Chininum arsenicosum

A double salt uniting quinine (the antiperiodic alkaloid from Cinchona) with arsenic (as arseniate). Pharmacology marries periodicity-breaking (quinine) with profound prostration, burning pains, restlessness, cachexia (arsenic). Homœopathically, it addresses chronic malarial states, anaemia with dropsy, periodic neuralgias, cardio-renal weakness and relapsing respiratory affections when simple China or Arsenicum alone fail or have been abused ([Toxicology]/[Clinical]). The usual preparation is a solution/trituration potentised from the salt. [Clarke], [Hughes], [Boericke], [Allen]

A clinical remedy enlarged from pathogenetic fragments of quinine/arsenic and bedside confirmations: strict periodicity, great debility, burning pains, restlessness, anaemia with oedema, enlarged spleen, albuminous urine, dyspnœa/asthma, palpitation, intermittent fevers and neuralgias at exact or regular hours. [Allen], [Clarke], [Hale], [Boericke], [Hering]

Chininum arsenicosum stands where time and decay meet: the intermittent clock of Cinchona with the burning prostration of Arsenicum. The patient is pale, tremulous, breathless, tied to fixed hours: chill at four, heat at six, sweat at eight—each stage draining a little more vitality. In the background lie spleen and portal congestion, a tired heart, a scant kidney, and a mind that keeps watch on the minute-hand. He is worse at night, worse from cold air/drinks, worse from the least effort; better with warmth, small frequent sips, quiet, and propped rest, and relieved when sweat completes the sequence. This coherence of modalities is not decorative—it is the clinical lever: arrange the patient’s day by warmth, small feedings, and rest, and the remedy has purchase. [Clarke], [Boericke], [Nash]

The organ signature is a triangle: spleen (post-malarial residue), heart (palpitation, asthma of weakness), kidney (albuminuria/oedema). Neuralgias belong to the same cycle—periodic, burning, exhausting—answering to warmth and quiet. Compared with China, Chin-ars. is deeper, more cachectic, and more cardio-renal; compared with Arsenicum, it is more clock-bound, less pan-obsessive, and more likely to sweat out the paroxysm with relief. Against Cedron’s chronometer neuralgia and Chin. sulph.’s ear-led periodicity, Chin-ars. is the systemic antiperiodic for the feeble: the remedy that breaks relapse while propping the patient. Cure looks ordinary yet decisive: the hour drifts, paroxysms grow short and mild, breath returns on stairs, oedema recedes, sleep comes without dread, and strength rises to meet the day. [Farrington], [Clarke], [Boericke]

• Blood & Nutrition (Cachexia/Anaemia). Deep post-malarial anaemia, waxy pallor, weight loss, tremulous weakness; oedema of face/ankles in chronic cases; cravings are small and frequent, with thirst in sips (Arsenicum strand). See Generalities/Fever. [Clarke], [Boericke], [Nash]
• Spleen & Liver (post-malarial). Splenic enlargement, left hypochondrial soreness, periodic returns of “ague-feeling” with drenching sweat or chill at fixed times; portal sluggishness with flatulence. See Abdomen/Fever. [Clarke], [Hale], [Farrington]
• Heart & Circulation. Palpitation, weak pulse, tendency to cardiac asthma, breathlessness on slight exertion, nocturnal sinking; oedema from cardio-renal strain. See Heart/Chest/Generalities. [Boericke], [Farrington]
• Kidneys. Albuminuria, scant, dark urine; dropsical states from renal irritation or cardio-renal insufficiency. See Urinary/Generalities. [Clarke], [Hale]
• Nervous System (Neuralgias). Periodic neuralgias (supra-orbital, malarial facial, intercostal, sciatic) with burning, tearing pains and extreme prostration; better warmth and quiet. See Head/Extremities. [Allen], [Farrington]
• Respiratory Tract. Asthmatic constriction at night or after exertion in cachectic patients; recurring bronchial catarrh with weakness and sweat. See Chest/Respiration. [Boericke], [Clarke]
• Gastro-intestinal Mucosa. Gastric irritability, burning epigastrium, periodic diarrhœa after chills; intolerance of cold drinks. See Stomach/Rectum. [Allen], [Hale]
• Ears (post-quinine states). Residual tinnitus or dulled hearing after quinine abuse, with periodic headaches—less marked than Chininum sulph., but present in cachectic convalescents. See Ears/Head. [Hughes], [Allen]

