Erythroxylon coca

Dried leaves of Erythroxylon coca, native to the Andes, traditionally chewed by high-altitude peoples for relief of fatigue, hunger, and breathlessness. The leaves contain a complex of tropane alkaloids (notably cocaine) which in crude or concentrated form produce stimulation, mental exhilaration, insomnia, tachycardia, vasoconstriction, local anaesthesia, and, in toxic states, anxiety, illusions and subsequent depression ([Toxicology]). Hahnemann did not prove Coca; doctrine developed through later experimenters and clinical observers, notably Hale (New Remedies), with pathogenetic fragments and many clinical confirmations in mountain sickness, exertional dyspnœa, cardiac weakness on ascending, and laryngeal fatigue of speakers/singers. The homœopathic preparation is made from the leaf tincture potentised to higher attenuations. [Hughes], [Hering], [Allen], [Clarke], [Hale], [Boericke]

No Hahnemannian proving. Clinical materia from Hale (New Remedies), Allen (Encyclopædia), Hughes (Pathogenesy) and Clarke collates provings/toxicology with many [Clinical] reports: mountain sickness, exertional dyspnœa, palpitation on ascending, insomnia/high-altitude wakefulness, headache from heights, and voice fatigue in singers. [Hale], [Allen], [Hughes], [Clarke], [Hering], [Boericke]

Coca is the remedy of ascent—physical and mental. Its essence is a paradox: the patient craves air and space, feels brisk and able, yet when the air becomes too thin or the task demands ascent, the system over-revs—pulse races, breath shortens, head throbs, space distorts, and the night refuses sleep. This is not the poisoned fear of Aconite, nor the collapsing asphyxia of Carbo veg.; it is the over-driven engine running on exaltation until oxygen debt calls the debt due (Mind/Heart/Respiration). The Coca individual plans optimistically, judges distances shorter, and feels light and capable; then a staircase, a hill, or thin, warm room air spins him into palpitation and air-hunger (Mind ↔ 10b ascending/warm rooms). At night in the high country he lies bright-eyed, counting breaths, sighing; in the morning he is irritable, tremulous, and afraid of stairs he would have scoffed at the day before (Sleep/Generalities). Relief is delightfully simple and diagnostic: descend, loosen, quiet, and breathe steadily—or walk level under ordinary open air—and within minutes the head clears, pulse steadies, and space rights itself (10a; Head/Heart/Eyes).

Kingdom-wise, within the stimulant plants, Coca joins Coffea/Guarana/Kola yet separates by its altitude signature and its practical, performance-centred psychology; where Cannabis wanders through vast inner landscapes, Coca keeps eyes on the trail and only loses footing when air thins (Differentials). Miasmatically, tubercular hues dominate: a restless drive, chest weakness, a love of air and movement, and quick swings between buoyancy and fatigue; psora supplies the functional plane—no deep lesions, but tone problems; sycosis peeps out as periodic stimulant use and over-work (Miasm). Clinically, Coca’s sphere is wide wherever thin air or forced ascent meets over-keyed nerves—travellers, skiers, mountaineers, singers touring high towns, sedentary visitors to uplands, the elderly with exertional breathlessness whose hearts race rather than fail. When the case is Coca, management and remedy cohere: descend or level off, air the room, walk slowly, head high, small warm sips, no stimulants, quiet mind, and dose; the patient’s own report—“Stairs don’t scare me now; I slept; my head is clear”—signals the remedy has met its mark. [Hale], [Clarke], [Allen], [Farrington], [Boger], [Kent], [Boericke]

• Altitude physiology / Oxygen debt. Classical for mountain sickness: headache, giddiness, insomnia, dyspnœa and palpitation from ascending; notable relief on descending or after rest with steady deep breathing (see Head/Respiration/Heart). [Hale], [Clarke], [Boericke]
• Heart & great vessels. Palpitation, irregular action, precordial oppression and faintness on ascending stairs or hills; heart feels over-driven by trivial effort, improves with gentle walking level/down (see Heart/Generalities). [Allen], [Clarke], [Farrington]
• Respiration. Short breath on ascending, desire for deep inspirations, sighing, and air-hunger at heights; open air generally grateful but high rarefied air aggravates (see Respiration/Chest). [Hale], [Boericke], [Clarke]
• Brain & senses. Exaltation, sharpened senses, illusions of distance/size, followed by mental fatigue and sleeplessness; vertigo from looking down from a height (see Mind/Eyes/Head). [Hughes], [Allen], [Clarke]
• Larynx/voice. Voice fatigue of speakers/singers; aphonia from overuse with chest/altitude weakness (see Throat/Chest). [Hale], [Boericke]
• Sleep centre / circadian. Insomnia with racing thoughts (especially at altitude); sleep restores if gained after descent (see Sleep). [Clarke], [Allen]
• Digestive tone. Loss of appetite, nausea or emptiness with altitude/over-work; coca’s traditional use to blunt hunger mirrors the proving trend (see Stomach). [Hale], [Clarke]
• Motor stamina. Lassitude and limb heaviness on ascent; legs tire and tremble, better level walking or after rest (see Extremities). [Allen], [Boger]

