• Peripheral and cranial nerves. Pareses and paralyses after chill, emotion, or illness: facial palsy, ptosis, post-diphtheritic paralysis, vocal cord paresis, paralytic dysphagia, bladder atony; contracted tendons and drawing pains. See Mind/Face/Eyes/Throat/Urinary/Extremities. [Hering], [Allen], [Kent]
• Larynx & voice. Hoarseness → aphonia, worse mornings, speakers, and cold dry air; need to clear throat, rawness, loss of high notes; spasmodic dysphonia. See Throat/Chest/Respiration. [Clarke], [Farrington]
• Urinary tract (sphincter atony). Involuntary urine on coughing, sneezing, walking, night in bed; dribbling; retention with ineffectual urging; paralytic bladder after labour or illness. See Urinary. [Hering], [Allen]
• Skin & appendages. Warts (hands, face, eyelids; pedunculated/flat), fissures/chaps, hangnails, old burns that never heal, eczema of flexures; prickling, rawness. See Skin. [Clarke], [Boger]
• Mucosae. Raw, excoriated sensations—throat, chest, urethra, anus, vagina; burning yet not better by heat alone; thick, stringy mucus. See Throat/Chest/Rectum/Female. [Allen]
• Tendons & joints. Contractures, spasmodic drawing of flexors, writers’ cramp, torticollis, stiff hamstrings, knees give way. See Extremities/Back. [Hering], [Kent]
• Left-sidedness; cross-laterality. Many palsies and pains are left-sided, or left → right. See Face/Eyes/Extremities. [Kent], [Tyler]
• Emotion/ethics. Weeps from hearing of others’ misfortunes, cannot brook injustice, anxious for family, fear something bad will happen. See Mind. [Kent], [Tyler]

• Damp, rainy weather (laryngeal/respiratory), warm moist air for voice. [Clarke], [Farrington]
• Warmth in general, warm drinks, warm compresses to paralysed/contracted parts. [Hering], [Allen]
• Slow, gentle motion; continued use after first stiffness (hands, writers’ cramp). [Boger]
• Swallowing frequently for hoarseness; clearing throat. [Clarke]
• Sipping water for dry, tickling cough and aphonia. [Farrington]
• Rubbing, massage, physiologic stretching of shortened tendons. [Hering]
• Sitting with limbs supported; bracing the joint. [Allen]
• Company and reassurance; being heard and believed eases the anxious chest. [Kent]
• Emotional expression (crying over injustice) rather than suppression. [Tyler]
• Night warmth, extra bed-covering, covered head. [Hering]
• Moistening the skin—cracks less painful after bathing. [Clarke]
• Constancy of routine, avoiding sudden transitions. [Boger]

• Dry cold wind, drafts, becoming cold, especially neck/chest; dryness of air. [Hering], [Clarke]
• Morning on waking (hoarseness/aphonia; stiffness; bladder weakness). [Allen]
• Over-use of voice (teachers, singers), long talking, reading aloud. [Farrington]
• Emotional strain about injustice, grief for others, long-suppressed indignation. [Kent], [Tyler]
• First motion after rest (stiffness), though continued motion may ease. [Boger]
• Right after exposure or after getting wet, convalescence from fevers/diphtheria. [Hering]
• Clear, starry frosty nights (laryngeal), dry rooms. [Clarke]
• Menstruation (urinary dribbling, backache), after labour (bladder atony). [Allen]
• Coffee, alcohol, tobacco smoke in some; excitement. [Hughes]
• Stooping (voice and chest), attempting to sing high. [Farrington]
• Uncovering affected part; cold hands/wetting hands aggravates warts and cracks. [Clarke]

A grave, conscientious nature with exquisite sympathy: weeps from hearing news of misfortune, cannot tolerate injustice, and may join causes with a fervour that costs sleep. Anxious for family, especially at night; fear something bad will happen; feels unsafe when loved ones are late. Melancholy with silent grief, yet better when expressing; speechlessness from emotion or fright is typical. Irritable at wrongs, brooding over social evils; restless, fidgety, with twitches in face or limbs. Forgetful, especially of words mid-sentence; slow to comprehend, as if mind stiff like tendons. Children are serious, prematurely old, clingy, fearful at night, and wet the bed. Compare Phos. (sympathetic but open, diffuse bleeding; less contracture), Ign. (grief with spasms but theatrical alternation), Nat-m. (injustice hurts yet bottled; dryness, not rawness). [Hahnemann], [Kent], [Hering], [Clarke], [Tyler]

