• of bladder, constant urging with scanty, ropy, milky or smoky urine; shreds/filaments, albumen or blood; tenesmus vesicæ after urination; gleet and gonorrhœa (subacute/chronic). See Urinary/Male. [Allen], [Hering], [Clarke], [Boericke]
• Kidneys (renal catarrh). Dull aching in costo-vertebral angle; hæmaturia, albuminuria, smoky urine with iridescent pellicle; backache worse stooping or walking; secondary dropsical puffs rare. See Back/Urinary. [Allen], [Clarke], [Boericke]
• Rectum & anus. Proctitis, haemorrhoids with violent pruritus ani, soreness, and smarting after stool; mucus-laden, jelly-like (“toad-spawn”) stools. See Rectum/Skin. [Hering], [Clarke], [Boericke]
• Skin (drug eruptions). Urticaria tuberosa, scarlatino-measly exanthems, papular itching rashes; often coincident with urinary/rectal symptoms—“copabic rash.” See Skin/Generalities. [Hughes], [Allen], [Clarke]
• Bronchi & larynx. Chronic catarrh with abundant whitish mucus, tickling and hoarseness, especially in old or catarrhal constitutions, often coexisting with urinary irritation. See Chest/Respiration. [Clarke], [Boericke], [Farrington]
• Female pelvic mucosa. Pruritus vulvæ, smarting urethra during pregnancy or leucorrhœa; urinary catarrh with vulvar heat. See Female/Urinary. [Hering], [Clarke]
• Prostate & spermatic tract. Prostatitis, gleet, sexual excitement or pain along urethra with chordee in toxic states. See Male. [Allen], [Clarke]

• Passing urine (momentary) when tenesmus has been high. [Hering], [Allen]
• Cold applications/bathing to itching parts (anus, vulva, eruption). [Clarke], [Boericke]
• Cool, open air for skin and chest; ventilated room. [Clarke]
• Rest with loose clothing, avoiding urethral/anal friction. [Hering], [Clarke]
• After a soft stool (pelvic fulness and head relieve). [Clarke]
• Large draughts of water (flushes urethral burning in some provers). [Allen]
• Milk-diet/light farinaceous during acute urinary catarrh. [Clarke], [Dewey]

• During and immediately after urination—burning, tenesmus, shreds. [Allen], [Hering]
• Night, especially after midnight—itching, urinary urging, cough. [Clarke], [Allen]
• Warmth of bed/room—itch-rash, anal/vulvar pruritus, chest tickle. [Clarke], [Hughes]
• Stooping, walking, riding—renal/back aching, urethral drag. [Boericke], [Allen]
• After coitus or sexual excitement—urethral burning returns. [Allen], [Clarke]
• Beer, spices, acids, and coffee—increase burning and mucus. [Clarke], [Dewey]
• Suppressing a gonorrhœal discharge—renal/skin symptoms light up. [Hering], [Hughes]
• Scratching—temporarily relieves but burning follows; eruption spreads. [Clarke]

Irritability is somatic, springing from burning, itching, and tenesmus rather than moral causes; he is fretful when urging recurs and sleep is broken (Mind ↔ Urinary/Sleep/10b night) [Clarke], [Hering]. Anxiety centres upon the next micturition or stool, with anticipatory aversion to the pain that follows (Mind ↔ Urinary/Rectum). In chronic catarrh he grows low-spirited, weary of long discomfort, yet rallies promptly when discharge grows less acrid and the itch subsides (Mind ↔ Skin/Affinities) [Clarke]. Conversation is avoided during bladder spasm; restlessness in bed is driven by warmth-itch and urging, not by fears (Mind ↔ 10b warmth/night). Oversensitivity to rubbing clothing at the meatus or anus begets a fastidious, cautious manner. Sexual excitability may heighten in toxic states, but homœopathically it more often wanes during burning urethritis (Mind ↔ Male). Improvement is plain when he sleeps through without urging, tolerates warmth, and speaks of itch as “bearable.” [Allen], [Clarke], [Hering], [Boericke]

A dull, congestive head accompanies urinary irritation; frontal weight with smarting eyes in warm rooms; better cool air (Head ↔ 10a cool) [Clarke]. Vertigo follows straining at stool or sudden rising at night to pass urine (Head ↔ Rectum/Urinary). Scalp may itch with the copabic rash. Headache after beer or spiced food tallies with the dietary aggravations already noted (Head ↔ 10b). [Allen], [Clarke], [Hughes]