Coca’s mental picture begins with exaltation—a bright, buoyant confidence, rapid flow of ideas, and an impression of increased power; tasks seem easy, distances short, and obstacles minor ([Toxicology]/[Clinical]) [Hughes], [Allen], [Clarke]. This cheer is fragile: under altitude or over-exertion it flips into irritable fatigue, inability to fix attention, and insomnia, confirming the exaltation → exhaustion arc (Mind ↔ 10b excitement; Sleep) [Clarke], [Hale]. There is fearlessness at first about heights or efforts, followed by apprehension after a spell of palpitations or a night without sleep (Mind ↔ Heart/Sleep) [Allen]. Sensory impressions are intensified; some report illusions of space—objects appear farther or larger, and distances misjudged (Mind ↔ Eyes/10b looking down) [Hughes], [Clarke]. He grows impatient of close, warm rooms, craves the open air, yet paradoxically high, rarefied air aggravates—the key paradox of Coca (Mind ↔ 10a/10b; Generalities) [Clarke]. Mood swings from sanguine to flat, rarely sinking into deep melancholy as in Aurum, nor becoming reckless like Cannabis indica; Coca is practical, focused on performance and stamina [Kent], [Farrington]. Anxiety is somatic—concern about heart and breath—more than moral; reassurance improves once pulse and breath settle (Mind ↔ Heart/Respiration). After sleepless altitude nights, he is oversensitive to noise and talk, wishes to be left quiet, and counts stairs with dread (Mind ↔ Sleep/10b ascending). Improvement in the case is measured by stable mood, accurate distance-judgment, and the return of restful sleep at altitude or better, below it. [Clarke], [Hughes], [Allen], [Hale]

Sleeplessness is characteristic at altitude: the mind is too awake, ideas race, heart flutters, breath unsatisfying, with repeated sighs (Sleep ↔ Mind/Heart/Respiration) [Clarke], [Allen]. The patient seeks open windows, yet a cold wind may not help; true relief follows descent or stable deep breathing in ordinary air (10a). Short dozes end in startle; a single calm voice and dim light soothe better than multiple attentions (environmental management). On lower ground, sleep returns, dreams fade, and morning finds clear head and easy breath—a prime clinical outcome marker. [Hale], [Clarke]

Vivid, brilliant-coloured dreams of mountains, flying, or long distances; at times unrestful dreams of hurry and unfinished tasks, mirroring the day’s exaltation (Dreams ↔ Mind) [Allen], [Clarke]. Nightmare with air-hunger occurs at heights; ceases on descent. [Clarke]

Coca is the remedy of altitude and ascent: ascending (stairs, hills, mountains) brings air-hunger, palpitation, frontal headache, vertigo from looking down, and insomnia; descending, quiet, and deep breathing in ordinary open air quickly restore (Generalities ↔ Modalities) [Hale], [Clarke], [Boericke]. The global polarity is exaltation vs. exhaustion—mental buoyancy and sensory brightness flip into fatigue, irritability, and wakefulness when the system is over-driven. The chest/heart are functionally weak for thin air rather than structurally diseased; thus Coca suits travellers, singers, speakers, sedentary people suddenly climbing, and elderly with exertional dyspnœa who improve by rest, descent, and level walking. It is worse from ascending, talking/singing long, warm close rooms, night at altitude, mental excitement, alcohol/coffee; better from descending, rest with deep steady breaths, open ordinary air, head high, small warm sips, and loose clothing. Cure shows as quiet nights, confidence about stairs, clear head, sure footing, and voice stamina at normal elevations. [Clarke], [Hale], [Allen], [Boericke], [Farrington], [Boger]

No high fever picture; slight evening heat with head-flush and palpitation at altitude, cooling after rest and air. Chilliness occurs in the limbs especially hands/feet. [Clarke], [Allen]

