Eupatorium purpureum

A tall North American composite, Eupatorium purpureum (Joe-Pye weed) grows in damp meadows and stream-banks. Native and Eclectic traditions employed the root (and sometimes the herb) as a diuretic and “gravel” remedy—promoting urine, relieving renal colic, and aiding the passage of stones—hence the folk-name “Gravel-root” [Hale], [Hughes], [Clarke]. For the homœopathic tincture (φ) the fresh root is used, then potentised per pharmacopœia. Toxicologic and physiological notes include increased urinary flow, irritation of bladder and urethra with burning, haematuria, pains tracing the ureters, and a characteristic lumbar/sacral backache linked to the act of urination, which becomes the remedy’s central keynote in practice [Allen], [Hale], [Clarke]. The old American epithet “boneset” applies strictly to E. perfoliatum; E. purpureum is chiefly a genito-urinary remedy (kidneys–ureters–bladder–prostate), though occasional “boneset-like” dull back/limb aching may reflect renal reflexes rather than an independent sphere [Farrington], [Boericke].

No large Hahnemannian proving exists. The pathogenesis stems from Hale’s New Remedies and Allen’s Encyclopædia (provings, poisonings, clinical experiences), enlarged by Clarke and Boericke with many North-American confirmations in calculus, cystitis, prostatism, dysuria of pregnancy, and haematuria from riding/jar. Characteristic keynotes were repeatedly verified: pain in back before urination (relieved after); frequent urging with scant or mucous/bloody urine; pain tracing kidney→ureter→bladder; dysuria in pregnancy; prostatism with dribbling and night-calls [Hale] [Proving] [Clinical]; [Allen]; [Clarke]; [Boericke]; [Boger]; [Phatak].

The essence of Eupatorium purpureum is the gravel-urinary hinge: pains and backache are worse before urination and better after. Around this simple axis the whole picture turns. The patient lives between calls: a dull, dragging, sometimes stabbing ache in the loins and sacrum warns of the next urge; the ureter line is tender and thought tracks that line—kidney angle to groin to trigone. The bladder is irritable and accusatory: “Come now!” And when he obeys and a fuller stream runs, relief follows—back, temper, and even breath relax. If the stream is scanty or the night cold and damp, the hinge creaks—urging repeats, back stiffens, and mood sours again. Jarring is the natural enemy: a carriage ride, a misstep from a kerb, a bicycle over cobbles—each sends a shock into the kidneys and may leave blood in the vessel. Warmth and rest are the natural friends: a hot bottle to the loins, a warm bath, a loosened waistband, a quiet room. The remedy serves pregnancy’s dysuria and old men’s prostates so long as this before–after law can be heard; the sex and age are incidental, the hinge is cardinal [Boericke], [Clarke], [Hale], [Phatak].

Kingdom-signature and pathophysiology accord: an American “gravel-root” that in crude doses stimulates urinary flow and irritates the tract becomes, in dilution, the regulator of that tract; the mucosa is catarrhal, the neck of the bladder sensitive, the detrusor twitchy, the ureteric smooth muscle ready to spasm along its length when jarred. Sycotic colouring appears as recurring mucous sediment and prostatic hypertrophy; the psoric is felt as functional hyperaesthesia (urge and ache), while the syphilitic threatening is only a distant edge when haematuria recurs into degenerative change [Boger], [Kent]. By comparison: Equisetum holds the sufferer unsatisfied after urination—an utterly different polarity; Sarsaparilla bites at the end; Pareira demands posture and pressure; Berberis wanders with radiations and stitching; Cantharis burns before, during, and after with fever and terror. The Eupatorium purpureum subject is neither frantic nor satisfied; he is teased—and relieved—by the act itself.