Smarting and catarrhal redness during drug rash; lids puffy in some cases; lachrymation in wind; no deep ophthalmia. Photophobia slight; relief with cool bathing (Eyes ↔ Skin/10a). [Allen], [Clarke]

Buzzing with nocturnal restlessness; ear-lobe itch in urticarial states; not a primary ear remedy. [Allen], [Clarke]

Coryza with sneezing, thin discharge during skin outbreak; nasal itching; smells of spices stir throat tickle (Nose ↔ Chest/10b spices). [Clarke], [Hughes]

Flushed in warm room when itching mounts; lower eyelids or lips may tingle/burn with the rash. Damp cool air restores comfort (Face ↔ 10a). [Clarke], [Allen]

Sticky saliva on waking; bitter or flat taste in drugged stomach; tongue coated slightly; thirst moderate, prefers cool water (Mouth ↔ 10a). [Allen], [Clarke]

Tooth-edge sensitive in warm room with skin heat; jaw tired from broken sleep; no cardinal dental note. [Allen]

Tickling in larynx on entering a warm room; hawking of white mucus; better cool air (Throat ↔ Chest/10a/10b). [Clarke], [Boericke]

Nausea with urethral burning; aversion to spiced/acidic foods; heaviness after beer (Stomach ↔ 10b diet). Eructation of balsamic odour reported in provers; appetite capricious with catarrh. [Allen], [Clarke], [Hughes]

Dragging in hypogastrium with bladder urging; flatulence aggravates pelvic heat; better after eructation or stool (Abdomen ↔ 10a). Iliac soreness if discharge suppressed. [Clarke], [Hering]

The centre: constant urging with scanty or frequent small jets; burning in meatus and tract; urine milky, smoky, or clear with stringy shreds/filaments; albumen, vesical epithelium, occasional blood (Urinary ↔ 9 Affinity) [Allen], [Hering], [Clarke]. Tenesmus vesicæ remains after urination; pressure at neck of bladder; sensation as if drop remained. Backache in kidney region worse stooping/walking (Urinary ↔ Back/10b). Suppression or abrupt checking of a gonorrhœal discharge invites renal and skin complications (Urinary ↔ Skin/10b suppression). Compare Cantharis (intolerable burning before, during, after, bloody urine; sexual frenzy), Sarsaparilla (pain at end of micturition), Terebinthina (smoky, violet-odour urine—distinctive of Tereb., not Copaiv.). [Farrington], [Clarke], [Allen]

Haemorrhoids with intense pruritus ani (night, warmth worse); soreness, smarting after stool; mucus-laden stools like “frog-spawn” (jelly-like masses) with tenesmus (Rectum ↔ 9 Affinity/10b warm; 10a cold bathing) [Hering], [Clarke], [Allen]. Fissural smarting may follow scratching; bleeding slight. Distinguish Ratanhia (knife-like fissure pain, little urinary link) versus Copaiv. (rectal itch/soreness with urinary catarrh). [Farrington], [Boericke]

Gleet; prostatitis with perineal weight; burning after coitus; discharge thin, mucous; prepuce and meatus sore, itching; chordee in toxic inflammation (Male ↔ 10b after coitus). Epididymal drag possible after suppression. [Allen], [Clarke], [Hering]

Pruritus vulvæ with urinary burning; smarting after urination; pregnancy may awaken urethral catarrh with itch-rash (Female ↔ 10b warmth/night) [Hering], [Clarke]. Leucorrhœa acrid, mucous, making vulvar skin sore; better by cool ablutions (Female ↔ 10a). Differentiate Cubeba (female mucous catarrh, nasal link stronger) and Sepia (pelvic laxity, not urethral burning). [Farrington], [Clarke]

Short breath in stuffy warmth; sighing in bed; relief at open window. No primary pneumonia; symptoms are catarrhal and reflex. [Clarke], [Boericke]

Palpitation from warm room and loss of sleep; otherwise secondary. Pulse quick in itching fits; quiets as urinary burning subsides. [Allen], [Clarke]

Tickling larynx, hoarseness, and bronchial catarrh with abundant white, sweetish mucus, worse warm rooms, better cool air (Chest ↔ 9 Affinity/10a/10b) [Clarke], [Boericke]. Cough nightly from tickle; lying warm excites; sits up to expectorate. Suits old catarrhal subjects with urinary troubles. [Farrington]

Dull renal aching, right or left, worse stooping/walking, better rest; soreness along ureters (Back ↔ 9 Affinity/10b). Pressure over kidney increases desire to pass urine. [Allen], [Boericke], [Clarke]