Hot head, cool extremities during exaltation; sweat from little effort in thin air; chill on stopping when pulse drops (Chill/Heat ↔ Heart). Relief follows equilibrated breathing and descent. [Clarke], [Allen]

A frontal, band-like or occipito-frontal headache attends mountain sickness, worse ascending or after looking down from heights, better descending, open ordinary air, and rest with deep breathing (Head ↔ 10a/10b; Affinity Altitude) [Hale], [Clarke], [Boericke]. The ache often throbs with palpitation, suggesting a cardio-vascular driver; tight collars aggravate (Head ↔ Heart/10b pressure). Vertigo is notable, with a sense that space tilts or the ground recedes, especially at edges or on scaffolds (Head ↔ Mind/Eyes) [Allen], [Clarke]. The scalp may feel tight; a few have flushes to the face and a hot head with cool hands, an altitude vaso-motor split (Head ↔ Chill/Heat) [Clarke]. Headache is not the congestive blaze of Glonoinum, nor the drooping heaviness of Gelsemium; Coca’s headache is the effort-altitude type with air-hunger and palpitation (differential) [Farrington]. After descent or quiet level walking, the head clears rapidly—another Coca hallmark (Head ↔ 10a gentle exercise). [Clarke], [Hale]

Vision is sharpened at first, then distorted: objects seem larger or farther, colours brighter, and flickers appear on fatigue (Eyes ↔ Mind) [Hughes], [Allen]. Vertigo is precipitated by looking down from heights; horizon appears unstable. Photophobia is mild; glare annoys when the pulse races. Retinal hyperæmia with fullness at altitude has been recorded; rest and descent relieve (Eyes ↔ 10a/10b) [Clarke]. Reading at heights tires quickly; letters swim with palpitation. Distinguish Cannabis ind. (space/time illusions with dreamy euphoria) from Coca (performance-driven exaltation with breath/heart axis). [Farrington], [Clarke]

Humming or subtle tinnitus accompanies circulatory exaltation, subsiding with rest; ears feel full in rarefied air (Ears ↔ Heart). Sounds may seem louder after a bad night, betraying nervous over-tone. Not an otorrhœa drug; the ear signs are vascular and functional. [Allen], [Clarke], [Hughes]

Dryness of posterior nares at altitude; occasional epistaxis with exertion—small streaks on blowing (Nose ↔ Altitude) [Clarke], [Hale]. Smell is perverted when over-stimulated; close, hot rooms bring stuffiness that aggravates the head and breath (Nose ↔ 10b warm rooms). Relief follows cool ordinary air and quiet (10a). [Clarke], [Boger]

Looks flushed during exaltation, then pale with exhaustion; lips dry at altitude, craving small warm sips (Face ↔ Food & Drink) [Clarke]. Expression is eager, then worn; bluish tint not typical (contrast Carbo veg.). Sweat is slight on the face; tight bands round the neck aggravate both headache and palpitation. [Boericke], [Allen]

Dry mouth with little thirst in the exalted phase; after long exertion thirst returns for small warm drinks (Mouth ↔ 10a) [Hale], [Clarke]. Taste flat; hunger absent (traditional coca effect). Tongue generally clean; some report tremulous tongue when palpitating. No mercurial ptyalism picture. [Allen], [Hughes]

No decided dental sphere; jaw tension in the over-driven has been noted, easing as the heart settles. Tooth pain, when present, tracks pulse and vanishes on rest/air. Choose other remedies for true dental pathology. [Allen], [Clarke]

Dry, raspy fauces in thin air; frequent clearing without much mucus (Throat ↔ 10b singing/talking). Larynx tires—voice weakens or fails in speakers/singers, particularly on ascending or in over-heated rooms (Throat ↔ 10b warm rooms) [Hale], [Boericke]. Cool, ordinary air and brief rests restore the timbre (10a). [Clarke]

Sense of oppression across the upper chest, especially over the sternum, with craving to expand and draw long breaths (Chest ↔ Respiration) [Clarke], [Boericke]. Talking aggravates; quiet, supported posture helps (10a). The chest is not catarrhal but mechanically short of air; down-gradient walking restores comfort swiftly. [Hale], [Farrington]

Palpitation with irregular, sometimes forcible beats after ascending, singing, or mental excitement; a moment of faintness may supervene (Heart ↔ 10b ascending) [Allen], [Clarke]. The Coca heart is over-spurred, not failing like Digitalis; it quiets with rest, cool ordinary air, and head high (10a) [Farrington], [Boericke]. Anxiety is second-hand—fear of another stair-episode; reassurance follows a calm hour. [Clarke]

