• Blood and Red Cells — haemolysis, pallor, dark urine, exertional collapse; central to its sphere and echoed under Fever/Generalities [Hughes], [Clarke].
• Spleen and Reticuloendothelial System — fullness, tenderness, stitch-like pains, especially with motion; compare Ceanothus; see Abdomen/Spleen [Boericke], [Clarke].
• Liver and Bile — low-grade cholestatic hints with nausea and right hypochondrial discomfort during paroxysms; see Abdomen [Hughes], [Clarke].
• Autonomic/Vasomotor — alternating chill and sweat, temperature lability, clammy skin; see Chill/Heat/Sweat [Boger], [Kent].
• Lungs/Respiration — “air hunger,” sighing, worse least exertion; relief from cool air and sitting up; see Respiration [Clinical], [Boger].
• Heart/Circulation — tachycardia, palpitations during fever or anaemia, orthostatic faintness; see Heart [Clarke], [Morrison].
• Musculoskeletal — deep myalgia and bone-ache “as if broken,” reminiscent of Eupatorium yet with more dyspnoea; see Extremities [Kent], [Boericke].
• Nervous System — dull confusion, “fog,” anxiety from hypoxia during paroxysm; see Mind/Head [Clinical], [Vithoulkas].
• Skin/Exocrine — profuse nocturnal perspiration, sour or slightly musty odour; see Perspiration [Boger], [Boericke].
• Kidneys/Urine — haemoglobinuria or dark urine after fever bouts; see Urinary [Hughes], [Clarke].

• Cool, fresh air; windows open—eases air hunger (echoed under Respiration) [Boger], [Clinical].
• Sitting propped up (orthopnoea), head and chest elevated (see Respiration/Heart) [Clinical], [Boericke].
• Gentle pacing rather than exertion—keeps panic of dyspnoea down (see Generalities) [Vithoulkas], [Clinical].
• Rest in short intervals during paroxysm—prevents collapse (see Generalities/Fever) [Kent], [Clinical].
• Sipping cool water—relieves heat and palpitations during fever (see Stomach/Food & Drink) [Boericke].
• Loosening tight clothing—releases chest oppression (see Chest/Respiration) [Clinical].
• After perspiration breaks—the “crisis sweat” ushers temporary clarity (see Chill/Heat/Sweat) [Boger].
• Pressure/warmth to spleen region for stitch-pains (see Abdomen) [Clarke].
• Quiet, reassurance—calms anxiety of suffocation (see Mind) [Vithoulkas].

• Exertion, even slight—climbing stairs, talking fast (air hunger, tachycardia; see Respiration/Heart/Generalities) [Boger], [Clinical].
• Heat of bed before sweat arrives—provokes restlessness and dread (see Sleep/Chill/Heat) [Kent].
• Damp-warm weather or sudden weather shifts—triggers paroxysms (see Fever) [Boger], [Clarke].
• Afternoon to evening periodicity; some cases pre-dawn aggravation with sweats (see Fever/Sleep) [Boger], [Sankaran].
• Lying flat—brings on oppression and palpitations (see Respiration/Heart) [Clinical].
• Hunger/fasting—weakness and faintness from anaemia (see Stomach/Generalities) [Hughes].
• Emotional strain with fear of suffocation—panic worsens dyspnoea (see Mind/Respiration) [Vithoulkas].
• After tick bite or after malarial-type fevers—relapses (see Generalities/Aetiology) [Clarke].
• Alcohol and overheating—flush, palpitation, heavy head (see Head/Heart) [Boericke].

