The mental state of Aralia racemosa is often one of restlessness and anxious anticipation, particularly regarding health and the onset of attacks. Patients may go to bed in a state of nervous apprehension, aware that the first moments of sleep will bring on suffocative paroxysms. There is a marked dread of nightfall, as it is associated with respiratory crises. Irritability may accompany the physical distress, but unlike remedies such as Nux vomica, this irritability is more a product of exhaustion and inability to obtain rest. [Clarke] notes that the mental unease is closely tied to physical triggers rather than deep-seated constitutional irritability.
Sleep
Disturbed by violent asthma soon after falling asleep. The patient may wake several times with the same tickling and coughing. Sleep is otherwise unrefreshing from the constant interruptions.
Dreams
Dreams may be vivid and anxious, often ending abruptly with the suffocative awakening.
Generalities
Suddenness of nocturnal respiratory attacks is the keynote. The aggravation after first sleep is highly characteristic and should be differentiated from remedies such as Sambucus nigra or Spongia. The asthmatic state is often linked with a history of late summer colds or seasonal change. The constitution may be tubercular, thin, and nervous, with quick reactions to environmental changes.
Fever
Mild evening feverishness from respiratory effort, with occasional perspiration after attacks.
Chill Heat Sweat
Slight chilliness before attacks, followed by heat of face and scalp. Sweat is not profuse but may appear on forehead during the worst of the dyspnoea.
Head
There may be a sensation of fullness in the head during attacks of dyspnoea, as though venous stasis develops rapidly from the respiratory obstruction. Some provers noted a dull, pressing headache across the forehead during bouts of coughing or wheezing, relieved when respiration was freer. This congestion may be accompanied by heat of the face and throbbing temporal arteries.
Eyes
During paroxysms, eyes may appear suffused and watery, with occasional smarting from reflex irritation. Lachrymation is not a primary symptom but may occur from violent coughing spells.
Ears
A feeling of congestion or fullness may be present, again as a reflex from respiratory strain. Occasional tinnitus or dull hearing during suffocative attacks has been reported in clinical cases.
Nose
Tingling in the nostrils, with the urge to sneeze, may precede an asthma episode. Nasal passages feel dry during the day but become suddenly obstructed at night, forcing mouth breathing. There may be acrid coryza in the early stages of autumn colds.
Face
Flushed and warm during the paroxysms, with slight cyanotic tinges about the lips if the dyspnoea is severe. Expression is anxious and distressed, the mouth often open to facilitate breathing.
Mouth
The mouth feels dry, particularly on waking from sudden nocturnal attacks. There may be a metallic taste before or after coughing fits. The tongue may be coated slightly white in morning hours, clearing by midday.
Throat
There is marked tickling and irritation at the suprasternal fossa, often described as “low down in the throat” just above the sternum, provoking constant hawking. This tickling is highly characteristic, and in Aralia racemosa it triggers violent coughing spasms, especially after lying down. Sensation as if something were lodged or rough in the trachea, which cannot be expectorated.
Chest
This is the grand centre of action for Aralia racemosa. The hallmark symptom is sudden nocturnal asthma occurring soon after lying down and falling asleep. The patient may wake with a start, gasping for breath, compelled to sit upright. The attack is accompanied by tickling in the throat-pit and an irresistible desire to cough. The cough is dry, hacking, and exhausting, producing great distress, yet expectoration is scanty or absent until morning. Wheezing and tightness across the chest are intense, with a feeling of fullness in the lungs. The aggravation after first sleep is so marked that it serves as a keynote for prescribing. [Hale] describes cases in which asthma recurred at the exact same time each night, often between 11 p.m. and 1 a.m., with such severity that the patient dreaded going to bed.
Heart
Palpitation during attacks of dyspnoea, due to both cardiac strain and anxiety. Pulse may be quickened during the paroxysms but returns to normal once breathing is restored.
Respiration
Short, oppressed breathing with a sensation of narrowing in the upper trachea. Asthma is violent, often coming in waves during the night, forcing the patient out of bed. Respiration is more laboured in warm, confined rooms and easier in cool, open air, though exposure to dampness may initiate attacks later. Breathing is better during the day and worse immediately after lying down.
Stomach
Sudden attacks of nausea may accompany or follow violent coughing, sometimes with retching. Appetite is usually diminished in acute states from the disturbance of night rest.
Abdomen
Muscular soreness in the abdominal wall from excessive coughing. No primary abdominal pathology in provings.