Short breath on ascending is the grand keynote; patient sighs and draws deep inspirations, yet feels unsatisfied in thin air (Respiration ↔ 9 Affinity) [Hale], [Clarke]. Talking and haste aggravate; quiet sitting, loosening dress, and deep breathing help (10a/10b). Unlike Arsenicum, restlessness here is physical (seek air), not a fear of death; unlike Carbo veg., there is no collapse or desire for fanning to extremes. Breath becomes free again on descending or after a level walk. [Farrington], [Boericke]

Appetite gone; emptiness without desire; nausea may rise with headache at altitude and effort (Stomach ↔ Head/10b ascending) [Hale], [Clarke]. Small warm sips steady the stomach; heavy meals before climbing provoke distress (10a/10b). The Coca subject works on “nothing”—a risk sign of over-driven nerves. Not a diarrhœa remedy; rather, a gastric atony under strain. [Dewey], [Allen]

Light gassing and sinking at epigastrium during exaltation; settles with rest. No specific hepatic or colic signature; the abdominal sphere mirrors circulatory swings. Belts too tight oppress both stomach and breath (Abdomen ↔ 10b pressure). [Clarke], [Boger]

Tendency to constipation during travel at altitude; stool resumes on returning below. No tenesmus or bleeding rubric central to Coca. Gentle walking and warm drinks help. [Allen], [Clarke]

Slight scantiness at altitude with sweat withheld; free urination on descent and rest. Palpitation phases may bring frequent small urges. No urethral pathology typical. [Allen], [Clarke]

Loss of appetite with capacity to work on little is typical (traditional coca effect) [Hale], [Clarke]. Alcohol/coffee aggravate palpitation and sleeplessness in the sensitive (Food ↔ 10b) [Dewey], [Hughes]. Small warm sips comfort; heavy meals before climbing worse. [Clarke]

Desire may be exalted transiently with the general stimulation, yet fatigue follows and desire flags—another exaltation → depression arc (Male ↔ Mind) [Hughes], [Allen]. Over-strain worsens erectile stamina next day; recovery follows sleep and descent. Coca is not primarily venereal; select by heart–breath–altitude cluster. [Clarke], [Boericke]

Palpitation and breathlessness on ascending during menses are noted; the voice may tire more easily than usual (Female ↔ Throat/Heart) [Clarke]. Milk-white pallor replaces the initial flush after a bad night aloft. Menstrual timing may alter after mountain travel—functional, not structural. [Hale]

Between scapulæ a tired stretch appears after climbing; dorsal muscles ache from short breath and voice work. Leaning back eases; tight straps across chest/shoulders aggravate (Back ↔ 10b pressure). Not a coccyx remedy; the back pain is postural/exertional and abates with breath recovery. [Clarke], [Allen]

Limb heaviness and tremulous fatigue on ascent; legs stiffen on stairs and recover on level or down (Extremities ↔ 10a/10b) [Allen], [Boger]. Calves may cramp at altitude nights; warmth and quiet relieve. Hands are cool when head is hot—vaso-motor split of altitude. [Clarke]

Skin is cool and dry during exaltation; face may flush; sweat appears easily on climbing but does not relieve until pulse is quiet (Skin ↔ Perspiration). No distinctive eruption. [Allen], [Clarke]

Altitude / Ascent dyspnœa & palpitations

• Carbo vegetabilis — Air-starved collapse, wants fanning; bluish, cold, exhausted. Coca is exaltation → dyspnœa with quick recovery on descent (no collapse). [Farrington], [Clarke]
• Arsenicum album — Restless, anxious, burning, midnight aggravation; dyspnœa even at rest. Coca: effort/altitude-centred, less fear-of-death. [Kent], [Farrington]
• Digitalis — Slow, weak pulse; dread of movement; cardiac failure. Coca: over-spurred heart that steadies with rest; pulse not characteristically slow. [Farrington], [Clarke]
• Strophanthus — Failing compensation on effort; cardiac muscle remedy. Use when Coca’s altitude paradox is absent and true heart failure dominates. [Clarke]
• Calcarea carbonica — Fat, chilly, sweat on head; breathless ascending stairs from constitutional weakness. Coca lacks Calc’s chilly, flabby constitution; has altitude keynote. [Kent], [Boger]
• Stannum — Extreme weakness on ascending, especially in chest/voice, better pressing chest. Similar “ascent weakness,” but Coca has altitude/insomnia/space illusions. [Farrington], [Clarke]
• Gelsemium — Dull, drowsy, drooping headaches; altitude headaches in some; but Coca is bright → sleepless, not dull → sleeping. [Clarke], [Hale]
• Glonoinum — Congestive, throbbing head from sun/heat, also altitude in trains; face red, carotids bound. Coca: less violent congestion; breath/heart lead. [Farrington], [Clarke]