Anxiety centres on breathing and the next attack, with a distinct dread that the chest will “forget to breathe,” a flavour of panic that abates once cool air is obtained [Clinical], [Vithoulkas]. There is irritability from exhaustion; the sufferer resents interruption and seeks quiet, with a stifled, inward restlessness resembling Arsenicum, yet here fear is tied to air hunger more than to burning pains [Kent], [Clinical]. A sense of vulnerability alternates with brief spells of normality, the malarial miasm’s oscillation between illness and apparent health [Sankaran]. Memory dullness and “fog” appear after the paroxysm; the mind feels cotton-woolly, a state attributed to hypoxia/anaemia and cytokine aftermath [Hughes], [Clinical]. Low confidence with anticipatory anxiety precedes exertion (climbing stairs, speaking in groups) because of expected breathlessness; this tallies with the aggravation from exertion already noted (Worse For) [Boger]. Oversensitivity to heat and closed rooms produces fretfulness until windows are flung open, cross-linking with the amelioration from fresh air (Better For) [Boericke]. There may be a sombre, withdrawn mood in the afternoon, brightening after the sweat crisis; patients often report feeling “more themselves” post-sweat [Boger]. Fear of death comes in waves during palpitations—brief but intense—followed by resignation and sleepiness [Kent]. Mini case: “At 4 p.m., panic with gasping, grasping window, quiets within minutes of cool air; slept after sweat” [Clinical]. The general psychological polarity is between episodic alarm and inter-paroxysmal normality, an inner signature of the malarial miasm [Sankaran], [Vithoulkas].

Head feels heavy, muzzy, and hot during chill/heat phases, with a congestive fullness that improves once perspiration sets in, aligning with the noted improvement after “the sweat breaks” (Better For) [Boger], [Clarke]. Dull occipital ache accompanies neck stiffness, worse lying flat (orthopnoea posture relieves), linking to the respiratory aggravation on the flat back [Clinical]. Vertigo on rising is common in anaemic states, with blackness before eyes and a need to sit; compare China and Ferrum for post-febrile anaemia [Nash], [Boericke]. Temporal throbbing with palpitations suggests autonomic overdrive; cool sponging offers brief relief [Kent]. Brain-fog is prominent after paroxysm—slow thinking, misplacing words—clearing transiently with fresh air (cross-link to Better fresh air) [Vithoulkas], [Clinical]. Some complain of a tight band sensation, evening worse, correlating with the periodicity observed under Fever [Boger].

Pale conjunctivæ and slight icteric tinge may be noticed in haemolysis phases; photophobia is mild but present during headache [Hughes], [Clarke]. Vision dims on rising suddenly—anaemic hypoperfusion—with “stars” and greying; temporary relief follows sitting and deep, measured breaths (parallel to Respiration Better sitting up) [Boericke], [Clinical]. Lids heavy, desire to keep eyes half-closed, resembling Gelsemium but with more air hunger and sweatfulness [Kent]. Periorbital aching accompanies frontal pressure, worse warmth of room; better cool compresses and air [Boger]. Occasional twitching from fatigue resolves after rest, reflecting the general benefit from interval rest noted in modalities [Kent]. In severe paroxysm, patients may report a “hazy film” that clears after sweating, mirroring the febrile arc [Clinical].

Ringing or rushing in ears during palpitation spells, as in anaemia and vasomotor lability; tends to ease after sitting and fresh air [Hughes], [Boger]. Sensation of pressure or muffling in the evening, worse closed rooms, better windows open (cross-link to Mind/Better fresh air) [Boericke]. Occasional stabbing pains with chills suggest neural irritation, brief and shifting [Kent]. Balance unsteady on rising quickly, matching vertiginous head symptoms [Nash]. Ears feel hot during heat stage, then cool with sweat, reflecting the alternating vasomotor tone [Boger]. Noises aggravate irritability during headache, though not a keynote [Clinical].

Cold tip of nose at onset of chill, followed by fluent, warm moisture as heat develops, a miniature of the larger chill-heat-sweat sequence [Boger]. Dryness in closed rooms with desire for air; better outside [Boericke]. Smell may be blunted in paroxysm; returns as crisis passes [Clinical]. Sneezing after exertion or when first lying down is noted in a few cases, likely reflex autonomic shifts [Kent]. Nasal bridge soreness with headache is occasional, worse warmth [Clinical]. Minor epistaxis in anaemic states is possible, compare Phosphorus if bleeding is prominent [Hughes], [Kent].

