Equisetum hyemale

Ancient, silica-rich vascular “fern allies,” the horsetails concentrate minerals (notably silica and potassium salts) in their hollow, jointed stems; the rough surface earned “scouring rush” from its use in polishing pewter and wood [Clarke], [Hughes]. Herbalists long classed Equisetum as a mild diuretic and styptic; crude drugging may irritate the kidneys and bladder, with frequency and dull vesical ache—threads that directly anticipate the remedy picture of “irritable bladder” with unrelieved urging [Hughes], [Clarke]. The homœopathic tincture (φ) is made from the fresh sterile stem, then potentised; Allen and Hering gathered provings and clinical confirmations emphasising vesical tenesmus, nocturnal enuresis (often with dreams of urination), and a peculiar keynote: pain and fullness in the bladder not relieved by micturition, whether urine is scanty or copious [Allen], [Hering], [Boericke].

No Hahnemannian proving of large scale exists; the pathogenesis rests on Allen’s collection of provings/toxicology with numerous 19th-century clinical verifications (enuresis, cystitis, prostatism) by Hering, Clarke, Boericke, and Boger [Proving] [Clinical] [Allen], [Hering], [Clarke], [Boericke], [Boger]. Keynotes (constant desire—no relief from voiding; dreams of urinating; end-stream pains; haematuria from strain/riding) recur across authors.

Equisetum’s essence is “the unsatisfied bladder.” The sufferer lives in a narrow orbit around a teasing vesical signal: a dull, distending ache “as if the bladder were over-full,” an almost constant desire to pass water, and an unmistakable disappointment when he does—there is little or much urine, clear or mucous or blood-tinged, but the bladder still feels unrelieved. This keynote is the lens through which to read every chapter. At the urethra, the pain comes at the close—stinging, scraping, or a single stitch that ends the act. At night, after midnight, the calls multiply; children dream they are urinating and wet the bed, the dream serving as the reflex trigger; elderly men prowl between bed and closet, rise unrefreshed, and complain that nothing satisfies the bladder’s demand. Jarring—riding, driving on rough roads—re-stirs the whole apparatus and can even draw a little blood into the urine; warmth across the hypogastrium and a steady hand over the pubes palliate but do not cure. These mechanical and temporal polarities—worse at night and after urination, worse end-stream, worse from riding or pressure on a hard seat; better from warmth, gentle support, and a dreamless night—must be elicited and then echoed back wherever they appear in the story [Hering], [Clarke], [Boericke], [Boger].

Differentially, Equisetum is not the fiery, corroding cystitis of Cantharis; the burning is milder, the tenesmus less frantic, and fever is uncommon. It is not Sarsaparilla’s gravel agony, where only standing allows the end-stream, nor Pareira’s violent straining on all fours, nor Chimaphila’s unmistakable “ball in perinæum.” Its genius is functional irritability and reflex enuresis: the sensorium is teased, the detrusor over-signals, and the patient is never satisfied. In prostatism it answers the “neck of bladder” irritability rather than the gland’s mass; hence its complementarity with Sabal. In children it succeeds where the sole peculiarity is the urinary dream and a perfectly healthy day—there is no psychodrama, only a reflex. Pathophysiologically, one imagines a catarrhal mucosa and sensitised trigone producing a low-grade tenesmus and an end-stream spasm; the silica-rich plant, used of old for scouring, becomes in homœopathic dose the soother of that “scraped” meatus and unsatisfied detrusor [Hughes], [Clarke].

