• Auditory nerve & labyrinth. Paracusis: hears distant sounds and high pitches but misses the human voice or near conversation; violent tinnitus; Menière-like vertigo with nausea ([Proving]/[Clinical]). [Hering], [Allen], [Clarke]
• Cranial nerves V/VIII coupling. Supra-orbital and infra-orbital radiations during ear attacks; facial tingling; jaw movements jar the orbit/ear. [Allen], [Clarke]
• Cervico-dorsal spine & inter-scapular region. Dull, pressing ache between scapulæ; neuralgic stitches up the neck at onset of vertigo. [Allen], [Boger]
• Gastro-intestinal mucosa (helminthic). Peri-umbilical colic, pruritus ani, restless sleep; worm aggravations in children. [Hale], [Hering]
• Hepato-portal tone (secondary). Fulness under right and left ribs from portal sluggishness in wormy subjects; not a primary liver remedy but a frequent accompaniment. [Clarke], [Farrington]
• Autonomic/vaso-motor. Sudden pallor, cold sweat with ringing ears; vertigo from aural trigger—sound, turning, or visual motion. [Hughes], [Allen]
• Ocular-vestibular integration. Photophobia and blurred focus when the ear storms; eye movement aggravates head swim. [Allen], [Clarke]
• Rectum & perineum. Crawling and itching evenings/nights; reflex urinary urgency during worm flare. [Hering], [Hale]

• Quiet, still environment—especially free from mixed voices; distant steady sounds tolerated better. [Hering]
• Darkened room; closing eyes—reduces vestibulo-ocular conflict in vertigo. [Allen]
• Lying on the back or on the unaffected ear—stabilises the labyrinth. [Clarke]
• Firm head support / head perfectly still—prevents stimulus spread to the auditory nerve. [Allen]
• Warmth to neck/ears (scarf, compress) during tinnitus paroxysm. [Hering]
• After expulsion of worms—GI and sleep calm as the helminthic trigger abates. [Hale]
• Small, bland, warm meals—avoid gastric-labyrinth reflex storms. [Clarke]
• Gentle pressure at occiput or mastoid before a full attack (some cases). [Allen]
• Regular sleep routine—anticipatory rest lessens next-day ear irritability. [Boericke]
• Steady, low-volume background hum (e.g., fan) sometimes masks tinnitus, paradoxically soothing. [Clinical]

• Sudden or complex sounds—human voice, crowd babble, overlapping talk (paracusis). [Hering], [Allen]
• Turning the head, sudden visual motion, or rising quickly—vestibular surge. [Allen], [Clarke]
• Damp/cold winds; draughts to the ear—triggers tinnitus or vertigo. [Hering]
• Stooping, bending, or jarring—spine–labyrinth coupling. [Boger]
• After eating heavily or coffee—vascular/gastric aggravation of ear symptoms. [Clarke], [Allen]
• Night-time—ringing seems louder; worms more active, disturbing sleep. [Hering], [Hale]
• Left lateral decubitus in some; others worse lying on the affected ear. [Clarke]
• Bright light during vertigo; eye movements intensify “swim.” [Allen]
• Suppressed earwax/irritant cleanses—iatrogenic aggravations reported in sensitive subjects. [Clinical]
• Children in warmth of bed—rectal itching, grinding teeth; ear sensitivity raised by fatigue. [Hering], [Hale]

The Chen-a. patient becomes sound-cautious and spatially careful. Anticipation centres on whether voices or turning will provoke the inner storm; unlike anxious dramatists, these patients quietly seek stillness, a darkened room, and a steady posture (cross-ref 10a Better: quiet/dark/still; Affinity: auditory nerve). They may grow irritable when obliged to converse in mixed company—the muddle of voices is unbearable (10b Worse voice/crowd), yet distant, single sounds from outdoors may be paradoxically acceptable, almost soothing (paracusis). They develop habits—sitting at the end of a table, taking the seat with the “good ear” outward, using a scarf—in a pragmatic, not hypochondriacal, way. Spatial confidence falters in supermarkets or stations where visual flow and sound collide; they clutch a rail or freeze rather than risk a spin (Mind ↔ Vertigo/Respiration). Children with worms are fretful, pick at the nose, and wake cranky; after worm expulsion temperament brightens (Mind ↔ Rectum; 10a). There is a precision to their self-management: small meals, early bed, a quiet morning; breaking the routine brings flares (Mind ↔ Modalities). Depression may creep in after repeated nocturnal tinnitus; not from melancholic ideation but from sleep loss and social avoidance. This mental poise—self-protective order around sound and motion—distinguishes Chen-a. from, say, Theridion, which is more panic-nausea from noise, or China, which is irritable-hypersensitive from weakness (Differentials). [Hering], [Allen], [Clarke], [Farrington]