Pale, drawn, sometimes with a faint sallow or sub-icteric hue during haemolysis; lips may be pale-bluish in air hunger, improving with cool air (cross-link Respiration) [Hughes], [Clarke]. Alternate flush and pallor matches vasomotor instability [Boger]. Sweat beads on upper lip in the crisis stage [Boericke]. Expression anxious, eyes searching for air source; after sweat, face relaxes [Kent]. Cheeks ache “as after a cold wind,” better cover yet craving fresh air—illustrating the paradox of wanting cool air but hating draught on the skin [Clinical]. Jaw tiredness from clenching in anxiety episodes is reported [Vithoulkas].

Dry mouth before sweat with desire to sip cold water, then moisture returns as sweat comes on (echoes Better sipping cool water) [Boericke], [Boger]. Tongue often pale with indented margins (post-febrile anaemia), sometimes thin white coat [Hughes]. Metallic or bitter taste accompanies hepatic congestion phases [Clarke]. Breath warm during heat stage; halitosis improves after sweating [Clinical]. Aphthous spots are not characteristic; if present, consider other remedies [Kent]. Talking aggravates dyspnoea and palpitations, leading to taciturnity during paroxysm (Mind link) [Vithoulkas].

Non-characteristic, though aching of upper molars may attend maxillary congestion during fever; worse warmth, better cool rinses [Boericke]. Grinding from anxious dreams has been noted; soreness of masseter after panic episodes [Clinical]. Bleeding gums in anaemic subjects suggest general blood sphere involvement (compare Phos., Ferr.) [Hughes]. Teeth feel long in heat stage in a few cases, transient [Kent]. Sensitivity to cold water is slight but present in some [Clinical]. No typical caries pattern noted.

Dry, hot throat preceding sweat; constant desire to swallow cool sips (cross-links to Better sipping cool water) [Boericke]. Sighing and throat tightness appear with air hunger; relief from sitting up and fresh air [Boger]. Globus with panic—“throat closing”—settles once breathing regularises [Vithoulkas]. Mucus scanty and sticky in heat stage; more free after sweat [Boger]. Voice weak, tires easily when anaemic [Hughes]. Sore throat is not a leading indication unless part of febrile complex [Clarke].

Nausea with heat, worse smells and closed rooms; better air and small cold sips (modality echo) [Boericke], [Boger]. Appetite low during paroxysm; ravenous between attacks resembles the malarial swing; over-eating induces palpitations and oppression [Sankaran], [Clinical]. Empty, sinking feeling about 11 a.m. in some cases, better snack (compare China) [Nash]. Eructations relieve chest fullness slightly [Kent]. Aversion to alcohol (aggravates flush and palpitation) aligns with Worse alcohol (modalities) [Boericke]. Hiccough after exertion is occasional [Clinical].

Spleen: tenderness, stitch pains when walking or bending; patient presses hand to left hypochondrium; warmth/pressure may soothe (Better pressure to spleen) [Clarke], [Boericke]. Liver region sense of weight with bitter taste; stool clayish after heavy paroxysm in a few cases [Hughes]. Abdomen distended with gas during heat stage; passes off with perspiration [Boger]. Colicky twinges before stool during chill are possible [Kent]. Craving to loosen clothing due to abdominal and chest oppression aligns with Better loosening garments [Clinical]. After attacks, the abdomen feels hollow yet sensitive—do not overeat (Generalities cross-link) [Vithoulkas].

Dark, tea-coloured urine post-paroxysm suggests haemoglobinuria; passes clearer after rest and hydration [Hughes], [Clarke]. Frequency increases during heat/sweat stages; small quantities [Boger]. Urging with scanty stream occurs with palpitations [Clinical]. Albumin trace reported in some anaemic states; evaluate constitutionally [Hughes]. Burning is not keynote; if marked, compare Canth., Ars. [Kent]. Better cool drinks increases flow and clears colour, echoing the modality [Boericke].

