinical portrait, organ affinity for adenoids/Eustachian, climate modalities; Cooper notes.
Boericke — Pocket Manual of Homoeopathic Materia Medica (1901): keynotes—adenoids, catarrhal deafness, damp-fog aggravation, diarrhoea from cold drinks.
Tyler — Homoeopathic Drug Pictures (1942): “bluebell child,” classroom deafness, practical monitoring indices; relations with Calc-p., Baryt-c., Tub.
Hughes — A Manual of Pharmacodynamics (1893): botanical/constituent context; rationale for mucosal/lymphoid effects.
Boger — Synoptic Key of the Materia Medica (1915): generalities of catching cold, tubercular tinge, weather aggravations; relationships.
Hering — Guiding Symptoms of Our Materia Medica (1879–): comparative notes on catarrhal states and climatic effects (contextual references).
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): general comparative catarrh; fragmentary mentions (context for non-proven remedies).
Kent — Lectures on Homoeopathic Materia Medica (1905): comparative child types (Baryt-c., Calc-p., Psor.); miasmatic considerations.
Dewey — Practical Homoeopathic Therapeutics (1901): ENT therapeutics; adenoids/tonsils comparisons (Baryt-c., Calc-p., Hepar, Puls.).
Farrington — Clinical Materia Medica (1887): climatic catarrhs and ENT remedy comparisons (Kali-bi., Hydrastis, Puls.).
Hale — New Remedies (var. eds.): context for “organ remedies” and fresh-plant use per Cooper school.
Cooper, R. T. — Papers on the therapeutic action of fresh-plant tinctures (late 19th c.): organotropic approach applied to adenoids (as cited by Clarke/Tyler).