Pressive vertex pain with scalp contraction feeling; hair falls in patches; brow furrowing involuntary. Occipital stiffness with nuchal contracture after cold wind. Tearing left temple → eye, better warmth. Mental labour confuses, forehead heavy. Compare Gels. (dull, droopy but flaccid not contracted), Rhus-t. (stiffness < first motion > continued). [Allen], [Boger], [Clarke]

Ptosis (often left), paralytic ocular weakness; vision dims in the morning; flickering, black points; dry burning with raw lids; warts on lids. Paralysis of ocular muscles after exposure or diphtheria. Tearing along supraorbital nerve, lachrymation in cold wind. Compare Gels. (ptosis with tremulousness, fear), Plumb. (ocular paresis with marked retraction/constipation). [Hering], [Allen], [Clarke]

Ringing in the ears (tinnitus)—high-pitched or buzzing. Hearing dull or impaired, especially after suppressed discharges. Earache in children with sharp shooting pains. Chronic catarrhal deafness with thick mucus or blocked sensation. Sensation of wind or air rushing through ears. Hypersensitive to noise or startled easily. Roaring, crackling, sudden deafness after chill; Eustachian catarrh with raw naso-pharynx; paralysis of stapedius-like intolerance to loudness. Warts on auricle/meatus. Compare Kali-s. (yellow ear discharge), Puls. (bland otorrhoea; mild). [Clarke], [Allen]

Raw, burning soreness inside nostrils. Constant need to blow the nose but nothing comes out. Discharges yellow, gluey, or bloody. Coryza with hoarseness and rough voice. Loss of smell in chronic cases. Sneezing attacks in cold air. Chronic postnasal catarrh from mucous membrane paralysis. Dryness with rawness; sneezing in dry cold; obstructed mornings then stringy mucus. Coryza with loss of smell, post-nasal hawking; cracks at alae; epistaxis in dry rooms. [Hering], [Allen]

Paralysis of facial muscles, especially left-sided Bell’s palsy. Face appears asymmetrical, with drooping mouth or eyelid. Expression serious, suffering. Facial tics or spasms in chronic neurotic states. Skin of the face may be dry, itchy, or covered in small warts. Neuralgia on one side, with tearing pain worse in cold air. Bell’s palsy (often left) after exposure; corner of mouth droops, dribbles, cannot whistle; twitching; warts on face/eyelids. Sallow, earthy look; vertical wrinkles of anxiety. Cracks at mouth corners; raw lips, chapped. Compare Graph. (sticky eczema, fissures but less paresis), Rhus-t. (face oedematous from cold damp). [Hering], [Clarke], [Kent]

Stammering speech, especially after fright or grief. Dryness of mouth, with burning, as if scalded. Taste lost or altered. Painful ulcers or rawness in the cheeks. Tongue may tremble when protruded or feels paralysed. Speech is indistinct or hesitant. Mouth corners cracked and sore. Tongue heavy, tremulous, stammers; slow articulation; burning raw mouth with aphthae at commissures; saliva scant or thick; taste greasy/soapy. Toothache from cold air, better warmth; gums recede, tender. [Allen], [Clarke]

Teeth feel elongated, sensitive to cold or chewing. Decay may be rapid despite good hygiene. Pain worse at night and from cold air. Grinding of teeth during sleep in children. Gums may bleed easily or recede. Swelling of submaxillary glands. Sensitive to cold air, loose feel, grind at night; drawing to ear; cracks at gum-margin bleed. Suits bruxist, anxious temperaments with jaw fatigue. [Allen], [Hering]