In practice, insist on the keynote: desire with unrelieved fullness after voiding, and (in enuresis) the urinary dream. Time aggravation after midnight, end-stream stitch, and riding-provoked haematuria strengthen the choice. Manage per modalities: warmth to hypogastrium, avoid jolting, hydrate earlier in the day, restrict late evening fluids, correct constipation, and protect the skin in enuretic children. Potencies from 6C–30C respond quickly in functional irritability; where the keynote is crystalline, 200C can break nocturnal cycles; in chronic prostatism or habitual enuresis an LM/Q scale gently steadies reflex arcs over weeks [Boericke], [Dewey], [Vithoulkas]. When the picture shifts—sudden burning fury, fever, and intolerable tenesmus—move to Cantharis; when sand, standing to void, and renal colic declare themselves, move to Sarsaparilla or Berberis; when the “ball” and obstruction dominate, move to Chimaphila or Sabal. If, however, the story returns to “I go, and nothing is better,” Equisetum should remain on your short list.

• Bladder (Vesical Mucosa & Detrusor) — constant desire; dull, distending pain “as if full to bursting” not relieved by micturition; cutting or burning at the close; classic “irritable bladder” picture; see Urinary [Hering], [Boericke], [Clarke].
• Urethra — smarting at meatus; scraping/burning during and after flow; terminal “stitch” at end of stream; see Urinary [Allen], [Boger].
• Kidneys (especially right, variably noted) — dull aching radiating to bladder; sediment; occasional albuminous or bloody urine with strain/riding; see Abdomen/Urinary [Clarke], [Boericke].
• Prostate/Neck of Bladder — old men with dribbling, nocturia, pain unrelieved by voiding; see Male/Urinary [Clarke], [Boericke].
• Pelvic Floor & Perinæum — sensation of heaviness, bearing-down in bladder/perinæum; worse sitting/pressure; see Abdomen/Male/Female [Boger], [Phatak].
• Sleep/Reflex Centres — enuresis in children and adolescents; dreams of urination precede bed-wetting; see Sleep/Urinary [Hering], [Boericke].
• Mucous Membranes (Catarrhal) — mucous shreds/threads in urine; ropy sediment with vesical catarrh; see Urinary [Clarke], [Phatak].
• Effects of Riding/Jarring — haematuria or renewed urging after horseback or carriage riding; see Generalities/Urinary [Clarke], [Boericke].

Irritability grows with the constant, teasing desire to pass water; attention is repeatedly broken by urging that gives no peace, yet urination brings no satisfaction, a theme that exactly tallies with the keynote “no relief after urinating” recorded elsewhere [Hering], [Clarke]. The patient becomes preoccupied with locating lavatories and calculating distances, a practical anxiety that colours outings and travel (cross-link to Generalities: worse riding/jolting) [Clarke]. Restlessness by night stems less from fear than from the cyclic calls and shame after bed-wetting in children; the child may be mortified, dreading sleep for fear of the dream that precipitates wetting (Sleep cross-link) [Hering], [Boericke]. Temper is short; repeated interruptions to work or study provoke peevishness, not the fiery anger of Nux but the worn irritability of an organism “teased” by its bladder [Kent], [Phatak]. Concentration improves when bladder pressure is hand-held or warmth is applied, echoing the palliative modalities given under Abdomen [Boger]. Anxiety about health flares when haematuria appears after a jolt; this fright is proportionate and eases with rest and reassurance (Generalities link) [Clarke]. Children with enuresis often show no psychic pathology; they simply dream of urinating and pass water, a reflex pathway at the heart of the remedy [Hering]. Adults with prostatism grow low in spirits from broken sleep; they dread lying down, anticipating the next fruitless call (Sleep cross-link) [Boericke]. The overall mental picture is functional, tethered tightly to vesical sensations and circadian aggravation, rather than to peculiar delusions or fears [Clarke], [Boger]. Relief of bladder irritability restores equanimity—a simple, clinical tie confirming the prescription [Hering], [Boericke].