Back
Occasionally, a dull aching between the scapulae is noted during respiratory distress, likely from muscular strain.
Extremities
Extremities may be cold during nocturnal paroxysms, with occasional numbness of fingers from poor oxygenation.
Skin
Some historical herbal records note eruptions and itching as part of Aralia’s broader action, though this is not well confirmed in homeopathic provings. In tubercular constitutions, a history of recurrent eczema may coexist with the respiratory pattern.
Aralia racemosa is a perennial herb native to North America, particularly abundant in the eastern United States and parts of Canada. Belonging to the Araliaceae family, it grows in rich woodlands and produces large clusters of aromatic roots. In herbal medicine, the root is noted for its warming, expectorant, and diaphoretic properties. The homeopathic remedy is prepared from the fresh root before flowering, macerated in alcohol.
Traditionally used by Native American tribes as a remedy for coughs, colds, rheumatism, and skin eruptions. In herbalism, it has been valued as a warming expectorant for chronic bronchitis, asthma, and as a tonic for convalescence. Roots were also infused to treat menstrual irregularities and promote perspiration during fevers.
First introduced into homeopathy by Dr. E. M. Hale, with provings conducted in the United States in the late 19th century. Symptomatology was further confirmed clinically in respiratory and asthmatic cases.
Respiratory tract, especially larynx, trachea, and bronchi, with marked nocturnal aggravations.
Lungs, particularly right upper lobe and apical regions, with tubercular tendencies.
Mucous membranes of the upper respiratory passages.
Skin, with pruritic and inflammatory eruptions.
Nervous system via reflex spasms of respiration from laryngeal irritation.
Sitting upright or leaning forward to ease breathing.
Early part of the night before midnight.
Mild, open air with moderate warmth.
Lying down, particularly soon after retiring to bed, with sudden attacks of asthma.
After first falling asleep.
Warm, close rooms and hot weather.
After exposure to damp night air.
Onset of cold, especially in late summer and autumn.
Sambucus nigra – Also has asthma after first sleep, but attacks are more associated with nasal obstruction in children.
Spongia tosta – Cough after sleep, but more croupy, dry, with “sawing” respiration and without the characteristic throat-pit tickling.
Arsenicum album – Asthma after midnight with great restlessness, but more gradual onset rather than sudden waking soon after sleep.
Grindelia robusta – Asthma with inability to breathe lying down, but with more frothy mucus and easier expectoration.
Complementary: Phosphorus, Sambucus nigra.
Antidotes: Nux vomica, Ipecacuanha.
Inimical: None recorded.
Follows well: Sambucus, Grindelia.
Aralia racemosa embodies the picture of sudden, violent nocturnal asthma, marked by an almost clock-like precision in its occurrence soon after the patient falls asleep. The essence is one of vulnerability to night air and positional change, with reflex irritation of the larynx producing intense coughing and suffocation. It suits tubercular, nervous constitutions who are fine during the day but dread the night’s inevitable struggle for breath.
Particularly suited to asthma and bronchial irritation in late summer and early autumn. A valuable intercurrent for patients who suffer yearly at the same time, often in August or September. Useful in coughs from laryngeal irritation following damp night air exposure. Often acts best in the 3rd to 6th potency, though higher potencies may be indicated in purely reflex cough cases.
Mind
Anxiety on going to bed from anticipation of asthma attacks.
Restlessness from difficulty breathing.
Head
Congestion of head during cough.
Headache from coughing.
Eyes
Lachrymation from cough.
Eyes suffused during suffocative paroxysm.
Stomach
Nausea from violent coughing.
Retching with cough.
Skin
Itching eruptions in tubercular constitutions.
Skin symptoms alternating with asthma.
Extremities
Cold hands during attacks.
Numbness of fingers from poor oxygenation.
Generalities
Asthma after first sleep.
Worse lying down; better sitting up.
Hering – The Guiding Symptoms of Our Materia Medica: Detailed respiratory and nocturnal aggravation symptoms.
Clarke – A Dictionary of Practical Materia Medica: Clinical confirmations of nocturnal asthma and throat-pit tickling.
Hale – New Remedies: Historical introduction and proving notes.
Allen, T. F. – Encyclopedia of Pure Materia Medica: Primary proving symptoms.
Boericke – Pocket Manual of Homœopathic Materia Medica: Keynotes of nocturnal asthma after first sleep.
Disclaimer: The content on this page is for educational purposes only and is not medical advice. Always seek guidance from a qualified healthcare professional before starting any treatment.
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