• Portal System & Rectum/Anus. Central action on portal congestion with hæmorrhoids—large, blind or bleeding; constipation with stick-like pains and pruritus ani; bleeding often relieves fulness. See Rectum/Abdomen/Generalities. [Hale], [Clarke], [Allen], [Boericke]
• Pelvic Veins (Female pelvis). Varicosities and pelvic heaviness; hæmorrhoids of pregnancy; pruritus vulvæ with congestion; menses with pelvic throbbing. See Female. [Hale], [Clarke], [Farrington]
• Heart (secondary to portal stasis). Palpitation, cardiac irritability, and oppression linked to constipation/hæmorrhoids (“heart and piles together”). See Heart/Chest. [Clarke], [Boericke]
• Throat/Larynx (venous catarrh). Chronic laryngitis of speakers with vascular fulness, hawking of stringy mucus—improves as portal symptoms clear. See Throat/Chest. [Hale], [Clarke]
• Liver & Hypogastrium. Dull hepatic ache, right hypochondrial drag, abdominal flatulence with pelvic pressure. See Abdomen. [Hale], [Allen]
• Skin & Mucosae. Intolerable itching about anus and genitals, fissures, ulcerated margin in long cases; surface mirrors venous stasis. See Skin/Rectum/Female. [Hering], [Clarke]
• Lower Limbs (Veins). Varicose veins with aching, bursting sensation, worse standing; pregnancy veins. See Extremities. [Boericke], [Boger]
• Head (portal reflex). Congestive headaches with piles/constipation; throbbing temples, fullness relieved by stool or bleeding. See Head. [Clarke], [Farrington]
• Urinary Neck of bladder (reflex). Frequent urging in pelvic congestion; uneasy pressure, worse pregnancy; irritative but not destructive. See Urinary/Female. [Clarke], [Hale]

• After stool or hæmorrhoidal bleeding—relieves pelvic/portal fulness and cardiac fret. [Clarke], [Hale]
• Cold bathing/ablutions to anus and vulva; cool compresses to varices. [Boericke], [Dewey]
• Gentle walking in cool air (not long standing); lying left side with knees slightly flexed. [Boger], [Clarke]
• Loose clothing, unconstricted waist, avoiding heat around pelvis. [Clarke]
• Light diet, avoiding rich/greasy foods and alcohol; small, frequent warm broths may soothe portal distress. [Dewey], [Hale]
• Sitz baths (cool to tepid) in subacute piles/pruritus. [Boericke]
• Pregnancy hygiene—rest with hips elevated, alternating with short walks. [Farrington]
• After scratching lightly (brief), though often followed by burning—warning sign. [Hering]

• Constipation; straining; suppressed hæmorrhoidal discharge. [Hale], [Clarke]
• Pregnancy, prolonged standing, sitting on soft feather beds, warm rooms. [Boericke], [Boger]
• Tight waist-bands, corsets, belts—increase pelvic venous load. [Clarke]
• After coffee, spirits, rich/fried foods; late suppers. [Dewey], [Hale]
• Night (itching/pruritus), evening congestion; after going to bed. [Hering], [Clarke]
• Jar and walking uphill; ascending stairs aggravates varices. [Boger]
• Mental worry and sedentary habits—portal stasis worse. [Clarke], [Farrington]
• During menses (pelvic weight, piles) and after delivery if constipated. [Clarke], [Boericke]

The Collinsonia patient is preoccupied with bodily obstruction—a sense that the pelvis and rectum are engorged, the outlet narrow, and any interruption (constipation, suppression) threatens a storm of itching and heart-fret (Mind ↔ Rectum/Heart/10b). He becomes irritable at night when pruritus drives him from bed, walking the floor for cool air or a sitz bath (Mind ↔ Skin/10a). Anxiety is somatic rather than metaphysical: fear not of death but of the next stool with its stick-like pains (Mind ↔ Rectum). He is sensitive to tight clothing and company that keeps him standing; relief and good humour return after a soft stool or a cool ablution (Mind ↔ 10a after stool/cold bathing) [Clarke], [Hale], [Hering]. There is aversion to exertion when varices throb, yet gentle walking is welcomed if it prevents stagnation—an inner push–pull between rest and motion typical of venous remedies (Mind ↔ 10a/10b) [Boger]. Mentally he may grow low-spirited, easily vexed, indifferent to conversation when pelvic weight dominates; sexual thoughts may irritate because they worsen congestion (Mind ↔ Female/Male). With improvement, he reports a light pelvis, quiet heart, and “no itching at night,” which become simple, reliable outcome markers. [Clarke], [Boericke], [Hale]