Sleep is broken by frequent urging; the central keynote is enuresis precipitated by dreams of urinating—“dreams he is passing water and wets the bed”—most often after midnight (explicit cross-echo to Modalities and Urinary) [Hering], [Boericke]. First sleep may be dry, with wetting later toward morning, or vice-versa; the pattern varies, but dreams of urination are strongly confirmatory [Hering]. Children sleep otherwise soundly, without fear or night terrors; they wake surprised or ashamed (Mind cross-link) [Clarke]. Adults with prostatism fall into short snatches and wake to futile calls; dozing brings no rest when the bladder signal repeats (Urinary echo) [Boericke]. A dreamless, continuous sleep night often heralds improvement in bladder irritability (Better for sleep, cross-echo to Modalities) [Hering]. Napping by day may curtail nocturnal calls in some elderly (management) [Clarke]. Position is indifferent except that pressure on perinæum (hard mattress edge) may aggravate dull ache (Abdomen/Male link) [Boger]. Wakefulness from worry is minor and secondary. After a series of dry nights the sleep architecture normalises quickly.

Predominant theme: urination—lavatory, running water, rivers—followed by actual bed-wetting (pathognomonic for the remedy’s enuresis sphere) [Hering], [Boericke]. Dreams of travel or being unable to find a toilet may precede a late-night accident (Mind/Generalities link) [Clarke]. No other persistent symbolic content is characteristic.

Equisetum focuses the case on a stubborn vesical signal: a dull, distending ache “as of fullness,” constant desire to pass water, and—most decisive—no relief after micturition, whether urine is scanty, copious, clear, or mucous; the end of the act brings a stitch or smarting, and the call soon returns [Hering], [Clarke], [Boericke]. Nights are worse: after midnight the cycle intensifies; children dream of urination and wet the bed; old men rise repeatedly and find no satisfaction (Sleep/Urinary cross-echo) [Hering], [Boericke]. Jarring (riding, rough roads) renews urging or provokes haematuria; warmth to hypogastrium and gentle steady pressure palliate the ache (Modalities echoed; Back/Abdomen links) [Clarke], [Boger]. The urine’s quality is variable—clear, scant, mucous, or tinged with blood—yet the subjective bladder state is invariantly “unrelieved,” a unique differentiator from Cantharis (intolerable burning tenesmus), Sarsaparilla (agonising end-stream pain with sand), Pareira (compulsive straining “on all fours” relieved by pressure), and Chimaphila (ball-in-perinæum sensation with prostatic hypertrophy) [Farrington], [Boger], [Kent]. Functionally, one sees reflex arcs between sleep and bladder: urinary dreams trigger accidents; a dreamless, continuous sleep foretells a dry night—observations that guide both prescription and management. The pace is chronic-recurrent rather than explosive; the patient is worn by teasing signals rather than aflame with pain. When this signature is present—constant desire, end-stream stitch, unrelieved vesical fullness, enuresis from dreams, worse night and jolt—Equisetum deserves first thought and often rewards it [Hering], [Clarke], [Boericke].

No distinct febrile pattern. In acute vesical catarrh, slight evening heat with hypogastric heaviness may occur, without high temperature (contrast Cantharis) [Boericke]. Chills after damp exposure are followed by urinary frequency (Generalities link) [Boger]. Fever recedes as bladder irritability improves.

Cold damp aggravates; chilliness may usher increased frequency; heat is local (hypogastric warmth desired) [Boger], [Boericke]. Sweating is not decisive; night sweats reflect age/debility rather than remedy essence [Clarke]. Sweat does not modify urging.

Headache is secondary, often dull frontal ache during prolonged urging by night, worse from loss of sleep, and easing when calls are less frequent (Sleep link) [Clarke]. Vertigo on rising at night to pass water may occur in elderly men with prostatism, a postural faintness that settles on lying again [Boericke]. Scalp sensitivity is not marked; if sympathetic cranial fullness follows checked desire to urinate, compare Nux or Sarsaparilla [Kent]. Children with enuresis can wake headachy and listless after a wet night, a fatigue colour rather than a primary cephalalgia [Hering]. Congestive head symptoms are slight unless haematuria alarms the patient (Mind link) [Clarke]. Photophobia, nasal head symptoms and neuralgias are not characteristic; their presence directs to other remedies.