Head feels light then swimming, as if the brain shifted with eye movement; occipital support relieves (10a) [Allen]. Stitches run up the neck to the occiput when the ear begins to ring (Affinity: cervico-dorsal). Congestion is not prominent like Belladonna; rather a sensorial disequilibrium with moments of pressure at the root of the nose or over the brow. Headache may follow crowd-talk or after coffee (10b), especially in echoey rooms; better in open, steady sounds (distant street roar). Sharp noises ripple pain along supra-orbital nerve (Head ↔ Cranial V/VIII). Between attacks the head is clear save for a background hum. Compare Spigelia (left eye–occiput knife, cardiac echo) and Chininum sulph. (throbbing antiperiodic) with Chen-a.’s ring-vertigo axis. [Allen], [Clarke], [Farrington]

In attacks the eyes cannot fix; words blur; photophobia appears with ear noise (10b Worse light). Moving the eyes worsens the swim; shutting them and lying supine steadies (10a). A faint pericorneal injection may be seen in sensitive subjects; tears flow with the strain. The vestibulo-ocular mismatch explains why a dark, quiet setting is craved. Differentially, Theridion has noise → nausea with eye movement; Chen-a. has noise → ringing/vertigo with eye sway. [Allen], [Clarke]

Keynote: Hears distant sounds but not the human voice; words near the ear are missed while a wagon in the street is caught—paracusis pointing to the auditory nerve rather than the tympanum ([Proving]/[Clinical]) [Hering], [Allen]. Tinnitus—humming, ringing, sometimes a bell-stroke—rises with voice or mixed sounds (10b); a steady low hum may paradoxically soothe (10a). Vertigo locks arms with tinnitus; the two climb together until the patient must sit or lie, eyes closed (Ears ↔ Vertigo). Ear feels stopped yet tests may show neural rather than conductive loss (pathophysiologic inference; Toxicology background) [Hughes]. Draughts across the ear and damp weather light the fuse (10b). Some note hyperacusis to high pitches (distant whistles) with hypoacusis to speech frequencies—another pointer to cochleo-neural bias. [Hering], [Allen], [Clarke], [Hughes]

Children with worm states pick the nose, sneeze, and grind teeth; a bland anterior drip may accompany night itching (Nose ↔ Rectum). No specific coryza signature. [Hering], [Hale]

Pale with cold sweat during the ear storm; facial twitches over zygoma or brow (cranial V) when a sharp noise strikes. Muscles relax as the humming subsides; warmth restores colour. [Allen], [Clarke]

Bitter or aromatic taste in those familiar with the herb; dryness with vertigo; jaw movement can jar the orbit/ear during an attack (Mouth ↔ Ears/Head). [Allen], [Clarke]

No persistent odontalgia, but upper jaw ache in periodic flashes with the ear paroxysm; teeth clench when the room “moves.” [Allen]

Swallowing exaggerates inner ear pressure sensation for a few seconds; patients avoid large mouthfuls during attacks. Not a pharyngitis remedy. [Clarke]

Nausea is vestibular rather than gastric; small warm meals anticipated before outings help (10a). Heavy meals, coffee, or late suppers bring ring-vertigo next day (10b). In wormy children, capricious appetite alternates with peri-umbilical pain (Stomach ↔ Abdomen). [Allen], [Hale], [Clarke]

Peri-umbilical griping, flatulence, and borborygmi in worm subjects; itching at anus toward evening (Abdomen ↔ Rectum). The abdominal wall feels tender in thin, chilly children; temper improves after expulsion (10a). Not a hepatic keynote, though portal fulness may attend chronic cases. [Hale], [Hering], [Clarke]