Fullness and throbbing in temples with piles and constipation, occasionally a vertex weight that lifts after stool or hæmorrhoidal bleeding (Head ↔ Rectum/10a) [Clarke]. Headaches follow rich meals and late suppers, especially in the sedentary (Head ↔ 10b diet/worry) [Dewey], [Hale]. The face may flush during pelvic throbbing; noise and heat aggravate. Occipital drag corresponds to sacro-iliac heaviness (Head ↔ Back). Headache from tight hats mirrors aversion to constriction elsewhere. Distinguish Aesculus (dry, wooden back; less head-throb relief from bleeding) and Hamamelis (bleeding piles with sore bruised feeling but less constipation). [Farrington], [Clarke], [Boger]

Venous suffusion with bluish or dark rings under eyes on nights of itching; smarting lids after loss of sleep (Eyes ↔ Sleep). No primary ophthalmia, rather congestive appearance matching portal stasis. Vision tires with long standing at evening gatherings; relieved by sitting and cooling (Eyes ↔ 10a/10b). [Clarke], [Boericke]

Buzzing or humming with head-congestion, worse in warm rooms; clears after open air or after a satisfactory stool (Ears ↔ Head/Rectum). Nothing chronic; signs are vascular. [Clarke], [Hale]

Nasal membranes dry in heated rooms at night of pruritus; occasional epistaxis in congestive persons, which relieves the head (Nose ↔ Head). Smells of cooking/fry may aggravate portal distress indirectly by dietary indiscretion. [Clarke], [Dewey]

Flushed, sometimes dusky, with small venules visible during pelvic throbbing; lips dry with constipation. In pregnancy a heavy expression attends varicose states (Face ↔ Female/Extremities). Bluish tinge under eyes after wakeful itching. [Hering], [Clarke]

Bitter taste mornings in bilious types; tongue coated yellowish-white when portal stasis is marked. Dryness with thirst for small quantities—large draughts oppress in sedentary dyspeptics (Mouth ↔ Stomach). [Allen], [Clarke], [Hale]

Teeth/grinding not characteristic; gnashing may occur from itch torment, not a dental remedy. Jaw aches after nights of loss of sleep. [Hering]

A remedy for chronic laryngeal catarrh of speakers/clergymen when there is pelvic/portal background: husky voice, constant hawking of sticky mucus, throat dry yet congested, worse evening rooms, better open air; improves as hæmorrhoids/constipation lessen (Throat ↔ 9 Affinity/10a) [Hale], [Clarke]. No violent rawness as in Spongia; it is a venous fulness, not acute croup. [Farrington]

Heaviness after rich or late meals with flatulence and right hypochondrial weight; a sinking at epigastrium before stool, improving after evacuation (Stomach ↔ 10a after stool) [Hale], [Clarke]. Eructations relieve chest oppression, showing heart–stomach sympathy. Desires simple food; spirits/coffee aggravate piles and heart palpitation (Stomach ↔ 10b). No violent gastritis; the disorder is portal, with secondary dyspepsia. [Dewey], [Boericke]

Full, heavy, congested, especially in hypogastrium and right hypochondrium; clothes feel too tight; stitching about sigmoid when straining (Abdomen ↔ 10b tight clothing/straining) [Clarke], [Hale]. Flatulence difficult to pass; rumbling without relief; bearing-down into rectum and genitals (Abdomen ↔ Rectum/Female). Cold sponging or cool sitz eases the heat of congestion (Abdomen ↔ 10a). Distinguish Aesculus (backache as if broken; rectum dry) and Aloe (insecurity of sphincter, sudden stool). [Farrington], [Boger]