A picture of quiet anxiety with great weakness. The patient is restless yet exhausted—changes posture, seeks warmth, asks for small sips (10a), fears the recurrence at the fixed hour (10b), and dreads being alone at night [Arsenicum colouring]. He plans the day around meals and rests to blunt the fall in strength (Mind ↔ Generalities), and experiences discouragement when palpitations or chills return after slight exertion (Mind ↔ Heart/Fever). During the chill he is irritable and chilly, during heat anxious and parched, and post-sweat relieved but spent (Mind ↔ Chill/Heat/Sweat). Careful and tidy, he often notes the exact time of return (sycotic periodicity): this temporal vigilance distinguishes Chin-ars. from the vague expectation of Gelsemium (Mind ↔ Modalities) [Clarke], [Farrington]. Children in malarial houses are peevish, clingy at dusk, and wake in the night thirsty for small drinks, scared by palpitations or short breath; they settle with warmth and quiet (10a) [Boericke]. Unlike China, where the mind is more oversensitive to noise/light with tympany, Chin-ars. is weather- and time-bound, heart- and breath-centred, and relieved by completion of sweat [Farrington], [Clarke].

Broken by palpitations, dyspnœa, and anxious heat at set hours (10b). Dreads lying down; dozes propped on pillows (10a). After sweat, sleep is heavy but not refreshing; dreams of haste and missing appointments (temporal anxiety). Regular bedtime, warm drinks, and quiet shorten nocturnal attacks (hygiene echo). [Clarke], [Boericke], [Nash]

Dreams of being late for the hour, of lost trains, or striving and weakness—the psyche mirrors periodicity and exhaustion; they ease as the cycle loosens. [Clarke]

A periodicity remedy for feeble, pale, chilly patients with heart–kidney strain, splenic residue, and great prostration. Worse: fixed hours, night, cold air/drinks, least exertion, lying flat, damp/malarial weather; Better: warmth, small frequent sips/feeds, quiet, propped posture, and after sweat (modal concordance). It bridges China and Arsenicum: breaks the intermittent cycle while supporting circulation and vital reaction. Outcome signs: hour drifts/omits, breath steadies, oedema lessens, urine clears, sleep returns, and the patient can walk without sinking. [Clarke], [Boericke], [Farrington], [Nash]

Intermittent fever with strict periodicity: chill → heat → sweat. Chill: shaking, pallor, blue nails, great weakness; Heat: burning, anxiety, thirst for small sips; Sweat: often copious and relieving; may be subnormal between attacks with great prostration (Arsenicum strand) [Clarke], [Boericke], [Allen]. Stages may blur in chronic cachexia. Distinguish China/Chin-s. (flatulence, sensorial irritability) and Cedron (clock-minute neuralgia) from Chin-ars., where heart–kidney weakness with arsenical restlessness colours the cycle. [Farrington]

Chill: worse cold air/drinks; better wrapping and warm sips (10a/10b). Heat: burning, anxious; palpitations, dyspnœa; desire to be propped. Sweat: ending-valve of paroxysm; if suppressed, suffering prolongs (10b). [Clarke], [Allen]

Periodic headaches—frontal or supra-orbital—precede or accompany the fever hour; throbbing with weak, empty feeling, pallor, and sometimes tinnitus in those quinine-sensitive (Affinity: Ears) [Allen], [Hughes]. The head is heavy on least exertion; better warmth, worse cold air (10a/10b) [Clarke]. Vertigo on rising with black specks before eyes in anaemic states; clears after a little hot beverage (10a) [Nash]. Compare Chininum sulph. (ringing, roaring, ear-led) vs Chin-ars. (fever-time, prostration, heart–spleen nexus) [Farrington]. The headache diminishes as sweat opens (Head ↔ Fever), leaving a drained but clear state [Clarke].

Pale conjunctivæ in anaemia; photophobia during heat stage; dimness on exertion with palpitation (Eyes ↔ Heart). Not an ocular-centred remedy, but eye weakness tracks the circulation; steadies with rest and warmth (10a). [Clarke], [Boericke]

Tinnitus or muffled hearing in quinine-abused subjects, worse in the fever hour or at night, better lying warm and quiet (10a/10b). No hyperacusis as China; rather far-away sounds with cardiac throbbing. [Hughes], [Allen], [Farrington]

Dryness in chill; watery coryza in heat in some intermittents; not guiding unless constitutional picture supports Chin-ars. [Clarke]

Pale, waxy or earthy; circumoral pallor during sinking; flush in heat stage; oedematous lids in cardiac/renal cases (Affinity: Kidneys/Heart). [Boericke], [Clarke]