Voice & laryngeal fatigue

• Argentum nitricum — Stage dread, hoarseness of speakers; gastric/diarrhœic strand. Coca: altitude/effort laryngeal weakness, not stage panic. [Kent], [Clarke]
• Causticum — Chronic hoarseness, aphonia from exposure; rawness. Coca suits overuse in thin air with cardiac breath element. [Boger], [Boericke]
• Phosphorus — Voice tires, burning chest, tall, open persons. Use Phos. if chest weakness persists despite Coca’s descent/air corrections. [Kent]

Space/height sensations

• Cannabis indica — Expansive space/time illusions, dreamy. Coca: brisk, performance-driven exaltation with altitude dyspnœa. [Farrington], [Clarke]
• Aconitum — Fear of death after exposure; acute tachycardia. Coca: little panic, more over-driven stamina picture. [Kent]

Insomnia from stimulation

• Coffea — Joyous over-excitement, hyperæsthesia, acute senses. Coca adds altitude/effort axis and breath-hunger at night. [Allen], [Clarke]
• Guarana / Kola — Nervine stimulants for fatigue; lack Coca’s ascent keynote and palpitation on heights. [Hale], [Clarke]

• Complementary: Carbo vegetabilis — follows Coca when altitude pallor tends to collapse; Carbo restores oxygenation and venous tone. [Farrington], [Clarke]
• Complementary: Stannum — joins Coca in ascent weakness of chest/voice; Stannum deepens the expiratory fatigue. [Farrington]
• Complementary: Gelsemium — for dull, heavy altitude headaches after Coca has calmed the palpitation/air-hunger. [Clarke]
• Follows well: Aconitum — after initial fright/shock of exposure, if altitude dyspnœa + insomnia remain. [Kent]
• Follows well: Digitalis/Strophanthus — when genuine cardiac failure complicates ascent and Coca is insufficient. [Farrington], [Clarke]
• Precedes well: Phosphorus — lingering laryngeal and chest fatigue in thin, open people after travel. [Kent]
• Compare: Coffea, Cannabis ind., Guarana — stimulatory remedies; Coca is chosen by altitude and ascent modalities. [Allen], [Hale]
• Antidotes (practical): Nux vomica for over-stimulation/coffee/alcohol aggravations; Camphora for faint, vasomotor collapse (general guidance). [Dewey], [Clarke]

• Mountain sickness / altitude travellers. Coca 6C–30C every 2–4 hours during ascent if symptoms begin; space/stop as soon as breath steadies, head clears, and sleep returns; pair with descent, loose clothing, and steady breathing. [Hale], [Clarke], [Boericke]
• Exertional palpitations on stairs (elderly/sedentary). Coca 12C–30C before unavoidable climbing; if failure signs appear (slow pulse, duskiness), think Digitalis/Strophanthus instead. [Farrington], [Clarke]
• Voice fatigue in thin air (speakers/singers). Coca 6C–12C before performance at altitude; emphasise room ventilation and brief rests; follow with Phosphorus if chest weakness lingers. [Hale], [Boericke], [Kent]

Case pearls (one-liners):
• Visitor to 3,000 m: frontal throbs, vertigo looking down, night air-hunger → Coca 30C q3h day 1; slept on night 2; walked level without fear. [Hale], [Clarke]
• Elderly clerk: stairs = palpitation/short breath; level walking fine → Coca 12C pre-stair; descent and pacing taught; confidence returned. [Clarke], [Farrington]
• Touring soprano at altitude: voice faded after second aria; palpitations, hot head → Coca 6C pre-performance for two nights; voice stamina restored. [Hale], [Boericke]

Mind

• Exaltation; feels equal to undertakings. Early stimulant phase; over-driven risk. [Hughes], [Allen]
• Illusions of distance/size; misjudges space. Space-sense distortion at heights. [Clarke]
• Irritability after sleepless night at altitude. Exaltation → exhaustion. [Clarke]
• Aversion to close, warm rooms; desires open air. Environmental key. [Boger], [Clarke]
• Fear/apprehension about stairs after palpitations. Behavioural selector. [Clarke]
• Mental activity prevents sleep. Stimulation insomnia. [Allen], [Clarke]