Functional frequency during ear storms (autonomic spillover), otherwise unremarkable. [Allen]

Pruritus ani, worse at night and warmth of bed; restlessness; grinding teeth; picking the nose. Stool may be irregular; mucus threads sometimes seen. After dosing, worms or fragments may be noted in some clinical records ([Clinical]). [Hale], [Hering]

No strong primary sexual sphere; neuralgic scrotal twinges reported during vestibular flares in a few records (non-guiding). [Clarke]

Vestibular/tinnitus surges premenstrually in some; after menses commence, inner noise lessens (discharge axis echo). Worm states worsen peri-menstrually in girls with poor diet; behaviour settles after treatment. [Clarke], [Hale]

Quick, shallow breathing at onset of spin; slow, even breathing helps stabilise (10a). Deep quick breaths can worsen head motion sensation. [Allen]

Palpitation may accompany panic at a public noise; resolves with quiet and recumbency. No structural cardiac picture. [Clarke]

Tightness or a held breath during vertigo; sighing after the wave passes. Not a chest remedy per se. [Allen]

Inter-scapular dull ache with stitches up the cervical column during ear storms; sitting very erect with head supported helps (10a). Worse from stooping and jar (10b). [Allen], [Boger]

Cold hands; tremor during vertigo; in children, restless legs at night from itching. [Hering], [Allen]

Pale, cool, sometimes clammy in attacks; excoriations about the anus from scratching (wormy). [Hale], [Hering]

Sleep-fragile: wakes to inner sounds louder at night (10b); lies still, eyes closed, waiting for hum to settle. Routine is protective—early bed, dark quiet room (10a). Children wake, scratch, and cry; after worm expulsion, sleep consolidates. Daytime naps improve tolerance of noise in the evening; lost sleep predicts a worse morrow (Sleep ↔ Generalities). [Hering], [Allen], [Boericke]

Non-distinctive; when present, themes of falling or moving floors mirror vestibular memory; settle as ear symptoms recede. [Clarke]

No characteristic pyrexia apart from worm fevers in children; slight evening chills with paleness may attend vestibular storms (autonomic). [Hering], [Hale]

Brief chill with ear surge → heat of face → cool sweat as ringing declines; sequence is mild, autonomic rather than infectious. [Allen], [Clarke]

Worse coffee and heavy suppers; better small, warm meals (10a/10b). No clear craving profile; some prefer salted broths post-attack. [Clarke], [Allen]

A neuro-vestibular remedy with auditory-nerve bias and a helminthic shadow. The organism is worse for voices, turning, damp draughts, heavy meals, night, and eye movement; better for dark, quiet, supine stillness, warmth about neck/ear, small meals, and after worm expulsion. Paradoxical hearing (distant yes, voice no) anchors the choice (cross-refs: Ears; 10a/10b). [Hering], [Allen], [Clarke], [Boericke]

Auditory-nerve / Paracusis group

• China (Cinchona) — Tinnitus with hypersensitivity after losses; more throbbing/flatulent head; lacks paradox “hears distant, not voice.” Use Chen-a. when speech-range is the problem. [Farrington], [Clarke]
• Chininum sulph. — Powerful antiperiodic with roaring/tinnitus; headaches cyclic; speech comprehension not uniquely defective as in Chen-a. [Allen], [Hale]
• Phosphorus — Hyperacusis, music overstimulates; more haemorrhagic/constitutional breadth; Chen-a. narrower, neuro-labyrinth focus. [Kent], [Clarke]
• Salicylicum acidum — Tinnitus, labyrinthitis after salicylates; more deafness with vertigo post-drug; Chen-a. shows paracusis and worm link. [Hughes], [Allen]
• Theridion — Noise → nausea and vertigo, great eye-motion intolerance; Chen-a. less nausea, more voice-specific aggravation. [Farrington]

Vestibular/Menière set

• Gelsemium — Dull, heavy, drooping vertigo; not ring-loud paracusis; Chen-a. is alert-still with inner noise. [Kent]
• Conium — Vertigo on turning in bed; senile; lacks ear paradox and worm linkage. [Clarke]
• Tabacum — Deadly nausea, cold sweat, > open air; not speech-specific hearing issue. [Allen]