Burning tongue, metallic taste in fever; thirst for frequent small sips, worse at night (10b), better warm drinks (10a). Lips dry and cracked in cachexia. [Clarke], [Allen]

Neuralgic toothache with fever-hour periodicity in malarial subjects; better warmth, worse cold air (modal echo). [Farrington]

Dry, burning fauces in heat stage; swallowing small warm sips soothes; desire for cold water ends in chill aggravation (10b paradox). [Allen], [Clarke]

Oppression, cardiac asthma at night; must sit propped-up (10a) [Boericke]. Cough with exhaustion more than pain; scant expectoration; paroxysms at fixed times or in damp chill (10b). Warm wraps, sips, and quiet help. [Clarke]

Palpitation on least effort; weak, intermittent pulse; precordial anxiety at night; breathless on stairs (Heart ↔ Generalities) [Boericke], [Farrington]. Oedema and albuminuria indicate cardio-renal strain—Chin-ars. often bridges China’s periodicity and Arsenicum’s burning/restlessness. Better warmth, propped posture, small sips (10a). [Clarke], [Nash]

Short breath, sighing, wants cool air but is worse in cold wind (10b). Asthmatic constriction around midnight or before dawn—precise times; relieved by sitting up and warmth (10a). [Boericke], [Clarke]

Burning at epigastrium with faintness, especially after exertion or at night; small, frequent nourishment tolerated better (10a). Nausea before chill; vomiting of bile during heat in some; cold drinks disorder the stomach (10b). Appetite capricious, yet hunger fails to restore strength (psoric weakness). [Allen], [Clarke], [Nash]

Splenic soreness and weight in left hypochondrium; cannot lie on left in some; relief lying on right (10a) [Clarke]. Abdominal distension with portal sluggishness; stool alternates between loose at fever-time and constipated between bouts. Compare Ceanothus (organ-spleen positional, mechanical) vs Chin-ars. (systemic periodicity with heart–kidney tie). [Farrington], [Clarke]

Diarrhœa at the hour of fever or in early morning in cachectic states; stools watery, offensive, with exhaustion; alternates with constipation from weakness. Better warmth and rest, worse cold drinks (10a/10b). [Allen], [Clarke]

Diarrhoea at the hour of fever or in early morning in cachectic states; stools watery, offensive, with exhaustion; alternates with constipation from weakness. Better warmth and rest, worse cold drinks (10a/10b). [Allen], [Clarke]

Craves warm drinks frequently in small quantities (10a); cold drinks provoke chill or gastric burning (10b). Appetite poor; small, nourishing feedings sustain between paroxysms. Alcohol and coffee aggravate flutter and heat. [Clarke], [Allen], [Nash]

Sexual power low in cachexia; emissions exhaust; occasional orchialgia at fever-time, better warmth. Not a primary sexual remedy. [Clarke]

Weakness after menses with palpitation, chilliness; malarial women show fever at fixed hours around menses; milk scant in nursing cachexia; oedema in late disordered states. [Clarke], [Boericke]

Weak lumbar region with trembling after short walks; sacral ache during chill; better heat and rest, worse damp. [Boger], [Allen]

Trembling and weakness on slight exertion; oedematous ankles; neuralgic shooting pains at periodical hours (sciatic/intercostal) — warmth >, cold < (10a/10b). Hands cold in chill, burning in heat. [Clarke], [Farrington], [Boericke]

Waxy pallor or sallow tint; dropsical swelling; cold, clammy sweat in sinking; later, warm sweat closes paroxysm (Skin ↔ Chill/Heat/Sweat). [Boericke], [Clarke]

Intermittents / Periodicity

• China (Cinchona) — Antiperiodic with tympany, sensory irritability after losses; less cardio-renal weakness. Chin-ars. when heart–kidney and small-sip thirst predominate. [Farrington], [Clarke]
• Chininum sulphuricum — Tinnitus, roaring, sensorial periodicity; less cachexia. Chin-ars. for fever-hour, oedema, palpitation. [Allen], [Hughes]
• Natrum muriaticum — Chronic intermittents with headache at sun-times, lip herpes, salt desire; Chin-ars. if heart–kidney and arsenical restlessness colour the case. [Farrington], [Clarke]
• Eupatorium perfoliatum — Bone-breaking pains, thirst before chill; not cardio-renal; Chin-ars. when weakness and palpitation dominate. [Farrington]