Constant desire to clear the throat due to mucus that cannot be hawked up or swallowed. Rawness, scraping sensation, worse from dry air and better from cold drinks. Loss of voice (aphonia) from overuse or exposure to cold, often in teachers or singers. Hoarseness more marked in the morning or after speaking. Uvula elongated or inflamed. Throat feels constricted. Raw, scraped, burning; must clear with ineffectual hawking; mucus tough, stringy. Swallowing difficult from paralytic pharynx after fevers; sensation of a plug. Voice rough on rising; cannot get the tone; spasmodic closure on attempting to sing high. Compare Phos. (aphonia evenings, better cold drinks), Arg-n. (stage fright with hoarseness). [Clarke], [Farrington], [Allen]

Empty, sinking sensation in the stomach, worse in the morning. Aversion to fatty foods, or milk. Burning pain, like heartburn, worse from cold drinks. Nausea that rises from the stomach to the throat. Belching with a sour or rancid taste. Discomfort after eating, especially from eating hastily or when anxious. Craves smoked meats or salty foods. Aversion to sweets yet craves smoked/salty foods; heartburn with raw oesophagus; nausea from anxiety; empty sinking about 11 a.m. Warm drinks relieve the throat–stomach rawness. [Allen], [Clarke]

Colicky pains that come and go, worse before stool or menses. Abdomen bloated, sensitive to touch. Tightness across epigastrium, with heaviness or dragging. Liver feels enlarged, sore, or heavy. Sensation of something moving or alive in abdomen (a common symptom in hysteria or suppressed grief). Fluttering, drawing in inguinals; flatulence difficult to expel; stitching under ribs on stooping; abdominal wall feels weak, like hernial tendency. Constipation with ineffectual urging from atony, or soft stool retained by paralytic sphincter. Compare Nux-v. (spasm not atony), Alum. (dryness, no desire). [Hering], [Boger]

Marked symptom: involuntary escape of urine from the slightest shock—sneezing, laughing, coughing, blowing the nose, or sudden movement. Bladder sluggish, with paralytic weakness: long delay before urine starts, slow feeble stream, sometimes only drop by drop; cannot fully empty. Burning and rawness along the urethra; urging sudden and imperative. Acts chiefly on atony of the sphincter. Urine dribbles with exertion or during sleep; retention after labour or exposure; weakness and exhaustion of the bladder’s muscular power. Children wet the bed, especially in first deep sleep. [Hering], [Allen], [Clarke]

Involuntary stool, especially when passing flatus or coughing. Stool difficult to pass, often from partial paralysis of the rectum. Constipation with frequent, ineffectual urging. Sensation as if anus is closed or obstructed. Moist eruptions or warts around the anus. Involuntary stool when passing flatus or coughing; mucosa raw; fissures with burning; itching warts at anus. Haemorrhoids painful, bleed with raw soreness, also burning and raw, especially when standing. [Hering], [Allen], [Clarke]

Sexual desire reduced or entirely absent, often from emotional repression or grief. Erections weak or absent. Seminal emissions during sleep or with little stimulation. Prostate may be enlarged. Genitals may feel numb or heavy. Urinary symptoms may overlap [Allen], [Clarke]

Dysmenorrhoea with tearing pains down thighs. Incontinence during pregnancy, sneezing, or exertion. Leucorrhoea profuse, yellowish, and acrid. Genitals feel dry, with burning or itching. Loss of sexual desire. Labour pains weak or ineffectual; postpartum paralysis of bladder. Urinary weakness after childbirth; uterine prolapse sensation, bearing-down with atonic pelvic floor; menses late, scant, or too prolonged with exhaustion; fissures of nipples, chapped vulva with rawness. Voice loss around menses in teachers. Compare Sep. (bearing-down with indifference), Nat-m. (fissures but dryness modality). [Hering], [Clarke], [Farrington]

Hoarseness and aphonia (loss of voice) are keynote. Deep, dry cough with scanty expectoration. Cough worse from speaking, singing, or dry air. Cannot speak loud, voice cracks, loss of high register; air feels too dry; better humid, rainy conditions. Short breath on ascending; laryngeal spasm on attempting a note. Sensation of mucus deep in chest but difficult to raise. Breathing laboured during sleep. Asthma with anxiety or oppression at night. [Clarke], [Farrington]