Head

• Headache from ascending/mountain sickness. Coca keynote. [Hale], [Clarke]
• Vertigo on looking down from a height. Height trigger. [Allen], [Clarke]
• Frontal band-like pressure with palpitation. Cardio-vascular link. [Clarke]
• Better descending; better open ordinary air. Relief rubric. [Hale], [Clarke]
• Hot head with cool extremities. Vaso-motor split. [Clarke]
• Tight collars aggravate. Mechanical aggravation. [Clarke]

Eyes

• Objects appear larger/farther; colours bright. Sensory exaltation. [Hughes], [Allen]
• Flickering on fatigue at altitude. Visual fatigue sign. [Clarke]
• Vertigo from looking down. Eye-head link. [Allen]
• Reading at heights tires quickly. Functional marker. [Clarke]
• Retinal hyperæmia at altitude. Vascular cue. [Clarke]

Throat/Larynx

• Aphonia/hoarseness from overuse (singers/speakers). Voice fatigue. [Hale], [Boericke]
• Dryness of fauces in thin air. Altitude dryness. [Clarke]
• Talking aggravates chest and breath. Effort trigger. [Clarke]
• Better after short rest and cool ordinary air. Management rubric. [Hale]

Respiration/Chest/Heart

• Shortness of breath on ascending. Grand Coca rubric. [Hale], [Clarke]
• Sighing; desire for deep inspiration. Air-hunger expression. [Clarke]
• Palpitation from ascending stairs/hills. Effort heart sign. [Allen], [Clarke]
• Oppression over sternum (tight clothing <). Mechanical/vascular. [Clarke]
• Better descending and resting quietly. Relief pattern. [Hale]
• Insomnia at altitude with palpitation and dyspnœa. Night cluster. [Clarke]

Sleep

• Sleepless at high altitude. Coca hallmark. [Clarke]
• Mind too active to sleep. Stimulant insomnia. [Allen]
• Wakes often; sighing; air-hunger. Night physiology. [Clarke]
• Better sleep after descent. Diagnostic relief. [Hale]
• Dreams vivid, of mountains/flying. Thematic link. [Allen], [Clarke]
• Open window desired (still unsatisfied at altitude). Paradox cue. [Clarke]

Generalities

• Ascending aggravates; descending ameliorates. Master modality. [Hale], [Clarke]
• Warm, close rooms aggravate. Environmental aggravation. [Boger]
• Open ordinary air ameliorates. Practical counsel. [Clarke]
• Haste and talking aggravate. Effort-exaltation link. [Clarke]
• Alcohol/coffee aggravate palpitation/insomnia. Dietetic caution. [Dewey], [Hughes]
• Works on little food (loss of appetite). Terrain note. [Hale], [Clarke]

1. M. Hale — New Remedies: Clinical and Pharmacological (1864–1891): Coca in mountain sickness, exertional dyspnœa, voice fatigue; dosing suggestions.
   T. F. Allen — Encyclopædia of Pure Materia Medica (1874–79): pathogenetic fragments; mental exaltation; vertigo from heights; palpitations.
   Richard Hughes — A Cyclopædia of Drug Pathogenesy (1891–95): toxicology of Coca/cocaine; stimulation–insomnia–depression arc; sensory exaltation.
   John Henry Clarke — A Dictionary of Practical Materia Medica (1900): altitude picture; modalities (ascending <, descending >); insomnia; management.
   William Boericke — Pocket Manual of Homœopathic Materia Medica (1906): keynotes—mountain sickness, exertional dyspnœa, voice fatigue, insomnia.
   C. M. Boger — Synoptic Key of the Materia Medica (1915): environmental modalities (open air >, warm rooms <); ascent aggravations.
   E. A. Farrington — Clinical Materia Medica (1887): differentials—Carbo veg., Arsenicum, Digitalis/Strophanthus, Stannum, Gelsemium, Glonoinum.
   James Tyler Kent — Lectures on Materia Medica (1905): miasmatic frame; comparisons with Phosphorus, Calcarea, Argentum nitricum.
   S. R. Phatak — Concise Materia Medica (1977): succinct Coca cues—breathless ascending, insomnia; generalities.
   W. A. Dewey — Practical Homœopathic Therapeutics (1901): regimen—avoid stimulants; small warm sips; travel counsel.
   Margaret Lucy Tyler — Homoeopathic Drug Pictures (1942): altitude vignettes; travelling patient advice (contextual).