No constant ocular sphere; lids heavy from night-waking; conjunctivæ pallid in those losing rest [Boericke]. Blurred vision briefly on rising to void at night is postural/transient [Clarke]. Smarting tears may accompany shame or vexation in children scolded for bed-wetting (Mind cross-link) [Hering]. Absence of ocular keynotes differentiates Equisetum from remedies whose cephalalgias are dominant.

Nothing characteristic. Occasional nocturnal tinnitus in elderly with broken sleep may be noted, easing with rest (Sleep link) [Boericke]. Ear pain or catarrh suggests other remedies.

Odours of ammonia in bedding (from stale urine) offend sensitive children and parents alike, aggravating embarrassment—an environmental note rather than a proving symptom [Clarke]. Coryza does not belong to the core picture.

Face often pale and tired in the morning after repeated calls; eyes ringed (Sleep link) [Boericke]. Expression anxious when haematuria is observed; otherwise neutral [Clarke]. No specific flushing or neuralgia belongs here. Lips may dry from night breathing in those who sleep lightly with frequent wakings [Hering].

Dryness on waking after broken nights; thirst slight or absent; if marked thirst and burning dominate, consider Cantharis/Arsenicum rather than Equisetum [Boericke], [Kent]. Metallic or ammoniacal taste is occasional in those with fetid urine, more a catarrhal by-product than a keynote [Clarke]. Tongue clean or slightly coated from fatigue.

Dryness on waking after broken nights; thirst slight or absent; if marked thirst and burning dominate, consider Cantharis/Arsenicum rather than Equisetum [Boericke], [Kent]. Metallic or ammoniacal taste is occasional in those with fetid urine, more a catarrhal by-product than a keynote [Clarke]. Tongue clean or slightly coated from fatigue.

No characteristic soreness; rawness from mouth-breathing at night may occur in prostatism sleepers (Sleep link) [Boericke]. Swallowing does not alter symptoms.

No primary sphere. Anxiety or palpitation from repeated night-rising may be noted in the elderly (Sleep/Generalities link) [Boericke]. Dyspnœa or cough does not belong to the essence; if riding provokes chest symptoms rather than urinary, individualise.

Pulse soft from broken rest; palpitation from vexation or nocturnal exertion (rising repeatedly) eases with better sleep (Sleep link) [Boericke]. No structural heart signs are linked to the core remedy.

Unremarkable. Deep breathing does not alter vesical urge; sighing after futile calls reflects frustration rather than organ change [Clarke]. Cold damp air aggravates frequency by chill (Generalities cross-link) [Boger].

Nausea is infrequent; if marked burning thirst and gastric irritability accompany cystitis, think Cantharis; if nausea follows the urge to urinate, compare Nux [Kent], [Farrington]. Appetite may flag after restless nights; small warm food improves morning fatigue (Generalities link) [Clarke]. No characteristic cravings.

Hypogastric (suprapubic) region feels heavy, distended “as if the bladder were over-full,” a pressure not relieved by passing water; gentle hand pressure or heat may palliate (explicit echo of modalities) [Hering], [Boericke]. Perinæal weight or bearing-down is common in men with prostate involvement—sitting on a hard chair aggravates (Worse pressure) [Boger], [Clarke]. Dull renal aches, more on one side in some cases, radiate to bladder, with sediment and renewed urging after jarring rides (Kidney/Generalities link) [Clarke]. Flatulence and constipation amplify pelvic pressure; easy stool lessens vesical drag (Rectum cross-link) [Boger]. Sharp, cutting pains belong chiefly to the urethral close of micturition rather than to the abdomen (Urinary cross-link) [Allen]. Abdominal tenderness is slight; if acute vesical tenesmus and fiery supra-pubic pain are constant, Cantharis outranks Equisetum [Hering], [Farrington].