Weariness from night-watching and itching; restless legs with warmth; occasional urticarial wheals on limbs, worse bed-heat, better cool sponging. [Clarke], [Hughes]

The copabic eruption: urticaria tuberosa; scarlatinoid or morbilliform rashes; papular outbreaks with furious itch and burning after scratching; warmth aggravates, cool bathing/air relieves (Skin ↔ 9 Affinity/10a/10b) [Hughes], [Allen], [Clarke]. Eruptions often coincide with genito-urinary symptoms and may replace or follow a checked discharge—key clinical relationship. Compare Apis (pale oedematous wheals, stinging, thirstless), Urtica urens (hives after shell-fish, no urinary link), and Rhus (vesicular, better warmth—opposite modality). [Farrington], [Boericke]

Broken by urging to urinate and by itching, especially after midnight; warm bed makes both worse (Sleep ↔ Urinary/Skin/10b). Patient turns the cool side to the sheets; dozes between calls to stool/urinal. Dreams of searching for a privy or of exposure due to itching. Improvement is seen when he sleeps through the early morning without urging and can tolerate warmth. [Clarke], [Hering]

Dreams of hot rooms, scratching, public inconvenience (no place to pass water), or of being soiled by mucus—transparent somatic echoes that subside with urinary/skin relief. [Clarke] (clinical)

Dreams of hot rooms, scratching, public inconvenience (no place to pass water), or of being soiled by mucus—transparent somatic echoes that subside with urinary/skin relief. [Clarke] (clinical)

Heat of bed/room brings out itch and catarrh; sweat aggravates burning after scratching; cool air soothes though may chill the surface—manage judiciously (Chill/Heat ↔ Modalities). [Clarke], [Hughes]

Beer, spices, and acids increase urinary burning and catarrh; coffee irritates; craves cool water. Some tolerate milk-diet well during acute flares (Food ↔ 10b/10a). [Clarke], [Dewey]

A mucous-membrane remedy knitting urinary, rectal, skin, and bronchial catarrh: worse during/after urination, at night, in warmth, after coitus, with spices, beer, coffee, and on stooping/walking; better cool air, cool bathing, free water, rest, and loose clothing (Generalities ↔ Modalities) [Clarke], [Boericke], [Hering]. Watch cure by clearer urine with fewer shreds, less tenesmus, itch tolerable or gone, anal/vulvar comfort, and quiet nights. [Allen], [Clarke], [Hughes]

Acute burning cystitis/urethritis

• Cantharis — Scalding before, during, after urine; constant intolerable urging; haemorrhagic urine; sexual frenzy. Copaiv.: burning with shreds, mucus, post-micturition tenesmus; less frenzy. [Farrington], [Clarke]
• Sarsaparilla — Pain at end of micturition; child must stand to urinate; gravel. Copaiv. has shreds/albumen and skin link. [Boericke], [Farrington]
• Terebinthina — Smoky, coffee-ground urine with violet odour; gastric flatulence; nephritis. Copaiv. smoky without the violet odour; more mucus shreds. [Clarke], [Allen]
• Pareira brava — Violent urging, must kneel, pain down thighs. Copaiv. lacks the kneeling necessity; has copabic rash. [Farrington], [Clarke]
• Chimaphila — Prostate congestion, ropy urine, better standing with feet wide. Copaiv. has more burning and skin. [Clarke], [Boericke]
• Cannabis sativa — Early gonorrhœa, greenish discharge, chordee; less renal albumen. Copaiv.: later/catarrhal stages with shreds and rash. [Farrington], [Allen]

Gleet & prostatitis

• Thuja — Chronic suppressed discharge; split stream; fixed warty diathesis. Copaiv.: mucous, burning, with urticaria link. [Kent], [Clarke]
• Sabal — Prostatic pain with incomplete emptying; sexual debility. Copaiv.: mucous urethral catarrh with itch-skin. [Clarke]

Rectal catarrh/haemorrhoids

• Aesculus — Dry, raw rectum; wooden sacral back; little bleeding. Copaiv.: mucous “frog-spawn” stool with pruritus ani. [Farrington], [Clarke]
• Aloe — Sudden, watery stools, insecurity; piles spurt. Copaiv.: tenacious mucus, itch-dominant. [Boger], [Boericke]
• Ratanhia — Fissure knives; burning after stool; no urinary tie. Copaiv.: itch-mucus with urinary catarrh. [Farrington]

Skin (urticaria/drug rash)