Frequent urging with pelvic fulness, more in pregnancy, sometimes smarting at neck of bladder; urine otherwise normal (Urinary ↔ Female). Passing urine may provoke rectal desire by pelvic pressure. Sitz baths calm both urges. [Clarke], [Hale], [Boericke]

The grand sphere. Hæmorrhoids—large, protruding, blind or bleeding; burning, itching, smarting, with a sensation as if sharp sticks or splinters were in the rectum (keynote) [Hale], [Clarke], [Allen]. Constipation obstinate, stool dry, in hard lumps, with much straining and aching; after stool smarting and throbbing; bleeding often relieves the pelvic and cardiac oppression (Rectum ↔ Heart/10a) [Hale], [Boericke]. Pruritus ani is often intolerable at night; the sufferer walks about, bathes in cold water, or applies cold cloths for ease (Rectum ↔ 10a/10b) [Hering], [Clarke]. Fissures and ulcerated margins may develop in chronic cases; soreness to touch and sitting on soft feather beds worse (better on firm seat) [Clarke]. Differential points: Aesculus—dry, raw rectum and backache “as if it would break,” less bleeding; Hamamelis—bleeding with soreness but not much constipation; Ratanhia—knife-like fissure pains, less venous theme; Pæonia—ulcerated anus with great rawness. [Farrington], [Boger], [Boericke]

Hæmorrhoids with sexual congestion; pruritus of scrotum where varicosities exist. Varicocele tendency (confirmatory). Sexual desire variable; prolonged standing or excess intensifies pelvic throbbing (Male ↔ 10b standing). [Clarke], [Hale]

Hæmorrhoids of pregnancy with constipation, varicose vulva/legs, pruritus vulvæ often intolerable at night; cool bathing relieves (Female ↔ 10a/10b) [Hale], [Clarke], [Boericke]. Bearing-down; pelvic weight before menses; palpitations accompanying pelvic congestion; urging to stool during menses from pelvic pressure. Post-partum piles with fissure respond when the stick-like rectal pain is present. Distinguish Sepia (bearing-down with indifference; better vigorous exercise) and Pulsatilla (mild, changeable, thirstless; soft stools) from Collin.’s venous and itch-dominant picture. [Farrington], [Clarke]

Breathing short when pelvic and portal fulness mount; sighing for relief; better after eructation or stool. No primary bronchitis; the dyspnœa is vascular. [Clarke], [Hale]

Classic note: “Heart and piles together.” Palpitations, fluttering, irritable pulse associated with portal congestion, constipation, and hæmorrhoids; relief follows rectal evacuation or hæmorrhoidal bleeding (Heart ↔ 10a after stool/bleeding) [Clarke], [Boericke]. Tight waist-bands worse; cool air and quiet better (Heart ↔ 10b/10a). Distinguish Sulphur (congestive plethora, early-morning stool) and Nux (irritable, small frequent stool) by the stick-in-rectum and venous varix emphasis of Collin. [Farrington], [Boger]

Oppression and stitching about sternum with flatulence; deep breath unsatisfying during pelvic throbbing; voice husky in evening rooms (Chest ↔ Throat/Stomach) [Hale], [Clarke]. The chest feels relieved by eructation or after stool, showing the portal–cardio link. [Clarke]

Sacral and sacro-iliac heaviness; aching as if weights hung from pelvis; worse standing, better sitting firm (Back ↔ 10b/10a) [Clarke]. Not the wooden, breaking Aesculus back; Collin. ties pain to pelvic throbbing and itch. [Farrington], [Boger]

Varicose veins of legs with aching, bursting, evening worse, standing worse; cool sponging and horizontal rest relieve (Extremities ↔ 10a/10b) [Boericke], [Clarke]. Feet hot after standing; shoes feel tight; ankles throb in pregnancy. [Hale]

Intolerable itching—especially about anus and vulva—worse night and warm bed, improved by cold; excoriations from scratching; ulcerated fissures at anal margin in chronic cases (Skin ↔ Rectum/Female/10a/10b) [Hering], [Clarke]. Bluish venules and mottled congestive skins in sedentary subjects. [Boericke]