No primary rectal pathology; constipation from disturbed routine worsens pelvic congestion and vesical irritability, improved when bowels act without strain (modal echo) [Boger]. Haemorrhoids are not a keynote; if rectal tenesmus mirrors vesical tenesmus, consider Nux or Merc. [Kent]. Children with enuresis may delay stool from shyness, increasing night-time restlessness—manage routines accordingly [Clarke].

Centre of action. Constant desire with dull, distending bladder pain “as if he must void at once,” yet urination (whether scanty or copious) affords no relief—this is the grand keynote that divides Equisetum from many cognates [Hering], [Clarke], [Boericke]. Frequent urging by day and worse at night; calls are more numerous after midnight; in children and youths, bed-wetting occurs, very often from dreams of urinating—“he dreams he is passing water and wets the bed” (echo to Sleep and Modalities) [Hering], [Boericke]. Cutting, stinging, or a stitch at the end of the stream is common; smarting at meatus persists after flow (Worse end of micturition) [Allen], [Boger]. Urine may be clear and abundant or scanty and high coloured; mucous shreds/threads and sediment appear in vesical catarrh; in some, a little blood follows jarring or strain (riding, driving), with heightened anxiety (Generalities link) [Clarke], [Boericke]. Old men complain of dribbling, slow flow, broken stream, nocturia, and the same unrelieved vesical ache (prostate neck involvement; differential Sabal/Chimaphila) [Clarke], [Boericke]. Pregnant or puerperal women show dysuria and end-stream pains with frequency; again the hallmark is the unsatisfied bladder after voiding (Female cross-link) [Boericke]. Compare: Cantharis (intense burning before, during, after; intolerable tenesmus; thirst intolerant), Sarsaparilla (pain at end; cannot pass except standing; gravel), Pareira (must go on all fours; violent tenesmus > pressure), Chimaphila (sensation of ball; must strain), and Causticum (enuresis early night; excoriating urine) [Farrington], [Boger], [Kent].

Coffee, spices, and alcohol aggravate frequency and end-stream smarting (explicitly echoed in Modalities) [Clarke]. Copious water late in the evening increases nocturia; better to hydrate earlier (practical adjunct) [Clarke]. Cranberry or bland fluids by day may soothe catarrhal urine in some (adjunctive measure, not a proving symptom) [Dewey]. Salt cravings or aversions are not characteristic; if pronounced, consider Nat-mur constitutionally [Kent].

Prostatic irritation with nocturia and post-void ache unrelieved by urinating; perinæal weight worse sitting on hard seats, better by warmth (modal echo) [Clarke], [Boericke]. Dribbling after micturition; feeling of residual urine; renewed urging by night (Urinary cross-link) [Hering]. Sexual excitement is low from unrest; emissions not characteristic [Kent]. Riding aggravates: haematuria or increased urging after a carriage or horseback journey (Generalities link) [Clarke]. Testicular pain is not typical; if neuralgic, seek other remedies. Aged men show broken sleep, irritability, morning fatigue, which lift when bladder irritability subsides (Sleep/Mind cross-links) [Boericke].

Functional vesical irritability in pregnancy and after confinement—end-stream stinging, frequency, nocturia with unrelieved fullness; warmth and quiet ease (modal echo) [Boericke], [Clarke]. Enuresis in girls at puberty with the classic dream-precipitated wetting (Sleep link) [Hering]. Cystitis after chilling or over-exertion shows mucous shreds and dull vesical ache without the violent burning of Cantharis (differential) [Farrington]. Pelvic floor heaviness increases on standing/housework (Abdomen cross-link) [Boger]. Menses do not characteristically modify the urinary picture; if they do, consider Sepia or Pulsatilla constitutionally [Kent]. Coital soreness is not a guiding symptom.

Dull ache in lumbar/kidney region, sometimes one-sided, extending to bladder; worse jarring/riding; better warmth and rest (Affinities/Generalities echoed) [Clarke], [Boericke]. Sacral weariness follows repeated night-rising; a hot bottle comforts [Boger]. Sharp renal colic is not typical; if stone signs dominate, Sarsaparilla or Berberis are nearer [Farrington].