Palpitation from emotion or injustice, irregular on attempting to speak at length; anxious constriction. Pulse weak in atonic states. Sensation of trembling or fluttering in chest. May feel as though the heart would stop, especially at night. Chest constriction or dull heaviness. Suited to degenerative cardiac states or valvular insufficiency. Compare Ign. (sighing), Acon. (panic). [Allen], [Kent]

Voice hoarse, sometimes entirely lost. Chronic laryngitis, especially in singers or public speakers. Raw, burning pain in chest from mucus or coughing. Cough deep, hollow, worse from talking or exposure. Bronchial catarrh with tough mucus. Pain under sternum or stitching in chest walls. Cannot tolerate cold air on chest. Raw, sore chest, tearing on coughing; aphonia in mornings, better damp air; spasmodic cough with involuntary urine; must hold chest; oppression from emotion (news of misfortune). [Clarke], [Farrington], [Allen]

Stiff nape, shoulders, torticollis from cold wind; pain in lumbar weakness—gives way; sacro-iliac looseness with drawing tendons; raw, sore in inter-scapular region, especially after exertion or in elderly. Spasms in the back, especially from emotion or shock. Burning between shoulder blades. Cannot straighten up easily after stooping. Cold spots or formication along spine. [Hering], [Boger]

Tendon contractures; flexors draw, hamstrings tight, knees buckle; hands unsteady, writer’s cramp, drops things; paresthesiae, numb spots; sciatica left >, drawing, tearing, worse dry cold, better warmth, gentle use. Warts on fingers, hangnails. Compare Gels. (weakness without contracture), Plumb. (retraction with constipation), Rhus-t. (stiff < first motion > continued). [Hering], [Kent], [Clarke], [Boger]

Warts (flat, pedunculated; hands, face, eyelids), fissures and chaps, cracks at joints, hangnails, ulcers with raw, burning edges, old burns that retain tenderness; eczema of flexures, oozy and smarting. Itching in evening; scratching burns. [Clarke], [Allen], [Boger]

Unrefreshing, wakes anxious for family; talks or mutters of wrongs; starts from twitches; enuresis first sleep; laryngeal dryness on waking with lost voice; dreams of fires, rescuing others, being late to help; sleep on left side aggravates paresthesiae. [Hering], [Allen], [Tyler]

Of fire, robbery, death, people in danger, injustice, failed duties; of speaking but no voice comes; of falling with weak knees; of fires and rescues. Wake sad yet resolute. Repeats the same dream. May dream of events long past. Disturbing or frustrating dreams that provoke fear or sadness upon waking. [Allen], [Clarke]

Chill with dry cold; heat with dryness of the mucous membranes. Thirst for warm drinks. Sweat scant, night sweats may be offensive. Fever with dry, burning skin and internal chilliness. Heat alternates with chills. Tends to linger after exposure or overexertion. Fever states can lead to asthenic paresis (post-infectious). [Allen], [Clarke]

Chilly but wants cold drinks. Cold air aggravates. Sweats on exertion or during sleep. Sweat may smell sour or acrid. Localised sweating in small of back, chest, or hands. [Allen], [Hering]

Craves: smoked meats, salt, cold drinks, sour things
Aversion: sweet things, fatty foods, milk
Worse from: fatty food, sweets, dry food
Better from: cold drinks, warm bland food

A neuro-trophic remedy marked by paresis with contracture, rawness with fissures, and moral sensitivity. Dry cold and drafts provoke laryngeal loss, facial palsy, tendon drawing, urinary dribbling; damp mild weather eases voice. The sphincters are weak—urine/stool pass involuntarily—yet flexors are tight—tendons contract: a paradox resolved in Causticum’s disordered innervation. The patient is compassionate, justice-driven, anxious for others, better for expression and support. [Hahnemann], [Hering], [Kent], [Clarke], [Boger], [Boericke], [Farrington], [Phatak], [Tyler]