Restless from itching; must rise to bathe parts or walk about; drowse and start as itch recurs (Sleep ↔ Skin/10b night) [Hering]. Difficulty falling asleep on soft feather beds; better on firm mattress (Sleep ↔ 10b). Sleep refreshes if a good stool is obtained toward evening; otherwise night fret continues (Sleep ↔ 10a). [Clarke]

Dreams of pressure at stool, of public places with nowhere to sit, or of tight clothing—symbolic of the venous blockade; frightful dreams in the itchy nights. Dreams ease as itch and pelvic weight lessen. [Clarke] (clinical observation)

Slight evening heat with pelvic fulness; hands/feet hot after standing; sweat with itching but no relief till cold is applied (Fever ↔ Skin/10a). No high-fever picture. [Clarke], [Hering]

Flushes with head and pelvis; sweat during fits of pruritus; chill after cold bathing if overdone. Balance cooling with gentle measures. [Clarke]

Rich, fried, and spirituous things worse; late suppers provoke portal and cardiac irritability; desires simple, non-greasy diet (Food ↔ 10b diet). Cold water locally helps; internally, small sips preferred by the sedentary dyspeptic. [Dewey], [Hale], [Clarke]

A venous–portal remedy: wherever stasis and fulness dominate—hæmorrhoids, varices, pelvic weight, cardiac irritability—and especially when constipation and the “stick in rectum” sensation rule, Collinsonia stands central. Worse from constipation, straining, standing, tight clothing, warm rooms, night, pregnancy, rich foods/spirits; better after stool or bleeding, cold bathing/compresses, loose clothing, firm seat/lying left, gentle walking in cool air. Cure is signalled by easier stools without straining, quiet nights (no itch), light pelvis, and quiet heart despite exertion. [Hale], [Clarke], [Allen], [Hering], [Boericke], [Boger], [Farrington], [Phatak]

Hæmorrhoids & Rectal pains

• Aesculus — Dry, raw, splinter-like rectum with lumbosacral “wooden” back; little bleeding. Collin. has pruritus, venous congestion, and heart–portal link; bleeding may relieve. [Farrington], [Clarke]
• Hamamelis — Bleeding piles with soreness/bruising, even at touch; constipation not marked. Collin.: constipation and stick-in-rectum keynote. [Clarke], [Boericke]
• Ratanhia — Knife-like fissure pains during/after stool; less venous plethora. Pair Ratanhia for fissure when venous picture abates. [Boger], [Boericke]
• Pæonia — Ulcerated anus with great rawness and oozing; less portal/cardiac sympathy. Collin. retains venous axis. [Clarke], [Farrington]
• Aloe — Urgent stool, insecurity, mucus; haemorrhoids with gurgling. Collin.: obstinate constipation with pruritus. [Boger], [Boericke]
• Nux vomica — Irritable, frequent ineffectual urging; piles of sedentary. Collin. when the venous signs, pruritus, and stick sensation dominate. [Farrington], [Kent]
• Sulphur — Burning anus, 5 a.m. stool, ragged skin. Collin. lacks early-morning stool and shows stronger varix theme. [Clarke], [Phatak]

Varicose veins / Pregnancy

• Pulsatilla — Varices, mild, weepy, thirstless; stools soft. Collin.: itch and constipation centre; cold bathing strongly better. [Farrington], [Clarke]
• Sepia — Bearing-down, indifference, wants exercise; varices. Collin.: itch, piles, and heart–portal thread; gentle exercise only. [Kent], [Clarke]

Cardiac irritability from portal stasis

• Lycopus — Thyroid–heart vascularity; less portal–rectal axis. Collin. guided by after-stool relief and piles. [Clarke]
• Digitalis — True myocardial failure, slow pulse. Collin.: functional irritability linked to venous load. [Farrington]

Throat/larynx (venous catarrh)

• Argentum nitricum — Speaker’s throat with nervous component, gastric wind. Collin.: venous fulness that tracks with piles. [Clarke]
• Spongia — Dry, sawing larynx; not venous. Collin. suits husky, congestive larynx with portal signs. [Farrington]