• Apis — Pale œdematous wheals, stinging, better cold, thirstless. Copaiv.: tuberculated hives with genito-urinary nexus. [Clarke], [Boericke]
• Urtica urens — Hives after shell-fish; no urinary picture. Copaiv. couples skin with urethra/rectum. [Boericke]
• Rhus toxicodendron — Vesicles, better warmth. Copaiv.: worse warmth, papular/measly. [Farrington], [Clarke]

Bronchial catarrh

• Cubeba (Piper) — Catarrh of nose/throat/urinary, less skin rash; often nasal prominence. Copaiv.: more urinary + urticaria. [Farrington], [Clarke]
• Kali bich. — Tenacious, stringy bronchial mucus; gastric weight; no urinary burning. Copaiv.: stringy urine, not so stringy sputum. [Clarke]

• Complementary: Sarsaparilla — finishes end-micturition pains and gravel after Copaiv. has cleared mucous burning. [Farrington], [Boericke]
• Complementary: Chimaphila — residual prostate swelling/ropy urine with pelvic weight. [Clarke], [Boericke]
• Complementary: Apis — lingering urticaria once urinary fire is quenched. [Clarke]
• Follows well: Cannabis sativa in acute gonorrhœa when discharge settles into catarrhal gleet with shreds. [Farrington], [Allen]
• Follows well: Cantharis after the scalding storm when a mucous state persists. [Clarke]
• Precedes well: Terebinthina if smoky haematuria dominates with violet odour and gastric flatulence. [Clarke]
• Precedes well: Thuja in old gleet with split stream and warty background. [Kent], [Clarke]
• Antidotes (practical): Camphora/Nux for medicinal over-action (gastric/rectal irritation); Apis has relieved copabic rash in some reports. [Hughes], [Dewey], [Clarke]
• Related: Cubeba, Terebinthina, Cantharis, Sarsaparilla, Pareira, Chimaphila, Thuja—choose by urine quality, site of pain, and skin/heat modality. [Farrington], [Boericke], [Clarke]

• Subacute urethritis/gleet with shreds; post-micturition tenesmus; milky/smoky urine. Copaiv. 6C–30C every 6–12 hours, then space; insist on free water, avoid beer/spices/coffee, cool ablutions; track shreds and burning daily. [Allen], [Clarke], [Boericke]
• Pruritus ani (night, warm bed <) with mucous stools “frog-spawn.” Copaiv. 6C–12C nocte; cool bathing, loose linen, and mild diet; often rectum and urethra improve together. [Hering], [Clarke]
• Chronic bronchial catarrh of elderly with coexistent urinary burning. Copaiv. 3x–6x t.i.d. for a short course while ventilating rooms; cough eases as white mucus lessens and urine clarifies. [Farrington], [Boericke]

Case pearls (one-liners):
• Gleet of three months, shreds and burning after water; nightly itch of anus—Copaiv. 30C b.i.d.; by day 5 shreds scant, itch slept through. [Clarke], [Allen]
• Old bronchitic with white morning sputum and vesical tenesmus in warm bed—Copaiv. 3x; ventilated chamber; cough and burning both receded. [Farrington], [Boericke]
• Pregnant woman, pruritus vulvæ with urethral smarting—cool ablutions + Copaiv. 12C; sleep restored, smarting rare. [Hering], [Clarke]

Mind

• Irritability from urging to urinate. Somatic fret; eases as burning abates. [Clarke]
• Anxiety before micturition, fearing pain. Anticipatory tenesmus. [Allen]
• Aversion to warmth of bed (itch and urging). Behavioural pointer. [Clarke]
• Restlessness at night from pruritus/urging. Sleep-breaker rubric. [Hering]
• Fastidious about clothing touching meatus/anus. Contact hyperaesthesia. [Clarke]
• Low-spirited during chronic catarrh; improves as discharge lessens. Prognostic. [Clarke]

Urinary

• Burning in urethra during and after micturition. Central keynote. [Allen], [Hering]
• Urine with shreds/filaments; milky or smoky; albuminous; hæmaturia. Qualitative selectors. [Allen], [Clarke]
• Tenesmus vesicæ after urination; feels drop remaining. Post-micturition sign. [Hering]
• Urging frequent with scanty emissions. Irritative bladder. [Allen]
• Backache in kidney region, worse stooping/walking. Renal catarrh. [Boericke]
• Gleet; chronic urethral catarrh. Therapeutic scope. [Clarke]