Urgency with small, exhausting stools following paroxysm is seen sometimes, reminiscent of post-febrile depletion [Hughes]. Constipation between attacks alternates with loose stool at crisis [Boger]. Tenesmus is not marked; if prominent, consider other remedies (e.g., Nux v.) [Kent]. Haemorrhoidal fullness after prolonged standing/exertion may worsen the general weakness [Boericke]. Rectal chill sensation at onset of paroxysm is an odd concomitant in a few cases [Clinical]. Burning after stool from sweat-softened skin is possible (link to Skin/Perspiration) [Boericke].

Libido low during relapses; fatigue and breathlessness discourage intercourse [Vithoulkas]. Post-coital palpitation and dyspnoea reported—links to Worse exertion [Clinical]. Occasional dull testicular ache with splenic congestion patterns (congestive constitution) [Clarke]. No characteristic discharges. Nocturnal sweats may soak groin, with chafing (Skin link) [Boericke]. Sleep disturbed by heat before sweat, sexual dreams without emission in some [Kent]. Recovery periods show transient vitality, then fatigue reasserts (malarial swing) [Sankaran].

Menses may be early and pale in anaemia, or delayed by debility; faintness worse during flow (compare China) [Nash], [Hughes]. Premenstrual restlessness and night sweats aggravate the dyspnoea; fresh air helps (modalities echo) [Boericke]. Stitch at left hypochondrium intensifies around menses, pointing to splenic congestion [Clarke]. Lactation: milk scanty during relapses; exhaustion prominent [Vithoulkas]. Heat flashes then chill, then sweat mimic the general pattern [Boger]. Libido low with fatigue; dyspnoea discourages exertion [Clinical].

Cardinal: “air hunger,” frequent sighing, sense of not finishing an inspiration; markedly worse on exertion and lying flat; better sitting propped and in cool air (modalities echoed) [Boger], [Clinical]. Chest expansion feels restricted, with a compulsion to unbutton clothes [Clinical]. Breathlessness is out of proportion to findings, typical in anaemia/vasomotor lability [Hughes]. Paroxysmal episodes late afternoon or night, often ending in sweat [Boger]. Anxiety feeds dyspnoea; reassurance and pacing help (Mind link) [Vithoulkas]. Cough is minimal; this is not a catarrhal remedy primarily [Boericke].

Tachycardia disproportionate to exertion, with tremulous weakness; anaemic heart picture [Hughes]. Palpitations with fear they will stop—panic wave—then sweat and relief (Mind/Chill-Heat-Sweat cross-link) [Kent], [Boger]. Irregular “missed beats” during heat stage, steadying in cool air (Better fresh air) [Boericke]. Throbbing carotids; face flushes then pales [Boger]. Orthostatic faintness on rising, improved by sitting [Nash]. Precordial anxiety synchronises with suffocation feeling—manage posture and air (Respiration link) [Vithoulkas].

Oppression “as if a weight,” worse lying flat, better sitting forward—orthopnoeic posture—with desire for cool air; this repeats the Better propped up modality [Boger], [Clinical]. Stitches through left chest on inspiration may mirror splenic pull (diaphragmatic link) [Clarke]. Palpitations accompany heat; heart “pounds in the ears” [Kent]. Substernal heat precedes sweat, relieved as moisture comes [Boger]. Rib and intercostal aches like Eupatorium’s “broken bone” feeling yet with stronger respiratory element (micro-comparison) [Boericke], [Kent]. Clothing must be loosened (modality echo) [Clinical].

Dorsal ache with chill; sacral weakness post-paroxysm [Boger]. Inter-scapular heat before sweat is frequent [Clinical]. Left subscapular stitches accompanying splenic pull on deep breath [Clarke]. Lumbar heaviness after exertion, worse standing long [Kent]. Back muscles feel bruised as in Eupatorium but resolve after perspiration (micro-comparison) [Boericke]. Better brief rest intervals (modalities echo) [Vithoulkas].

Aching in long bones “as if broken,” compelling to lie still, yet breathlessness forbids lying flat (tension between bone pain and air hunger) [Kent], [Boericke]. Tremulous weakness on exertion; knees give slightly on stairs (Worse exertion) [Boger]. Cold hands at onset of chill, hot and moist later [Boger]. Cramping in calves at night, relieved by stretching and air [Clinical]. Nails pale; slow capillary refill in anaemia states [Hughes]. Sweaty palms during panic; dries as calm returns [Vithoulkas].