• Complementary: Hamamelis — when bleeding predominates with soreness after Collin. has reduced congestion. [Clarke], [Boericke]
• Complementary: Aesculus — alternates in chronic piles: Aesc. for dry, wooden back/dry rectum layer; Collin. for itch–stick venous layer. [Farrington], [Boger]
• Complementary: Ratanhia / Pæonia — for fissures/ulceration after venous stasis yields. [Boericke], [Clarke]
• Follows well: Nux vomica — when irritative spasm/urgency abates and the venous obstruction remains. [Farrington], [Kent]
• Follows well: Sulphur — after general venous plethora is lowered; Collin. completes rectal cure. [Clarke]
• Precedes well: Lycopodium / Carbo veg. — for lingering flatulent portal dyspepsia after piles improve. [Clarke], [Dewey]
• Compare: Aloe, Sulphur, Nux, Aesculus, Hamamelis, Ratanhia, Pæonia, Sepia, Pulsatilla. [Boger], [Boericke], [Farrington]
• Antidotes (practical): Nux for dietary excess/coffee aggravations; Pulsatilla regimenally for rich, greasy diet lapses in gentle subjects. [Dewey], [Clarke]
• Inimical: None fixed; avoid mechanical alternation—choose by venous vs fissure layer. [Kent]

• Hæmorrhoids of pregnancy; obstinate constipation; intolerable pruritus ani/vulvæ. Collin. 6C–30C 1–3× daily, spacing as soon as stool easy and itch abates; strict cool ablutions, loose clothing, firm seat, short walks. [Hale], [Clarke], [Boericke]
• Cardiac palpitation linked to piles/constipation (“heart and piles together”). Collin. 12C–30C qd–bid; dietary simplification, gentle bowel routine; observe for after-stool relief as confirm. [Clarke], [Farrington]
• Chronic laryngitis of speakers with venous fulness and portal stasis. Collin. 6C–12C nightly × 1–2 weeks while regulating bowel and diet; often throat clears as pelvic symptoms lift. [Hale], [Clarke]

Case pearls (one-liners):
• Primigravida, evening varices & piles, “sticks in rectum,” must bathe with cold water to sleep → Collin. 30C b.i.d.; within 5 days stools soft, itch gone, legs tolerable standing. [Hale], [Clarke]
• Sedentary clerk with palpitations that cease after stool; bleeding piles relieve head-throb → Collin. 12C nocte; diet trimmed; cardiac fret vanished as bowels regularised. [Clarke], [Boericke]
• Speaker’s huskiness evenings; piles and pelvic weight → Collin. 6C h.s.; sitz baths; voice clear by week two as rectal pains ceased. [Hale]

Mind

• Anxiety about stool; dreads straining. Somatic fear of obstruction. [Clarke]
• Irritability at night from pruritus. Behavioural marker. [Hering]
• Aversion to tight clothing; intolerance of constriction. Venous theme. [Clarke]
• Low-spirited, sedentary, better after soft stool. Outcome cue. [Hale]
• Restlessness—walks about to cool itching parts. Modality confirms. [Hering]
• Cannot stand long; standing brings pelvic throbbing. Environment–vein link. [Boericke]

Head

• Headache congestive with piles/constipation; better after stool/bleeding. Portal reflex. [Clarke]
• Throbbing temples in warm rooms/evening. Heat/venous aggravation. [Clarke]
• Occipital weight with sacral heaviness. Axis sign. [Boger]
• Tight hats aggravate. Constriction <. [Clarke]
• Face flushed/dusky with pelvic throbbing. Visible stasis. [Hering]
• Open air and stool relieve head. Practical rubric. [Clarke]

Throat/Larynx

• Laryngitis chronic of speakers; venous fulness; hawks mucus. Venous catarrh. [Hale]
• Voice husky evenings; rooms warm <. Environment. [Clarke]
• Better as piles/constipation improve. Inter-organ clue. [Hale]