Cardio-Renal / Dropsy

• Arsenicum album — Burning, restlessness, midnight aggravation; less strict periodicity; Chin-ars. when intermittent pattern and quinine history exist. [Kent], [Clarke]
• Digitalis — Slow, weak pulse, blue face, desire to lie perfectly still; Chin-ars. is more restless and periodic. [Nash], [Boericke]
• Apocynum cannabinum — Dropsy with scant urine and thirstlessness; Chin-ars. thirsty in sips, feverish, periodic. [Farrington]

Spleen / Malarial Cachexia

• Ceanothus — Left positional spleen pain, “cannot lie left”; mechanical organ sign. Chin-ars. systemic periodicity + heart–kidney. [Clarke], [Farrington]
• Ferrum — Anaemia with flushing on least motion; less fever-clock; use after Chin-ars. improves organ weakness. [Nash]

Neuralgias (Malarial)

• Cedron — Clock-minute supra-orbital ring pain; meteorologic; less cardiac. Chin-ars. when fever-hour and prostration predominate. [Farrington], [Clarke]
• Spigelia — Left eye–heart axis; stabbing with eye movement; not cachectic nor small-sip thirst. [Kent]

Respiratory

• Gelsemium — Dullness, stupor, muscular weakness; not burning/restless nor small-sip thirst; Chin-ars. more anxious, cardiac. [Farrington]
• Carbo vegetabilis — “Air-hunger”, wants to be fanned, cold sweat; Chin-ars. has periodicity and warmth craving. [Nash]

• Complementary: China — constitutional builder after intermittent cycle breaks; Ceanothus when spleen residuum persists. [Farrington], [Clarke]
• Complementary: Arsenicum album — deepens action in burning/restless cachexia once periodicity is softened. [Kent], [Boericke]
• Follows well: Eupatorium perf. — after bone-aches subside but weak heart/periodicity remain. [Farrington]
• Follows well: Gelsemium — after torpid intermittents awaken; Chin-ars. organises the cycle with support to heart–kidney. [Farrington]
• Precedes well: Ferrum — to rebuild blood once cachexia and paroxysms are controlled. [Nash]
• Compare: Chin. sulph. (tinnitus-led), Nat-m. (sun-time HA), Cedron (minute-hand neuralgia), Digitalis/Apocynum (dropsy poles). Choose by periodicity vs organ-failure emphasis. [Farrington], [Clarke], [Boericke]
• Practical adjuncts: Warmth, propped posture, regular small feedings, avoid cold drinks/late exertion during convalescence. [Boericke], [Clarke]

• Obstinate intermittent fever with heart–kidney strain. Chininum arsenicosum 6C–30C during acute cycles (one to three times daily), space/stop as the hour loosens and sleep/strength return. [Clarke], [Boericke], [Farrington]
• Cardiac asthma of the feeble, post-malarial convalescent. Dose in evening; add propped posture, warm drinks, quiet; watch for albuminuria and manage fluids sparingly. [Boericke], [Nash]
• Periodic neuralgia in cachexia (supra-orbital/sciatic). Give in prodrome the day before the known hour for 2–3 cycles; warmth, rest; avoid cold air/drinks. [Allen], [Farrington]
  Case pearls:
  • Tertian ague with palpitation and ankle œdema; chills at 5 p.m. Chin-ars. 30C b.i.d. × 5 days → hour shifted to 7 p.m., sweat ample, palpitation eased; then q48h × 2 weeks. [Clarke], [Boericke]
  • Night asthma in malarial anaemia; albuminuria trace. Chin-ars. 200C prn at dusk for three evenings; propped sleep returned; follow-up with Ferrum for blood. [Nash], [Farrington]
  • Periodic supra-orbital neuralgia in damp heat; great debility. Chin-ars. 30C t.i.d. during spell; warmth; coffee avoided → attacks halved, then ceased as weather changed. [Allen], [Farrington]

Mind

• Anxiety and restlessness with great weakness (night). Arsenical strand with cachexia. [Boericke], [Clarke]
• Fear/anticipation of the fixed hour. Temporal vigilance. [Clarke]
• Desire for company, dread of being alone at night. Consolation calms. [Kent]
• Irritable during chill, anxious during heat, relieved after sweat. Stage psychology. [Clarke]
• Orderly, plans meals/rests to avert relapse. Practical management. [Farrington]
• Discouraged by slight exertion aggravating all symptoms. Exhaustion mind. [Nash]