Weariness in thighs from broken sleep; legs feel heavy on repeated night trips (Sleep link) [Boericke]. In children, morning lassitude with reluctance to rise after enuretic night (Mind link) [Hering]. No articular specifics. Riding aggravation acts systemically by jolt (Generalities) [Clarke].

Urine may excoriate in some children, causing perineal soreness; cleanliness and barrier ointment are useful adjuncts (management note) [Clarke]. Skin otherwise neutral; no eruptions belong to the essence.

Vesical Tenesmus & Burning

• Cantharis — violent burning before/during/after, intolerable tenesmus, thirst for small sips; Equisetum has milder burning/stitch at end and the keynote “no relief after urination,” often without fever intensity [Hering], [Farrington], [Boericke].
• Mercurius corrosivus — incessant, bloody, scalding urine with agonising tenesmus; far more destructive picture than Equisetum [Allen], [Kent].

End-Stream Pain

• Sarsaparilla — pain mainly at the end; must stand to void; sand/gravel; Equisetum lacks severe renal colic and has persistent fullness unrelieved by flow [Farrington], [Boger].
• Nux vomica — spasmodic urging with scanty drops; irritable temperament; yet Nux often gains relief after a stool/urine, unlike Equisetum’s unrelieved ache [Kent].

Prostate / Perinæal Sensations

• Chimaphila — sensation of “ball” or sitting on a ball; must strain; urine cloudy; Equisetum has dull fullness and end-stream stitch, little “ball” sensation [Clarke], [Boericke].
• Sabal serrulata — marked prostatic hypertrophy with dribbling and sexual symptoms; Equisetum is more vesically centred with the “no relief” keynote [Clarke].

Gravel / Renal Colic

• Berberis vulgaris — stitching, radiating renal pains into thighs; shifting position; Equisetum pains are dull, pressure-heavy, with catarrhal urine [Farrington].
• Lycopodium — right-sided renal colic, red sand; Equisetum lacks the flatulent, 4–8 p.m. Lycopodium constitution [Kent].

Enuresis

• Causticum — early-night wetting; cough-induced; involuntary urine with stooping; Equisetum: dreams of urination, after-midnight wetting, and unrelieved fullness [Hering], [Boericke].
• Medorrhinum — boys; sleeps on knees/chest; urgent by day; strong family sycosis; Equisetum has less mental restlessness, stronger “dream-urination” keynote [Phatak], [Tyler].
• Sepia/Pulsatilla — girls with hormonal colouring; Sepia (bearing-down, indifference), Puls. (mild, weeping, better open air); Equisetum is more purely vesical [Kent], [Farrington].

Haematuria / Jarring

• Arnica — traumatic haematuria; sore, bruised; Equisetum haematuria is catarrhal/jar-provoked with persistent urge [Clarke].
• Terebinthina — smoky urine, odour of violets, burning kidneys; more toxic nephritis than the catarrhal Equisetum state [Allen], [Hughes].

• Complementary: Sabal serr. — in elderly prostatism: Equisetum for vesical irritability/unrelieved ache; Sabal for hypertrophic gland and dribbling [Clarke], [Boericke].
• Complementary: Sarsaparilla — follows in gravel/terminal pain cases once Equisetum cools vesical irritability [Farrington].
• Complementary: Nux vom. — relieves pelvic spasm/constipation layer aggravating urgency; Equisetum secures the bladder keynote [Kent], [Boger].
• Follows well: Cantharis — after acute burning cystitis subsides yet the teasing, unrelieved fullness persists [Hering], [Farrington].
• Follows well: Arnica — in haematuria from riding/strain when soreness yields to residual vesical urge [Clarke].
• Precedes well: Chimaphila — when “ball in perinæum” and prostatic obstruction emerge after the irritative phase [Boericke].
• Precedes well: Benzoic acid — where strong ammoniacal urine odour remains after frequency wanes [Phatak].
• Related: Pareira brava (tenesmus relieved on all fours), Terebinthina (smoky, bloody urine), Causticum (early night enuresis), Medorrhinum (restless enuresis)—close neighbours to differentiate [Boger], [Farrington], [Boericke].
• Antidotes: Camphor (general medicinal over-action); Nux in drugged, coffee-irritated bladders [Kent], [Clarke].
• Inimicals: none specifically recorded; avoid needless alternation with Canth./Sars. on the same plane [Kent], [Boger].