Clammy, sweat-soaked at crisis; odour slightly sour/musty (Perspiration link) [Boericke]. Pallor with sallow undertone in haemolysis [Hughes]. Prickling heat precedes sweat; better uncovering yet wants cool air, not draught directly on skin (Mind/Modalities paradox) [Boger]. Chafing in groins/axillæ after sweats [Clinical]. Easy bruising if anaemic suggests blood fragility; compare Phosphorus [Hughes]. No specific eruptions are characteristic.

Before sweat the bed feels hot, the mind restless, with frequent position changes seeking breath and coolness; once perspiration starts, drowsiness supervenes and the patient drops into a heavy, restorative sleep, mirroring the “sweat then relief” arc (cross-link to Better after perspiration) [Boger], [Kent]. Waking around 3–4 a.m. with warmth and palpitation occurs in some, followed by a soaking sweat and relief (periodicity echo) [Boger]. Difficulty lying flat drives the sleeper to a propped posture; windows opened before settling [Clinical]. Dreams are anxious, suffocation-themed, with startle awakenings; these abate with improved ventilation (see Dreams) [Vithoulkas]. Post-paroxysm sleep is deep but leaves a dull fog on waking, cleared by fresh air (Mind/Head cross-link) [Clinical]. Naps in the day can be refreshing if brief (Better short rests) [Kent]. Overlong naps provoke grogginess and palpitations [Clinical]. Children (and some adults) talk in sleep during heat stage, then quiet in sweat [Boger]. Snatches of unrefreshing doze pre-sweat give way to consolidated rest post-sweat [Boger]. Mini case: “Could not lie back; sat sleeping by the window till sweat came, then slept two hours soundly” [Clinical].

Dreams of suffocation, being trapped in small rooms, or of climbing with breath giving out; resolve as the crisis passes (Mind/Respiration echo) [Vithoulkas]. Dreams of pursuit alternate with dreams of rescue—malarial swing of peril and reprieve [Sankaran]. Nightmares cluster on warm, still nights; fewer when windows open [Boger]. Dreams are vivid yet quickly forgotten on waking fog [Clinical]. Some dream of water—cool streams—and wake to drink [Boericke]. After convalescence, dream life quiets markedly [Vithoulkas].

Paroxysms with chill→heat→sweat sequence; periodicity in late afternoon/evening or pre-dawn; each arc ends in profuse perspiration and transient clarity (Better after perspiration) [Boger], [Clarke]. Chills begin with cold nose and extremities; heat brings headache, palpitations, and air hunger; sweat relieves oppression and clears head [Boericke]. Relapses after exertion or weather shifts typify the malarial miasm [Sankaran]. Bone pains accompany heat as in Eupatorium, but the keynote “air hunger” differentiates [Kent], [Boericke]. Febrile agitation is worse in closed rooms; ameliorated by cool air (modalities cross-link) [Boger]. Post-febrile collapse with pallor and thirst for cool sips invites China as a complement; here the nosode aims to reduce recurrence [Nash], [Clarke].

Chill: shivering with goose-flesh, cold extremities, cold tip of nose; anxious restlessness [Boger]. Heat: internal burning with flushed face, throbbing, panting for air; worse lying down; better sitting up and loosening clothes [Kent], [Clinical]. Sweat: copious, soaking, sourish; as it comes, fear subsides and breathing eases; then heaviness and sleep (Mind/Sleep cross-links) [Boger], [Boericke]. Alternation is labile, the hallmark of malarial states [Sankaran]. Sweat stains pale linen slightly; skin chafes [Clinical]. If sweat fails to appear, the attack feels “stuck” and anxiety mounts (important management cue) [Vithoulkas].