Head

• Headache, periodic, at fever hour (supra-orbital/frontal). Classic intermittent. [Allen], [Clarke]
• Vertigo on rising in anaemia; better warmth and hot drinks. Circulatory. [Nash]
• Tinnitus after quinine abuse; worse at night. Drug-residue. [Hughes], [Allen]
• Head emptiness with tremulous weakness. Prostration sign. [Boericke]
• Headache relieved as sweat breaks. Stage-link. [Clarke]
• Cold air aggravates head and chill simultaneously. Modal tie. [Clarke]

Heart/Chest/Respiration

• Palpitation on least exertion in cachexia. Core cardio sign. [Boericke]
• Asthma, cardiac, at night; must sit propped. Posture rubric. [Boericke], [Clarke]
• Oppression about precordia at fixed hours. Periodic chest. [Clarke]
• Pulse weak, intermittent. Failure tone. [Boericke]
• Dyspnœa worse lying flat, better warmth/quiet. Modality set. [Boericke]
• Dropsy with cardiac/renal origin. Sphere rubric. [Clarke]

Abdomen/Spleen

• Spleen enlarged, tender after malaria. Organ rubric. [Clarke], [Hale]
• Cannot lie on left; better on right. Positional rubric. [Clarke]
• Portal sluggishness with flatulence in cachexia. Terrain. [Farrington]
• Diarrhœa at fever hour; alternation with constipation. Stage stool. [Allen]
• Abdominal distension worse cold drinks. Modal link. [Clarke]
• Soreness left hypochondrium in damp weather. Weather tie. [Hale]

Urinary

• Albuminuria in malarial cachexia. Renal sign. [Clarke]
• Scanty, dark urine; dropsy. Failure axis. [Boericke]
• Micturition relieves dyspnœa slightly. Clinical note. [Clarke]
• Nocturia during heat/anxiety. Stage-linked. [Boericke]
• Weak stream from general debility. Tone loss. [Nash]
• Urine increases as heart steadies under remedy. Outcome marker. [Clarke]

Fever/Chill/Heat/Sweat

• Intermittent fever with strict periodicity (quotidian/tertian/quartan). Essence rubric. [Clarke], [Allen]
• Chill with pallor, trembling; thirst small sips. Stage detail. [Clarke]
• Heat with anxiety, burning, palpitation. Stage detail. [Boericke]
• Sweat copious, relieving; suppression aggravates. Valve rubric. [Clarke]
• Subnormal temperature between paroxysms. Cachectic phase. [Boericke]
• Relapse in damp, malarial weather. Environmental trigger. [Hale]

Generalities

• Great debility from chronic malaria. Identity rubric. [Clarke], [Farrington]
• Worse night, cold air/drinks, least exertion, lying flat. Master aggravations. [Boericke]
• Better warmth, small frequent sips/feeds, quiet, propped posture, after sweat. Master ameliorations. [Clarke]
• Oedema with anaemia; heart–kidney axis. Terrain. [Boericke]
• Periodic neuralgias with burning pains. Pain rubric. [Allen]
• Improves as “the hour” drifts or omits. Outcome marker. [Farrington]

Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): substance background; malarial cachexia; cardio-renal and splenic indications; modalities and periodicity.
Hughes, R. — A Cyclopædia of Drug Pathogenesy (1891–95): toxicology of quinine/arsenic; quinine-abuse sequelae (tinnitus); rationale for combined salt.
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): intermittent fever stages; periodic neuralgias; gastric burning; thirst modalities.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—prostration, small-sip thirst, cardiac asthma, albuminuria, dropsy; posture and warmth.
Farrington, E. A. — Clinical Materia Medica (1887): differentiations—China/Chin-s./Nat-m./Cedron/Eupatorium; selection by periodicity vs organ failure.
Hale, E. M. — New Remedies: Clinical and Pharmacological (1864–1891): clinical records in obstinate intermittents; spleen–portal notes; dosing cautions.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879): confirmations of intermittent cycles; neuralgia patterns; generalities of weakness.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): mechanical modalities (lying flat <, warmth >); lumbar weakness; fever sequencing.
Kent, J. T. — Lectures on Materia Medica (1905): miasmatic colouring; night anxiety/restlessness; comparisons with Arsenicum and Digitalis.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): anaemia with palpitation; management pearls for small feedings/rest; follow-on with Ferrum.
Tyler, M. L. — Homoeopathic Drug Pictures (1942): case sketches in malarial convalescence; heart–kidney balance; night aggravations (interpretive).
Phatak, S. R. — Concise Materia Medica (1977): condensed keynotes—periodicity, cachexia, small-sip thirst, warmth; practical modalities for selection.