• Larynx and Trachea — violent reflex excitability, spasmodic closure, tickling “as from a feather,” hoarseness; whooping-cough, laryngitis, laryngeal TB; see Throat/Respiration [Hahnemann], [Hering], [Farrington].
• Vagus/Respiratory Reflex Arc — paroxysmal cough ending in retching, vomiting, epistaxis; cough on lying down or on beginning to speak; see Respiration/Chest [Allen], [Boger], [Kent].
• Lungs (Apices) — tubercular diathesis, haemoptysis streaks with spasmodic cough; see Chest/Fever [Clarke], [Boericke].
• Intercostals/Diaphragm — stitching pains, “as if bruised” ribs from coughing; see Chest/Back [Kent], [Nash].
• Nose/Nasopharynx — epistaxis during paroxysm, fluent coryza around attacks; see Nose/Fever [Hering], [Boger].
• Stomach — nausea and vomiting with cough; hunger after paroxysm; see Stomach [Allen], [Boericke].
• Voice/Phonation — deep, bass, cracked or aphonic from laryngeal irritation; see Mouth/Throat [Farrington], [Kent].
• Sleep Centres — attacks rouse 12–3 a.m.; cough as soon as the head touches the pillow; see Sleep [Boger], [Tyler].
• Mind — suspicion, easily startled, concentrated irritability during paroxysms; see Mind [Tyler], [Kent].
• Skin/Sweat — clammy sweat on forehead during fits; heat and sweat close attacks; see Perspiration [Boger], [Boericke].
• Cervical/Neck Muscles — strain from paroxysms; need to hold chest/neck; see Back [Nash].
• Ears — bursting ear pains with whoop and retching; Eustachian irritation; see Ears [Hering].

• Open, cool air; window open—less tickling and spasm (echoed under Respiration/Sleep) [Boger], [Tyler].
• Sitting up, bending slightly forward; holding the chest—quiets the paroxysm’s violence (see Chest/Back) [Kent], [Nash].
• Firm pressure to larynx/chest wall during cough—reflex damped (see Throat/Chest) [Farrington].
• After expectoration, or after a spell of vomiting—the spasm breaks (see Stomach/Respiration) [Allen], [Boericke].
• Slow, measured breathing—prevents the “catch” at glottis (see Respiration) [Kent].
• Warm drinks sipped very slowly during convalescence—soothes tickle (exceptions exist; see Worse drinking) [Clarke].
• Silence—resting the voice reduces provocation (see Mouth/Throat) [Farrington].
• Steady, gentle motion in open air for convalescents—less paroxysmal tendency (see Generalities) [Vithoulkas].
• Later part of night after the main paroxysm has “broken”—post-fit relief (see Sleep/Fever) [Boger].

• After midnight, especially 12–3 a.m.; “the midnight whoop” (see Sleep/Fever) [Boger], [Kent].
• Lying down; as soon as head touches pillow—cough explodes (see Sleep/Respiration) [Hering], [Clarke].
• Speaking, reading aloud, singing—phonation triggers fit (see Throat/Mouth/Respiration) [Farrington], [Kent].
• Drinking (even cold water) or swallowing—liquids touch the laryngeal trigger (see Throat/Stomach) [Allen], [Boericke].
• Warmth of bed or warm, close rooms—tickling larynx worse (see Generalities/Respiration) [Boger].
• Tobacco smoke, dusty rooms, feathers—hyper-reactive mucosa (see Nose/Throat) [Hering], [Clarke].
• First going to sleep; on waking suddenly—glottic spasm (see Sleep) [Tyler].
• Rapid inspiration; deep breathing; laughing—start reflex (see Respiration) [Kent].
• Eating solid food—crumbs “go the wrong way,” set cough (see Stomach/Throat) [Allen].
• Sitting long in a warm room; entering a warm room from cold air—laryngeal tickle (see Generalities) [Boger].
• Slight exertion during attack—cyanosis, retching increase (see Chest/Generalities) [Hering].
• Pressure on abdomen during a fit—worsens retching; must hold the chest instead (see Stomach/Back) [Nash].

During paroxysms the mental state is taut, concentrated, and suspicious: the least movement or word feels provocative, and the patient resents interference, fearing any stimulus will “set it off” [Tyler], [Kent]. Between attacks the mood may be low and irritable, but without the great anguish of Arsenicum; rather a taut, guarded watchfulness—eyes set, listening for the next tickle [Hering]. There is distrust of people fussing about; the sufferer would prefer silence and dim light, a pattern that tallies with the modality “Better silence and resting the voice” and “Worse speaking” already noted [Farrington]. Oversensitive to external impressions—odours, dust, warm rooms—provokes fretfulness and even sudden rage if someone laughs or speaks while he is controlling a cough; such emotional hyperreactivity mirrors the respiratory reactivity [Kent]. Anxiety is anticipatory: if he lies down or lifts the cup he “knows” the fit will come; this anticipatory fear in the tubercular temperament seeks open air and a window, cross-linking to Better open air [Sankaran], [Boger]. Sleeplessness comes from fear of the midnight attack; when it comes, there is a flash of panic, then a mechanical fight for air, then exhaustion [Boger], [Vithoulkas]. Children in whooping cough become peevish, push away help, clutch the mother in a vice only at the peak of suffocation; afterwards, they want to be quiet and not spoken to—again echoing vocal provocation as a keynote [Hering]. A fastidious dislike of smoke, feathers and dust appears—he will “clear the room” before resting [Clarke]. Mini case: “Boy would glare at anyone who spoke as he prepared to lie down; if spoken to, paroxysm burst forth” [Clinical]. These mental colours—irritable vigilance, aversion to talk, anticipatory dread linked to lying down/drinking—interweave consistently with Drosera’s mechanical laryngeal spasm [Kent], [Farrington].

Head congestion accompanies heat of face during the fit, with bursting, hammering temples that peak at the whoop and ease after vomiting or free expectoration—an exact parallel to the crisis-relief pattern seen throughout (Better after expectoration/vomit) [Allen], [Boger]. Dizziness comes on with prolonged cough, blackness before eyes, as in pertussis; the child may stagger or fall asleep from exhaustion [Hering], [Nash]. Frontal pressure “as of a bar” in warm rooms, relieved at the window, links to the open-air modality [Boger]. Occipital aching when lying down can herald the nocturnal paroxysm; lifting the head slightly will sometimes delay the fit (echo to Better sitting up) [Kent]. Nosebleed may burst forth at the height of the attack, relieving the head [Hering]. Post-fit dullness and sound sensitivity are common; the slightest laugh or conversation can re-ignite the laryngeal tickle (Mind/Throat cross-link) [Farrington].