Abdomen/Rectum

• Hæmorrhoids, large, protruding; bleeding or blind. Core pathology. [Hale], [Clarke]
• Sensation as of sharp sticks in rectum. Keynote selection. [Allen], [Boericke]
• Constipation obstinate; stool dry, in lumps; much straining. Terrain. [Hale]
• Pruritus ani, intolerable at night; cold bathing >. Modality. [Hering], [Clarke]
• Fissures/ulcerated margin from scratching. Sequelæ. [Clarke]
• Better after hæmorrhoidal bleeding or soft stool. Relief-valve. [Clarke]

Female/Urinary

• Hæmorrhoids of pregnancy with constipation. Grand indication. [Hale]
• Pruritus vulvæ with pelvic congestion; cold ablutions >. Surface sign. [Clarke]
• Varices of vulva/legs in pregnancy; standing <. Venous law. [Boericke]
• Urging to urinate from pelvic pressure. Reflex. [Clarke]

Heart/Chest

• Palpitation with piles/constipation; better after stool. “Heart and piles” rubric. [Clarke]
• Oppression about sternum with flatulence. Cardio–gastric link. [Hale]
• Tight clothing about chest/pelvis <. Constriction <. [Clarke]

Extremities/Veins

• Varicose veins, aching, bursting; standing <; cool sponging >. Peripheral vein rubric. [Boericke]
• Hot feet after standing long. Heat of stasis. [Clarke]
• Evening aggravation of leg throbbing. Chrono-venous law. [Boger]

Skin

• Itching, intolerable, anus/vulva; night <; cold bathing >. Signature surface. [Hering], [Clarke]
• Excoriations from scratching; smarting after washing warm. Technique nuance. [Clarke]
• Bluish venules visible. Stasis sign. [Boericke]

Generalities

• Standing aggravates; firm seat better than soft bed. Mechanical rubric. [Clarke]
• Tight clothing aggravates; loose clothing ameliorates. Venous rule. [Clarke]
• Rich/fried foods and spirits aggravate portal symptoms. Diet law. [Dewey], [Hale]
• Better after stool/bleeding; cold applications; gentle walking in cool air. Master ameliorations. [Clarke], [Boericke]
• Night aggravation from itching and heat of bed. Temporal key. [Hering]

E. M. Hale — New Remedies: Clinical and Pharmacological (1864–1891): primary source—portal stasis, hæmorrhoids of pregnancy, “stick-in-rectum,” cardiac irritability; dosing.
T. F. Allen — Encyclopædia of Pure Materia Medica (1874–79): collated provings/clinical symptoms—rectal pains, pruritus, venous states.
Constantine Hering — The Guiding Symptoms of Our Materia Medica (1879): confirmations—pruritus ani/vulvæ (night <, cold >), hæmorrhoids, fissures.
John Henry Clarke — A Dictionary of Practical Materia Medica (1900): synthesis—portal–pelvic–cardiac link; modalities (after stool/bleeding >; standing/tight clothes <); throat notes.
William Boericke — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—hæmorrhoids of pregnancy, varices, pruritus; regimen (sitz baths).
C. M. Boger — Synoptic Key of the Materia Medica (1915): modalities (standing <, cool >, tight clothing <); differentials (Aesculus, Aloe, Hamamelis).
E. A. Farrington — Clinical Materia Medica (1887): contrasts—Aesculus/Hamamelis/Nux/Sulphur; pelvic/portal states; pregnancy veins.
S. R. Phatak — Concise Materia Medica (1977): essentials—venous congestion, piles, constipation, varices; “itch–venous” terrain.
James Tyler Kent — Lectures on Materia Medica (1905): miasmatic framing; relationships (Nux, Sulphur, Sepia, Pulsatilla).
W. A. Dewey — Practical Homœopathic Therapeutics (1901): dietary/regimen rules—avoid spirits/grease; cold ablutions; sitz baths.
H. C. Allen — Keynotes and Characteristics (1898): rectal keynotes (“sticks,” pruritus), piles of pregnancy.
Margaret Lucy Tyler — Homoeopathic Drug Pictures (1942): bedside notes—firm seat vs soft bed; nightly itch management; pregnancy tips.