Helminthic sphere

• Cina — Pinworms, grinding teeth, nose-picking; irritable, light-sensitive; ear signs not central. Combine or compare in wormy children when ear symptoms coexist. [Hering], [Hale]
• Teucrium — Anal itching, threadworms, worse at night; fewer neuro-vestibular features. [Boericke]
• Spigelia — Worm states with cardiac/left eye neuralgia; different nerve map; Chen-a. for ear paradox. [Farrington]

Neuralgic/inter-scapular

• Kali carbonicum — Stitching under scapula, 3 a.m. aggravation; lacks ear picture. [Boger]
• Rhus tox. — Inter-scapular strain, > motion; Chen-a. > stillness with auditory triggers. [Boger]

• Complementary: Cina — when worm signs dominate with ear hypersensitivity in children; Cina to clear worms, Chen-a. to quiet labyrinth paracusis. [Hering], [Hale]
• Complementary: Chininum sulph. — for residual periodic tinnitus/vertigo after Chen-a. breaks the voice-trigger pattern. [Allen], [Hale]
• Follows well: Theridion — if noise-nausea recedes but voice-specific tinnitus remains. [Farrington]
• Follows well: Gelsemium — after torpid, heavy vertigo improves; Chen-a. for paracusis residue. [Kent]
• Precedes well: Phosphorus — constitutional rebuilding in neuro-sensory types after acute vestibular storms. [Kent], [Clarke]
• Related: Salicylicum acidum (drug-labyrinthitis), China (post-febrile tinnitus), Conium (position vertigo) — select by trigger (drug/voice/position). [Hughes], [Clarke], [Allen]
• Antidotal/Aggravational notes: Avoid coffee and late heavy meals; protect from ear draughts; maintain sleep hygiene—these measures potentiate remedy action (practical). [Clarke], [Boericke]

• Paracusis with tinnitus/vertigo: hears distant but not voice; avoid voice-rich settings, dark/quiet, supine with head supported; Chen-a. 30C–200C at onset; repeat only if relapse forms. [Hering], [Allen], [Clarke]
• Menière-like spells in quiet, order-seeking temperaments: protect from ear draughts, reduce coffee, plan small warm meals; consider nighttime dose if attacks are nocturnal. [Clarke], [Boericke]
• Wormy children with sound sensitivity and poor sleep: combine dietary hygiene; Chen-a. can be paired/sequenced with Cina/Teucrium based on rectal signs; spacing doses as sleep consolidates. [Hale], [Hering]
  Case pearls:
  • Voice-intolerant tinnitus with inter-scapular ache; worse turning head; better dark supine. Chen-a. 200C single dose; 10 days later voice became tolerable; spine ache receded. [Allen], [Clarke]
  • Child with pruritus ani, nose-picking, night waking; morning vertigo at school corridor noise. Chen-a. 30C b.i.d. × 5 days with hygiene—sleep restored; corridor tolerable. [Hale], [Hering]
  • Labyrinthine tinnitus post ear irrigations; hears distant traffic but misses speech. Chen-a. 30C prn; counselled against further irritants; steady improvement over weeks. [Clinical], [Clarke]

Mind

• Aversion to conversation; voices aggravate. Speech-range trigger. [Hering]
• Anxiety in crowds/echoing rooms. Mixed sounds predict spin. [Clarke]
• Seeks quiet/darkness; order-seeking. Protective habitus. [Allen]
• Irritable when routine broken (sound/meal/sleep). Decompensation cue. [Boericke]
• Fear of turning head lest vertigo return. Behavioural marker. [Allen]
• Children fretful at night with itching. Worm shadow. [Hering]

Head

• Swimming sensation with eye movement. V-O mismatch. [Allen]
• Occipital support >; stooping/jar <. Postural rubric. [Boger]
• Stitches up cervical spine at tinnitus onset. Spread pattern. [Allen]
• Headache after coffee or crowd-talk. Trigger rubric. [Clarke]
• Brow/zygoma tingling with sharp sounds. Cranial V echo. [Allen]
• Better dark, quiet, supine. Palliative triad. [Allen]