Rectum

• Itching anus at night; warmth of bed aggravates; cold bathing ameliorates. Classic modality. [Clarke], [Hering]
• Stool gelatinous, like frog-spawn; mucus masses. Pathognomonic stool. [Allen], [Clarke]
• Soreness and smarting after stool. Surface irritation. [Hering]
• Haemorrhoids with violent pruritus. Venous–surface link. [Boericke]
• Tenesmus recti with little fæces, much mucus. Catarrhal rectum. [Allen]
• Excoriation of margin from scratching. Consequence rubric. [Clarke]

Skin

• Urticaria tuberosa; burning after scratching; heat aggravates, cold bathing ameliorates. Copabic hive. [Hughes], [Clarke]
• Scarlatinoid/measly eruption with urinary symptoms. Drug exanthem. [Allen], [Clarke]
• Papular itching rash, worse at night. Chronology pointer. [Clarke]
• Eruption after suppression of gonorrhœal discharge. Relationship rubric. [Hering]
• Excoriations from scratching; soreness of covered parts. Management cue. [Clarke]
• Itching of genitals (male/female). Surface echo of mucosal catarrh. [Hering]

Chest/Throat

• Tickling larynx in warm room; cough at night; white mucus. Warmth < catarrh. [Clarke], [Boericke]
• Hoarseness with abundant whitish expectoration. Old catarrhal subjects. [Farrington]
• Better in cool, open air. Environmental law. [Clarke]
• Hawking of mucus from fauces. Continuity of catarrh. [Clarke]
• Oppression in warm, close rooms. Ventilation pointer. [Clarke]
• Sits up to expectorate at night. Postural aid. [Boericke]

Female

• Pruritus vulvæ with urinary burning. Genito-urinary nexus. [Hering]
• Leucorrhœa acrid, smarting vulva. Surface irritation. [Clarke]
• Pregnancy—urethral catarrh and vulvar itch. Clinical setting. [Clarke]
• Warmth aggravates, cool ablutions ameliorate. Modality pair. [Clarke]
• Smarting after urination. Keynote echo. [Hering]
• Coitus aggravates urethral burning. Aetiologic note. [Allen]

Generalities

• Warmth of bed/room aggravates complaints. Master modality. [Clarke]
• Night aggravation, especially after midnight. Timing rubric. [Allen]
• Beer, spices, acids, coffee aggravate. Diet law. [Clarke], [Dewey]
• Better cool air and bathing; worse scratching. Management law. [Clarke]
• Suppression of discharges brings on other symptoms (skin/renal). Causal rubric. [Hering], [Hughes]
• Catarrh of mucous membranes (urinary, rectal, bronchial). Sphere rubric. [Boericke], [Clarke]

1. F. Allen — Encyclopædia of Pure Materia Medica (1874–79): proving/toxicology—urinary shreds, albuminuria/haematuria, frog-spawn stools, copabic eruptions, renal/back pains.
   Richard Hughes — A Cyclopædia of Drug Pathogenesy (1891–95): toxicology and pharmacology—mucous-membrane irritation; scarlatinoid/urticarial rashes; renal catarrh.
   Constantine Hering — The Guiding Symptoms of Our Materia Medica (1879): clinical confirmations—tenesmus vesicæ after micturition, pruritus ani/vulvæ (night, warmth <), suppression relationships.
   John Henry Clarke — A Dictionary of Practical Materia Medica (1900): substance notes; spheres (urinary, rectal, bronchial, skin); modalities (warmth/night <, cool >); diet cautions.
   William Boericke — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—catarrh of genito-urinary tract, bronchial catarrh, renal backache worse stooping/walking; urticarial eruptions.
   C. M. Boger — Synoptic Key of the Materia Medica (1915): modalities; relationships among urinary catarrh remedies (Canth., Sarsap., Pareira, Tereb.).
   E. A. Farrington — Clinical Materia Medica (1887): comparisons—Cann. sat., Cubeba, Cantharis, Sarsaparilla, Pareira; chest–urinary catarrh; practical pointers.
   S. R. Phatak — Concise Materia Medica (1977): essentials—mucous catarrh (urinary/rectal), frog-spawn stool, urticaria, warmth <, cool >.
   James Tyler Kent — Lectures on Materia Medica (1905): miasmatic reading (sycotic catarrh) and relationships (Thuja, Canth.).
   W. A. Dewey — Practical Homœopathic Therapeutics (1901): regimen—dietary aggravants (beer, spices, coffee), cool ablutions; urinary catarrh management.
   H. C. Allen — Keynotes and Characteristics (1898): succinct urinary keynotes—post-micturition tenesmus, burning with shreds; pruritus ani/vulvæ.
   Carroll Dunham — Lectures on Materia Medica (1879): clinical reflections on mucous remedies; cautions about discharge suppression (contextual).