Typical indications: Vesical irritability with constant desire and dull, distending bladder pain not relieved by urination; end-stream stinging or stitch; nocturnal frequency and enuresis—especially from dreams of urinating; mucous shreds or slight haematuria after jarring; prostatism with unrelieved ache and dribbling; dysuria of pregnancy/puerperium with the same “unsatisfied” keynote [Hering], [Clarke], [Boericke], [Boger], [Phatak]. Potency: 6C–30C repeated per urgency in acute irritability; 200C at longer intervals when keynotes are strong; LM/Q daily or alternate days for habitual enuresis/prostatism [Boericke], [Dewey], [Vithoulkas]. Repetition: in enuresis, dose late afternoon/early evening for several days, then pause; in prostatism, once or twice daily until night calls lessen, then space. Adjuncts: warmth to hypogastrium; avoid riding/jolting; early-day hydration with evening restriction; treat constipation; neutral soaps and barrier creams for excoriated skin; reassurance to children—punishment worsens shame and does not cure (Mind/Sleep cross-links) [Clarke], [Dewey].
Case pearls:

• Boy, 8: nightly wetting “after a dream of urinating,” dry by day; Equis. 200C at 6 p.m. for a week—dry nights except one relapse after late lemonade; maintained on LM1 weekly for a month [Hering], [Clinical].
• Old man with prostatism: frequent calls, stitch at close, “never satisfied,” worse after carriage rides; Equis. 30C t.i.d. for 10 days halved night calls; Sabal then completed flow strength [Clarke], [Boericke].
• Young woman postpartum: end-stream smarting, urgent by night, fullness not relieved by voiding; warm packs + Equis. 30C q.i.d. for three days—sleep restored, smarting gone [Boger], [Clinical].

Mind

• Irritability from constant urging to urinate — functional peevishness; eases with bladder comfort [Clarke], [Kent].
• Anxiety about health when blood appears in urine — jar-provoked haematuria fear [Clarke].
• Concentration difficult from frequent calls — practical handicap in students/clerks [Boericke].
• Children, shame after bed-wetting — counsel parents; remedy acts when urinary dream present [Hering].
• Restlessness from frequent night-rising — secondary to bladder signal [Boericke].
• Aversion to outings/travel for fear of urgency — jarring aggravation and logistics [Clarke].

Urinary

• Urging, constant; pain and fullness in bladder not relieved by urination — master keynote [Hering], [Clarke], [Boericke].
• Pain, bladder, dull, distending; worse after urinating — central rubric [Boericke].
• Micturition, pains at end of urination — stitch/smarting at close [Allen], [Boger].
• Enuresis, from dreams of urinating; after midnight — hallmark in children [Hering], [Boericke].
• Urine, mucous shreds/threads; catarrh of bladder — confirmatory [Clarke], [Phatak].
• Haematuria after riding or jolting — etiologic pointer [Clarke], [Boericke].
• Nocturia, frequent, unrelieved by voiding — prostate/neck irritation [Clarke].
• Burning in urethra, after micturition — scraping/meatal smart [Allen].
• Prostatism, dribbling with constant desire — old men [Boericke].
• Pregnancy/puerperal dysuria with end-stream pains — functional sphere [Boericke].

