Eupatorium perfoliatum

Eupatorium perfoliatum is a native North American plant in the Asteraceae family. Its leaves grow “through” the stem—hence the name “perfoliatum.” Traditionally used by Native Americans for febrile illnesses, it was known for inducing profuse sweat and easing the pain of “break-bone fever.”

Proved by Dr. William E. Payne and introduced into homeopathy by Dr. C. Hering. Proving symptoms confirmed by Hering and Hale.

Eupatorium perfoliatum is the archetypal remedy for influenza with severe bone and muscle pain—the “boneset” state. It captures the collapse and suffering of febrile illnesses where the patient lies still, tormented by deep aching as if broken. Periodicity, thirst before chill, and relief from vomiting are hallmarks. It is a remedy of systemic suffering, where every structure—bone, muscle, mucosa—feels overwhelmed. The patient is silent, aching, and waiting for the sweat to bring mercy.

• Bones and periosteum – aching, bruised, or broken sensation
• Muscles – deep soreness, especially in limbs
• Liver – congestion, jaundice, dull ache
• Respiratory tract – bronchitis, influenza, rattling cough
• Stomach and digestion – nausea with chill, bitter vomiting
• Spleen – fullness, aching in malaria-type fevers
• Circulation – chill, fever, sweat cycle with marked periodicity

The Eupatorium mind is depressed and dull, often in sync with the profound physical suffering. There is a sensation of being overwhelmed by the intensity of pain and fatigue. Patients feel indifferent, silent, and prefer to lie quietly, though rest offers no true relief. [Hering] describes a sense of hopelessness during fever, accompanied by torpor and dread of movement. Anxiety may arise before the chill and vanish after sweating begins. Some exhibit irritability or aversion to conversation during acute attacks, particularly when nausea and aching coincide. The mental state is one of melancholy passivity brought on by systemic collapse.

Restless and disturbed during fever. Dreams are vivid and anxious. Sleep may be impossible due to aching bones or cough. Sleeplessness precedes the chill and continues through the fever.

Feverish, anxious dreams. Themes of falling, suffering, or being crushed. Sleep feels unrefreshing and light.

Marked periodicity in symptoms. Pains as if bones are broken. Complaints often appear before or during fever, and resolve with sweat. Worse motion, better lying still. Suited to malarial or influenzal states, especially with severe bone and muscle pain.

Fever comes in three stages: chill, heat, and sweat.

• Chill: Starts in the back or extremities, usually in the morning (7–9 a.m.), with thirst and nausea.
• Heat: Intense, dry, with bone pains, restlessness, and severe headache.
• Sweat: Profuse, offensive, often relieves symptoms.
  There is a strong periodicity—fevers return daily or every other day. [Hale] linked it to malarial and intermittent fevers.

• Chill: Violent, with nausea, retching, backache.
• Heat: Burning, with throbbing headache and thirst.
• Sweat: Profuse, drenching, especially on forehead and chest, bringing partial relief.
  Symptoms are often worse before chill, better after sweat.

Intense aching in the occiput and forehead, worse during chill or fever. The headache is dull, bursting, or pressive, and often described as “throbbing” and deep-seated. The sensation of a tight band around the head may be present. Pain is worse from movement and light, better lying with head elevated. The scalp feels sore to the touch. [Boericke] notes a characteristic occipital headache during chill with nausea. Headaches are closely tied to the cyclical nature of the febrile state and often coincide with aching in the limbs.

Eyes are red, sore, and sensitive to light during fever. Eyeballs feel bruised and painful, particularly on movement. Lids may be heavy, drooping, or difficult to keep open. A dull aching pain behind the eyes may radiate toward the temples or base of skull. Lachrymation is occasionally present. The appearance is one of fatigue and systemic illness, often with glazed or sunken eyes.

Ringing or roaring in the ears during febrile states. Hearing may feel muffled during intense chills. Eustachian congestion secondary to general catarrhal conditions may be noted, but not a primary sphere of action.

Coryza with fluent, bland discharge may precede or follow the febrile cycle. Some patients experience sneezing before the onset of chill. Congestion and fullness of the nasal bridge may accompany frontal headache. Discharge is non-irritating. Nosebleeds may occur during the fever stage.

Face is flushed, hot, and heavy during fever. A sallow, yellowish hue may develop, especially in malarial cases. Facial expression is drawn, reflecting suffering. Sweat may collect on the forehead and upper lip. During chill, the face is often pale and sunken.

Tongue coated white or yellow, with dryness and bitter taste. Mouth may feel sticky or pasty. During chill and fever, intense thirst for cold drinks is a keynote. The taste is bitter, especially after vomiting. Some experience a metallic taste before chill. Salivation is minimal.

No significant keynotes. Occasionally, dental pain during febrile states due to neuralgic referral.

Soreness, rawness, or burning in the throat, especially at the onset of catarrhal fevers. A dry, hacking cough may irritate the throat. Swallowing aggravates the raw sensation. There may be a sensation of tightness across the throat and upper chest. Mucus accumulation is scanty but irritating.