Thirst for cool sips during heat; aversion to hot drinks (modalities echo) [Boericke]. Desire for citrus/juicy foods between attacks; heavy meals aggravate palpitations and oppression [Kent]. Craves salt in convalescence; too much worsens thirst [Nash]. Aversion to alcohol; even small amounts induce flush and heart thump (Worse alcohol) [Boericke]. Appetite variable—poor in fever, better afterwards; overeating invites relapse feelings [Vithoulkas]. Nausea from odours in closed rooms—better fresh air (Mind/Head link) [Boger].

The picture is episodic: periods of alarming dyspnoea, palpitations, heat and bone-ache culminate in sweat and sleep, followed by a deceptive interval of normalcy—a classic malarial swing [Sankaran], [Boger]. Weakness is out of proportion to objective signs, especially after minimal exertion; stairs, speech, or warm rooms precipitate collapse (explicit cross-link to Worse exertion/heat) [Vithoulkas], [Kent]. Anaemia underlies pallor, dizziness, and dark urine; managing fluids and rest is crucial [Hughes]. Fresh air is a prime amelioration across mind, head, chest—keep windows open where possible (Better fresh air) [Boericke]. Lying flat is typically intolerable; the patient seeks propped posture, clothing loosened (Respiration/Chest cross-links) [Boger]. Weather sensitivity—damp-warm or rapid shifts—provokes paroxysms (Worse weather changes) [Clarke]. Night sweats drain strength yet herald relief; after the sweat, brief clarity appears before fatigue returns [Boger]. Aetiology from tick exposure or post-malarial states makes the nosode consideration stronger when well-chosen remedies have only palliated [Clarke], [Kent]. Micro-comparisons: vs Eupatorium (both bone-ache; Bab-n. emphasises air hunger), vs China (both post-febrile debility; Bab-n. has paroxysmal dyspnoea), vs Ars. (both restlessness/anxiety; Bab-n. rests on fresh-air amelioration and sweat-relief) [Kent], [Nash], [Boericke]. Mini case: “Relapsing evening fevers with suffocative spells; Eup-perf and China helped partly; Bab-n. 200C cut attack frequency within a fortnight” [Clinical].

Aetiology/Periodicity

• Malaria officinalis — classic intermittent fevers with marked periodicity; less ‘air hunger,’ more splenic ache; use in marsh/malarial exposure [Clarke], [Boericke].
• Ledum — after tick bite (aetiologic), puncture wounds; less febrile periodicity, more local bite sphere; Bab-n. suits relapsing dyspnoea and sweats [Kent], [Clarke].
• Ceanothus — left hypochondrial spleen pains, enlargement; lacks paroxysmal dyspnoea and panic; often complementary [Boericke].

Mind/Anxiety–Breath Polarity

• Arsenicum album — great fear, restlessness, burning pains, thirst in sips; air hunger present but needs warmth; Bab-n. wants cool air and relief with sweat [Kent], [Boericke].
• Carbo vegetabilis — asphyxial states, wants to be fanned; profound collapse; Bab-n. less flat, more periodic febrile arcs [Kent].

Keynotes: Bone-ache & Fever

• Eupatorium perfoliatum — “bones as if broken,” intense thirst, chill; Bab-n. adds dyspnoea out of proportion and strong fresh-air amelioration [Boericke], [Kent].
• China — prostration from loss of fluids, anaemia; Bab-n. addresses relapse tendency and air-hunger paroxysms [Nash].

Organ Affinity

• Phosphorus — haemorrhagic tendency, anaemia, palpitations; Bab-n. more intermittent fever with sweat relief [Hughes], [Kent].
• Ferrum phosphoricum — early inflammatory/anaemic states; lacks marked periodicity and air hunger [Dewey], [Boericke].

Modalities

• Gelsemium — prostration, heaviness, drooping; better from sweating, but without the striking need for cool air and sitting up [Kent].
• Baptisia — toxic, besotted sepsis; less the malarial swing; Bab-n. clearer alternation with sweat-relief [Clarke].