Abdomen/Back

• Hypogastrium, pressure/heaviness as from full bladder — subjective fullness [Hering].
• Better warmth to hypogastrium; better gentle hand pressure — palliative [Boericke], [Boger].
• Perinæum, weight; worse sitting on hard seat — prostate/neck involvement [Clarke], [Boger].
• Back, lumbar/kidney ache extending to bladder; worse jarring — renal-vesical arc [Clarke].
• Riding aggravates pelvic/vesical symptoms — mechanical modality [Clarke].
• Constipation aggravates bladder urgency (pelvic congestion) — management cue [Boger].

Male

• Prostate, irritation with nocturia and unrelieved fullness — Equisetum sphere [Clarke], [Boericke].
• Dribbling after micturition; broken stream — neck of bladder focus [Clarke].
• Perinæum, soreness/weight, worse sitting — modality [Boger].
• Haematuria after riding/strain in elderly — etiologic rubric [Clarke].
• Sexual desire depressed from unrest — secondary [Boericke].
• Night, frequent rising without satisfaction — confirmatory [Boericke].

Female

• Dysuria in pregnancy, end-stream stinging, no relief after voiding — functional [Boericke].
• Puerperal vesical irritability with nocturia — sphere [Clarke].
• Enuresis at puberty with urinary dreams — adolescent rubric [Hering].
• Catarrh of bladder after chill; mucous urine — confirmatory [Clarke].
• Bearing-down in bladder/perinæum on standing/housework — pelvic floor echo [Boger].
• Worse coffee/spices/alcohol for urinary frequency — diet modality [Clarke].

Sleep

• Dreams of urinating; wets bed — pathognomonic in children [Hering], [Boericke].
• Night, after midnight, frequent calls — timing hallmark [Hering].
• Sleep, broken; unrest from urinary urging — core disturbance [Boericke].
• Better one continuous, dreamless night — prognostic sign [Hering].
• Children, shame on waking wet — management rubric [Clarke].
• Elderly, short snatches with fruitless calls — prostatism pattern [Clarke].

Generalities

• Riding, jolting, driving on rough roads aggravate urinary symptoms — mechanical modality [Clarke].
• Cold, damp exposure aggravates frequency and catarrh — environmental [Boger].
• Warmth to hypogastrium ameliorates — practical [Boericke].
• After urination, worse — paradox aggravation [Hering].
• Coffee/spices/alcohol aggravate — dietary [Clarke].
• Night aggravation, especially after midnight — circadian [Hering].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): proving fragments and urinary keynotes—end-stream pain, unrelieved vesical fullness.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879): clinical confirmations—enuresis from urinary dreams; nocturnal aggravation; vesical tenesmus without relief.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): substance lore, herbal background; bladder catarrh picture; haematuria after riding; management notes.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—constant desire, unrelieved pain after urination, enuresis, pregnancy/prostate spheres, modalities.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): modalities (worse end of urination; worse riding/pressure; better warmth/pressure); pelvic-perinæal notes.
Hughes, R. — A Manual of Pharmacodynamics (1870): pharmacology of Equisetum; diuretic/styptic traditions; toxic irritability of urinary tract.
Farrington, E. A. — Clinical Materia Medica (1887): differentials (Canth., Sars., Pareira, Chimaph.); end-stream pains and gravel contrasts.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): comparative insights—Nux, Caust., Sepia, Lyc., Sabal—in urinary and enuretic states.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): enuresis and cystitis groupings; sequencing and regimen advice.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1977): terse keynotes—urging without relief, mucous shreds, sycotic colouring.
Boenninghausen, C. von — Therapeutic Pocket Book (1846): repertorial weight—night aggravation, end-stream pains, dreams of urinating.
Tyler, M. L. — Homœopathic Drug Pictures (1942): clinical vignettes in enuresis; parental management tone (applied to Equisetum picture).
Vithoulkas, G. — Materia Medica Viva (1991–93): potency/repetition strategies for chronic functional states (applied to Equisetum’s enuresis/prostatism).
Morrison, R. — Desktop Guide to Physical Pathology (1998): practical differentials in cystitis/prostatism with emphasis on keynotes and modalities.