Dry cough with great soreness in the chest, as if bruised. Pain is felt with every cough, and the cough is worse from motion or exposure to cold. Rattling, loose cough in the morning, with scanty expectoration. Cough precedes the chill, especially during influenza. [Clarke] observed cough with stitching pain through the lungs. Respiration is painful, and the chest feels heavy and raw. The bronchial mucosa is congested and inflamed.

Palpitations during fever or chill. Pulse is full, bounding, and sometimes irregular. Heaviness in the precordial region noted in some malarial fevers. The circulatory burden of the febrile process is reflected in the strong, throbbing pulse.

Dyspnoea with tightness in the chest, especially during chill and fever. Breathing may be shallow and painful. Sensation of constriction in the thorax. Great desire for fresh air during the febrile paroxysm.

Marked nausea before or during the chill, often followed by bilious vomiting. Vomiting is bitter, greenish, or yellow, and may relieve the nausea. Appetite is lost. Thirst is excessive, especially for cold water, but drinking may provoke nausea. A sinking sensation in the stomach accompanies the fever. [Hale] describes vomiting of bile as almost diagnostic. Pressure or dull ache may be felt in the epigastrium.

Abdominal discomfort with fullness and tenderness in the right hypochondrium (liver region). There may be stitching pains in the side or dull dragging in the loins. Spleen and liver are enlarged, especially in recurring fevers. Pain often felt in the lower abdomen during chill or fever, especially in malarial types. A dragging sensation may accompany lumbar and sacral soreness.

Constipation or sluggish stool, occasionally alternating with diarrhoea during febrile episodes. Stools may be yellow, offensive, or bilious. Diarrhoea may come on after chill or during sweating stage. Haemorrhoids may become painful during fever due to congestion.

Scanty, dark urine during chill and fever. May have a reddish or brick-dust sediment. Burning in the urethra or dull aching in the bladder during febrile states. Frequent urging may accompany sweating stage. Urine often relieves headache or nausea when passed.

Craving for cold drinks during chill and heat. Aversion to food. Vomiting may follow ingestion of food or drink. Some desire ice or sour things.

Occasional soreness in the testicles during fever. No prominent sexual sphere.

No strong gynaecological indications, but may support when chills and fever are aggravated around menstruation. Flu-like conditions that precede menses may point to Eupatorium.

Intense aching in the back, particularly in the lumbar region and sacrum, as if the bones were broken. Pain is deep, sore, and bruised, and worse for motion or pressure. [Hering] identified this as a key symptom. This back pain often appears before or during chill, and may be accompanied by chills running up and down the spine.

Severe bone pains, described as if the limbs were “broken” or beaten. Arms, legs, wrists, ankles—all feel sore and bruised, worse for movement or touch. Joints are stiff and painful. Chills seem to penetrate the bones. Pain in long bones—especially tibia and humerus—is intense and characteristic. [Kent] notes this as a striking keynote. The patient lies still, moaning with pain, afraid to move.

Skin is hot and dry during the fever stage, followed by copious perspiration that may offer relief. Rash is not typical, though in some influenzal states, skin may appear sallow or moist. Chillblains and alternating chills may suggest suppressed skin function.

• Arnica – Bruised pains but more from trauma; not periodic
• Bryonia – Pain worse from motion, but lacks marked bone soreness and vomiting
• Rhus tox. – Restlessness and aching, but better for motion and lacks periodic fever
• China (Cinchona) – Malarial remedy with debility, but less bone pain
• Gelsemium – Weakness and chilliness, but more nervous symptoms than pain

• Complementary: Arsenicum album, China, Gelsemium
• Antidotes: Nux vomica, Arsenicum album
• Follows well: Aconite, Bryonia, Nux vomica
• Precedes well: Sulphur, China

• Indispensable in influenza with bone pain
• Use in malaria, dengue, or post-viral syndromes with chill–fever–sweat cycle
• Excellent in bronchitis or pneumonia with bruised chest and violent cough
• Relieves migraine with nausea during fevers
• Effective in intermittent fevers with great thirst and nausea before chill

Mind

• Indifference during fever
• Anxiety before chill
• Dullness with aching pains

Head

• Headache, occipital, during chill
• Throbbing pain, heat during fever
• Pain, motion aggravates

Extremities

• Pain, bones, as if broken
• Aches, long bones
• Pain, limbs, motion aggravates

Back

• Pain, lumbar, before chill
• Soreness, sacrum
• Chills, spine

Fever

• Chill, 7–9 a.m.
• Heat, with thirst
• Sweat, profuse, relieves

Stomach

• Nausea, before chill
• Vomiting, bile
• Thirst, before chill

C. Hering – Guiding Symptoms of Our Materia Medica: Original proving, bone pain and periodic fever

William Boericke – Pocket Manual of Homoeopathic Materia Medica: Clinical use in influenza, cough, and bilious states

James Tyler Kent – Lectures on Homoeopathic Materia Medica: Distinguishing modalities and essence of suffering

John Henry Clarke – Dictionary of Practical Materia Medica: Detailed fever stages and complementary remedies

E. M. Hale – New Remedies: Fever, vomiting, and the classic influenza pattern with “broken bone” sensation