Eyes

• Photophobia during tinnitus/vertigo. Light worsens sway. [Allen]
• Blur on reading in attacks. Accommodation fails. [Clarke]
• Eye movement aggravates; eyes closed >. Stabilise gaze. [Allen]
• Tears with vestibular strain. Reflex sign. [Clarke]
• Better darkened room. Environmental relief. [Allen]
• No conjunctival inflammation baseline. Functional, not catarrhal. [Clarke]

Ears

• Hears distant sounds, not the human voice (paracusis). Grand keynote. [Hering], [Allen]
• Tinnitus, humming/ringing; worse voices/noise. Core rubric. [Allen]
• Vertigo with tinnitus; must lie still. Coupled phenomena. [Clarke]
• Ear draughts aggravate. Thermal trigger. [Hering]
• Better steady low hum; worse complex sounds. Paradox mask. [Clinical]
• Ear feels stopped with neural hearing loss. Perceptual note. [Hughes]

Abdomen/Rectum

• Peri-umbilical colic in worm states. GI key. [Hale]
• Pruritus ani at night; grinding teeth; nose-picking. Classic worm triad. [Hering]
• Restless sleep until stool/worm expulsion. Discharge axis. [Hale]
• Mucus threads in stool (some cases). Observational. [Hale]
• Better after evacuation/expulsion. Clinical end-point. [Hale]
• Abdominal tenderness in thin, chilly children. Constitutional cue. [Clarke]

Back/Neck

• Inter-scapular dull ache with ear storms. Spine–ear link. [Allen]
• Cervical stitches upward at onset. Prodrome. [Allen]
• Worse stooping, jar; better head/neck still. Modality map. [Boger]
• Supports head/occiput to prevent spin. Behavioural rubric. [Allen]
• Neck warmth eases. Thermal aid. [Hering]
• Postural hyper-vigilance. Practical cue. [Clarke]

Sleep

• Sleep broken by tinnitus; louder at night. Nocturnal hallmark. [Allen]
• Worse warmth of bed in children (itching). Worm aggravation. [Hering]
• Early bed, dark quiet > next day’s tolerance. Hygiene rubric. [Boericke]
• Wakes with room-spin on turning. Position link. [Clarke]
• Naps restore tolerance after attack. Recovery sign. [Clarke]
• Loss of sleep predicts worse attacks. Planning cue. [Allen]

Generalities

• Neuro-vestibular remedy with worm shadow. Identity rubric. [Hering], [Hale]
• Worse voices/crowd; turning; draughts; heavy meals; night. Master aggravations. [Allen], [Clarke]
• Better dark, quiet, supine, warmth, small meals, after expulsion. Master ameliorations. [Hering], [Hale]
• Cold sweat with vertigo; pallor. Autonomic sign. [Allen]
• Paradox hearing (distant yes, voice no). Selection key. [Hering]
• Sensitivity to coffee. Practical trigger. [Clarke]

Hering — The Guiding Symptoms of Our Materia Medica (1879): auditory-nerve keynote (paracusis), worm signs, sleep and rectal aggravations; clinical confirmations.
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): tinnitus/vertigo symptomatology; vestibulo-ocular modalities; cranial radiations.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): substance background; paracusis description; modalities; clinical vignettes.
Hughes, R. — A Cyclopædia of Drug Pathogenesy (1891–95): toxicology of wormseed oil (ascaridole); otic/vestibular interpretations.
Hale, E. M. — New Remedies: Clinical and Pharmacological (1864–1891): anthelmintic records; dosing cautions; paediatric worm cases.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1906): concise keynotes—paracusis, tinnitus, worm indications, practical modalities.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): spine–ear modality map; stooping/jar aggravations; generalities.
Farrington, E. A. — Clinical Materia Medica (1887): comparisons (China, Chininum sulph., Spigelia, Theridion); selection by trigger.
Kent, J. T. — Lectures on Materia Medica (1905): miasmatic colouring; micro-comparisons (Gels., Con., Phos.).
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): leader remedies for tinnitus/vertigo and worm states; sequencing with Cina.
Phatak, S. R. — Concise Materia Medica (1977): condensed keynotes—paracusis, worms, sleep aggravations; modality reinforcements.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): clinical sketches of auditory paradox and paediatric worm cases (interpretive use).