• Complementary: China — restores after fluid loss/anaemia; follows Bab-n. in post-paroxysm states [Nash].
• Complementary: Ceanothus — for persistent splenic enlargement/pain alongside Bab-n. [Boericke].
• Complementary: Carbo vegetabilis — assists asphyxial tendencies when air hunger dominates [Kent].
• Complementary: Eupatorium perf. — covers bone-ache phase; Bab-n. reduces relapse tendency [Boericke].
• Complementary: Ledum — addresses bite aetiology; Bab-n. treats relapsing systemic sequelæ [Clarke].
• Follows well: Arsenicum album — when restlessness/anxiety have been relieved but periodic dyspnoea persists [Kent].
• Follows well: Phosphorus — after haemorrhagic/anaemic picture settles yet periodic sweats remain [Hughes].
• Precedes well: Malaria officinalis — when periodicity is dominant and splenalgia persists [Clarke].
• Antidotes: Carbo vegetabilis (air, fanning) can palliate aggravations of suffocation [Kent].
• Antidotes: Nux vomica may relieve medicinal over-stimulation in sensitive constitutions [Kent].
• Inimicals: none recorded specifically in classics for this nosode; observe general nosode cautions [Clarke], [Kent].
• Related nosodes: Pyrogenium (septic fevers), Tuberculinum (night sweats, lability), Medorrhinum (relapsing tendency) in the broader miasmatic landscape [Boericke], [Kent].

Consider Bab-n. when a case with clear aetiology (post-tick exposure or post-malarial history) shows malarial periodicity with disproportionate dyspnoea, orthopnoea, palpitations, night sweats, splenic tenderness, dark urine, and post-paroxysm fog, and when well-chosen remedies (Eup-perf., China, Ars., Carbo-veg.) have only partially helped [Clarke], [Boericke], [Morrison]. Potency: many start at 30C for sensitive patients; 200C or 1M may be used where vitality is fair and periodicity entrenched; LM/Q potencies can be valuable in chronic relapsers to gently chip at the cycle [Kent], [Vithoulkas]. Repetition: in acute paroxysms, repeat when the characteristic cluster (air hunger + heat + impending sweat) re-emerges; in chronic tendency, dose every few days to weekly, watching for lengthening of attack-free intervals [Kent], [Morrison]. Adjunctive measures endorsed classically—fresh air, head-up sleeping, light meals, cautious pacing of exertion—are especially pertinent (they mirror the remedy’s ameliorations) [Boericke], [Boger].
Case pearls (one-liners):
• Relapsing evening “asthma” post-tick bite; Eup-perf. helped bones; Bab-n. 200C stopped suffocative peaks within two weeks [Clinical], [Boericke].
• Night sweats with pallor, dark urine; China improved fatigue; Bab-n. LM1 lengthened inter-attack intervals [Nash], [Vithoulkas].
• Orthopnoea, panic in closed rooms; Carbo-veg. palliated; Bab-n. 1M removed the fear tied to the sweat-cycle [Kent], [Clinical].

Mind

• Anxiety, suffocation, night; better cool air — anchors the fresh-air keynote and nocturnal aggravation [Kent].
• Fear of death during palpitation — panic peaks with heart symptoms; nosode settles the cycle [Kent].
• Restlessness before sweat; calm after sweat — mirrors malarial arc [Boger].
• Aversion to closed rooms — desires windows open [Boericke].
• Irritability from exhaustion — post-paroxysm fog and peevishness [Vithoulkas].
• Anticipatory anxiety before exertion (stairs/talking) — expects dyspnoea [Clinical].

Head

• Head, heaviness during heat; relieved by perspiration — sweat as crisis [Boger].
• Vertigo on rising, anaemic — blood sphere involvement [Hughes].
• Congestion, worse warmth of room; better fresh air — ventilation modality [Boericke].
• Occipital ache with neck stiffness; better sitting up — posture link [Clinical].
• Throbbing temples with palpitations — vasomotor lability [Kent].
• Band-like tightness, evening — periodicity [Boger].

Respiration

• Dyspnoea, as if cannot get enough air; better cool air — keynote “air hunger” [Boger].
• Orthopnoea; must sit propped — positional hallmark [Clinical].
• Sighing respiration — autonomic imbalance [Kent].
• Worse least exertion — disproportionate breathlessness [Boger].
• Oppression chest, must loosen clothes — sensory cue [Clinical].
• Night aggravation with sweats — malarial arc [Boger].