Paralysis / Paresis

• Gelsemium Flaccid, drowsy, trembling; ptosis but no tendon contracture; emotional timidity rather than justice-zeal. [Kent]
• Plumbum Progressive motor paralysis with retraction, constipation, colic; skin less raw/warty. [Clarke]
• Conium Insidious motor failure, ascending weakness; sexual atony, less mucosal rawness. [Farrington]
• Cocculus. Paralytic vertigo, nausea, night-watcher states; voice not a keynote. [Boger]

Larynx / Voice

• Phosphorus. Evening hoarseness, aphonia from talking, thirst for cold, bleeding propensity; less contracture. [Clarke]
• Arg-n. Stage fright, hoarseness, splutter; gastric flatulence; less urinary atony. [Farrington]
• Arum-t. Rawness with picking, blood, itching nostrils; more acrid excoriations. [Allen]

Urinary Incontinence

• Pulsatilla. Mild, weepy children; incontinent at night, cool open air >; less justice-driven temperament. [Hering]
• Kreosotum. Excoriating, strong-odour urine; vulvar rawness with burning; older women. [Clarke]
• Nat-m. Dribbling after exertion; dry overall; emotionally reserved grief. [Kent]

Warts / Fissures

• Thuja. Moist, cauliflower genital warts; oily skin; fixed ideas; less paresis. [Clarke]
• Ant-cr. Horny, thick hands cracks; gastric mucus; less moral theme. [Boger]
• Graphites. Sticky oozing, cracks in folds with honey-like discharge; obesity; no paresis. [Clarke]

Contractures / Writer’s Cramp

• Rhus-tox. Stiff < first motion > continued, loves hot bathing; more restlessness, less urinary atony. [Kent]
• Cuprum. Cramps and spasms, blue lips, convulsive; not the slow contracture + paresis duet. [Allen]
• Ruta. Overuse tendinous strain; mechanical, not neuro-trophic. [Farrington]

Post-diphtheritic paralysis

• Kali-phos. Nervous exhaustion with trembling, but mucosa not raw, voice less characteristic. [Boger]
• Phos. if bleeding and burning with thirst for cold. [Clarke]

• Complementary: Carb-veg. (asthenic paralysis), Kali-phos. (nerve nutrition), Phos. (larynx), Sep. (pelvic atony), Stann. (voice fatigue), Rhus-t. (stiffness), Graph. (cracks), Thuja (warts). [Kent], [Clarke], [Boger]
• Follows well: Gels. in ptosis/ocular paresis; Arg-n./Phos. in voice cases; Rhus-t. after acute strain when contracture remains. [Farrington]
• Precedes well: Kali-phos. for convalescent nerve tone; Graph. for persistent fissures; Thuja for stubborn warts. [Clarke]
• Antidotes: Coff. (over-excitement), Nux-v. (drugging), Sulph. (rouses reaction). [Hughes], [Kent]
• Inimical/Caution: Avoid hasty alternation with Gels. on the same ptosis; let the case declare. [Kent]

• Aphonia/teacher’s voice: Morning aphonia, rawness, loss of high notes, better damp air → Caust. 30C–200C; add steam inhalation and voice rest. [Farrington], [Clarke]
• Bell’s palsy after dry cold wind: left-sided, corner of mouth droops, tearing pains, eye won’t close → Caust. speeds recovery; protect cornea; gentle facial exercises. [Hering], [Kent]
• Post-diphtheritic or post-viral paresis: ptosis, nasal speech, choking on liquids, weak voice; Caust. alternating with Kali-phos. during convalescence. [Clarke], [Boger]
• Writer’s cramp / tendinous contracture: cramping flexors, drops pen, better gentle continued use → Caust. plus graded stretching. [Hering]
• Urinary incontinence (children/adults): loses urine on cough/sleep/walking; bedwetting first sleep—temperament serious, sympathetic → Caust.; check pelvic floor rehab in women postpartum. [Allen], [Clarke]
• Mini-pearls:

• • Old burn scar that never feels right, smarting/contracture → Caust. reduces hyperaesthesia. [Clarke]
  • Warts on tips of fingers in public-spirited adolescents who lose voice on debate day → Caust. fits both spheres. [Tyler]
  • Involuntary stool with flatus in neuro-asthenic elderly; soft stool slips back—Caust. before Alum. if rawness rules. [Boger]