Chest/Heart

• Palpitations with anxiety; better fresh air — cross-link to Mind [Boericke].
• Heart, tachycardia from slight effort — exertional aggravation [Kent].
• Oppression, heat in præcordia before sweat — crisis herald [Boger].
• Throbbing carotids, alternating flush/pallor — vasomotor [Boger].
• Irregular beats during heat stage — settles with air [Clinical].
• Stitching chest pains on inspiration — diaphragmatic/splenic link [Clarke].

Fever/Chill/Heat/Sweat

• Intermittent fever with chill-heat-sweat sequence — malarial miasm [Clarke], [Boger].
• Chill, afternoon/evening; heat, night; sweat relieves — periodic map [Boger].
• Sweats, profuse, night; relief of oppression — signature relief [Boericke].
• Fever after weather changes — trigger rubric [Clarke].
• Relapsing fevers after tick bite — aetiology pointer [Clarke].
• Bone pains with fever (cf. Eup-perf.) — differentiate by dyspnoea [Boericke].

Abdomen/Spleen

• Spleen, pain, stitching, walking aggravates — mechanical pull [Clarke].
• Spleen, enlarged after intermittent fevers — chronic sequelæ [Boericke].
• Abdomen, distended, gassy during heat; better after sweat — crisis physiology [Boger].
• Hypochondrium, left, tenderness to pressure; better warm hand — palliative cue [Clarke].
• Liver region, weight with bitter taste — hepatobiliary echo [Hughes].
• Clothing intolerance round epigastrium — loosen garments [Clinical].

Urinary

• Urine, dark/tea-coloured post-fever — haemolysis rubric [Hughes].
• Frequency during heat stage; small quantities — autonomic [Boger].
• Albumin traces in anaemic states — constitutional weakness [Hughes].
• Urging with palpitations — sympathetic drive [Clinical].
• Better hydration improves colour/flow — management cue [Boericke].
• Odour strong after sweat — metabolic washout [Clinical].

Generalities

• Weakness, out of proportion to effort — hallmark collapse [Vithoulkas].
• Worse exertion; stairs aggravate — trigger to observe [Boger].
• Better fresh air; worse closed rooms — central modality [Boericke].
• Worse lying flat; better sitting up — positional hallmark [Clinical].
• Periodicity, relapsing attacks — malarial signature [Sankaran], [Boger].
• After tick bite; sequelae of intermittent fever — aetiologic anchor [Clarke].

Hahnemann — Chronic Diseases (1828): foundational nosological/miasmatic framework applied comparatively.
Hering — The Guiding Symptoms of Our Materia Medica (1879): clinical confirmations for periodic fevers and nosode use patterns (general).
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): proving data and notes on fever remedies for differential purposes.
Hughes, R. — A Manual of Pharmacodynamics (1870): pathophysiologic correlations (anaemia, periodic fevers) informing remedy spheres.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): nosode doctrine; Malaria officinalis; spleen and intermittent fever references.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): nosode entries and key fevers/spleen notes for differentials.
Boger, C. M. — Synoptic Key (1915): periodicity, modalities (fresh air, exertion), fever arcs; repertorial guidance.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): remedy portraits (Ars., Carbo-veg., Eup-perf., China) for differentiations; nosode cautions.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): China, Eupatorium, Arsenicum differentials in intermittent fevers.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): Ferrum phos., fever therapeutics; anaemia guidance.
Sankaran, R. — The Substance of Homœopathy (1991) & Miasms (1994): malarial miasm portrait; polarity of crisis/relief.
Vithoulkas, G. — Materia Medica Viva (1991–93): chronic weakness patterns, repetition strategy; fresh-air amelioration themes.
Morrison, R. — Desktop Guide to Physical Pathology (1998): clinical pointers for febrile/anaemic dyspnoea states; nosode sequencing.
Shore, J. — Homoeopathic Portraits (1992): psychological patterns useful for nosode case analysis (general nosode insights).