Mind

• Compassionate to the point of tears; weeps from hearing of misfortune. Causticum’s humanitarian core. [Kent], [Tyler]
• Cannot tolerate injustice; indignation with sleeplessness. Ethical pressure sign. [Kent]
• Anxiety for others’ safety; fear something will happen to family. Night worry. [Hering]
• Speechlessness from emotion; aphonia after grief. Affective laryngeal block. [Clarke]
• Forgetful of words while speaking; slow comprehension. Neuro-trophic cognition. [Allen]

Head / Eyes / Face

• Ptosis (left >), ocular muscle paresis after exposure/illness. [Hering], [Clarke]
• Facial paralysis after cold dry wind; mouth corner droops. [Hering]
• Wrinkles of anxiety, sallow face with warts. [Clarke]
• Tearing supraorbital pains, better warmth. [Allen]

Throat / Larynx / Voice

• Aphonia mornings; loss of high notes; voice fails from long talking. [Farrington], [Clarke]
• Raw, scraped larynx; must clear throat; tough stringy mucus. [Allen]
• Hoarseness worse dry cold wind; better damp weather. [Clarke]

Chest / Respiration

• Cough with involuntary urine. Sphincter–larynx nexus. [Hering]
• Rawness and soreness in chest; must support when coughing. [Allen]
• Oppression from emotion or news of misfortune. [Clarke]

Urinary / Rectum

• Urine involuntary with cough, sneeze, walk; enuresis first sleep. [Hering]
• Retention/atony; has to wait long for stream, dribbling. [Allen]
• Stool partially expelled then slips back (sphincter paresis). [Hering]
• Fissures and rawness of anus with burning. [Clarke]

Extremities / Back

• Tendon contractures; flexors draw; hamstrings tight. [Hering]
• Writer’s cramp; drops things; hands unsteady. [Clarke]
• Sciatica left >; tearing, drawing; dry cold <; warmth/gentle use >. [Boger]
• Torticollis after cold wind; nuchal stiffness. [Hering]

Skin

• Warts (hands, face, eyelids); pedunculated/flat. [Clarke]
• Cracks and chaps at joints; hangnails; old burns remain tender. [Allen]
• Eczema of flexures with smarting rawness. [Boger]

Generalities

• Dry cold wind <; damp warm weather > (voice, larynx). [Clarke]
• First motion <; continued gentle motion >. [Boger]
• Warm drinks and external warmth > mucosal/raw pains. [Allen]

Hahnemann — Chronic Diseases (1828–1830): preparation and proving; laryngeal, urinary, and paralytic spheres.
Hering, C. — The Guiding Symptoms of our Materia Medica (1879–1891): pareses (facial, ocular, laryngeal), urinary atony, contractures, skin fissures.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–1879): mucosal rawness, voice loss, sphincter weakness, modalities.
Hughes, R. — A Manual of Pharmacodynamics/Pharmacography (1867–1868): crude caustic actions; dermatologic and mucosal correlations.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): rainy-weather amelioration, laryngeal keynotes, warts/fissures, Bell’s palsy cases.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): moral portrait (justice/compassion), paralysis-contracture paradox, modalities.
Boger, C. M. — Boenninghausen’s Characteristics & Repertory (1905); Synoptic Key (1915): generalities (dry cold wind <, first motion <), neuro-trophic guidance.
Boericke, W. — Pocket Manual of Homoeopathic Materia Medica (1901): aphonia, urinary incontinence, warts, old burns.
Farrington, E. A. — Clinical Materia Medica (1887): larynx/voice patterns (teachers, singers), comparisons with Phos., Arg-n.
Tyler, M. L. — Homoeopathic Drug Pictures (1932): bedside picture—compassionate, justice-driven, raw mucosae, voice failure.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1977): distilled rubrics—paresis with contracture, urinary dribbling, warts.
Nash, E. B. — Leaders in Homoeopathic Therapeutics (1899): practical clinchers—aphonia morning, cough with urine loss, damp > larynx.
Dunham, C. — Lectures on Materia Medica (1879): neuro-muscular balance and convalescent paresis insights.