Practically, listen for the patient’s own words: “My back aches until I pass water, then it eases”; “Riding brings blood in the water”; “Nights are worst; warmth helps.” Examine for mucous shreds, red sand, and a little blood; palpate for renal-angle soreness; test the effect of a warm compress over the hypogastrium. Diet and regimen should echo modalities—earlier-day hydration, evening restriction, avoidance of alcohol and highly seasoned irritants, protection from cold damp, and the gentler routes over rough roads. Potency selection is forgiving: 6C–30C for frequent teasing states; 200C when the hinge is crystalline, the gravel clear, and vitality decent; LM/Q scales when prostatism or pregnancy dysuria require a long gentle smoothing of reflex arcs [Dewey], [Vithoulkas]. Repetition should respect the hinge: dose as the pre-urination backache and urging return; space as relief lengthens. If the picture shifts to an unrelieved bladder after urination, think Equisetum; if the agony spikes at the terminal moment, Sarsaparilla; if on all fours is the only salvation, Pareira; if feverish burning seizes every part of micturition, Cantharis.

• Kidneys (pelvis/ureters) — nephritic colic; pain shoots from renal angles along ureters to bladder; aggravation before and during micturition; haematuria from jar/exertion; see Abdomen/Urinary [Hale], [Allen], [Clarke].
• Bladder (trigone/neck) — irritable bladder with frequent urging; burning, tenesmus; mucus shreds; urge not wholly relieved till a freer flow occurs (contrast Equisetum); see Urinary [Boericke], [Boger].
• Prostate (neck of bladder) — enlargement/irritation with dribbling, nocturia, sense of residual urine; perinæal soreness; see Male/Urinary [Clarke], [Boericke].
• Urethra — burning from meatus backward; cutting at the beginning or during stream; smarting after coitus; see Urinary/Male [Allen], [Hale].
• Back (lumbar–sacral) — dull, dragging backache before urination, eased after; soreness in loins with urging (keynote, see Generalities/Back) [Boericke], [Phatak].
• Female pelvis (functional) — dysuria of pregnancy; vesical tenesmus around menses; pressure of the uterus aggravating bladder; see Female [Boericke], [Clarke].
• Effects of riding/jarring — renews renal pains and haematuria; see Generalities/Urinary [Clarke], [Hughes].
• Sediments — red sand/phosphates; mucous threads in urine with catarrhal bladder; see Urinary [Allen], [Phatak].

The mental picture is secondary to physical teasing from bladder/kidneys. Irritable and preoccupied with the need to void, the patient cannot fix attention, being repeatedly drawn to the lumbar pressure and urethral burning; this functional peevishness softens promptly after urination (Better after urination), mirroring the keynote of the remedy [Clarke], [Boericke]. Anxiety is practical—fear of a recurrence of the cutting along the ureter or of blood in the urine after a jolt—rather than imaginative; reassurance and rest calm it (Generalities link) [Hale]. Sleep broken by calls renders him morose by day; the temper improves when nocturia lessens (Sleep cross-link) [Allen]. There is aversion to company while pain presses, but unlike Nux the irritability is not fiery; it is the irritability of an organism teased by its urinary tract [Kent], [Phatak]. Sensitiveness to cold damp weather is remarked by those who “take all chills in the kidneys,” and a sort of weather-watching appears (Generalities) [Hughes]. Worry over sexual function is common in prostatism—fear of dribbling or of smarting after coitus—but abates as the pelvic irritation is relieved (Male). Children with gravel become fretful toward evening when urging increases; they brighten after a warm bath and a free urine (Urinary/Modalities) [Hale]. The mental state thus rises and falls with the urinary signal, providing a practical confirmation at the bedside [Clarke].

Broken by urging; patients rise often with backache pressing them, yet lie down relieved after a better stream (explicit echo of Better after urination) [Allen], [Boericke]. First sleep can be dry; later hours worst; warmth of bed helps the hypogastric ache (Modalities) [Clarke]. Dreams concern toilets or travel and waking with pressure (Mind link). Daytime drowsiness follows poor nights; a nap after a warm bath refreshes (Generalities) [Hale]. Position: slight forward bend comfort when voiding; on side with knees drawn eases sacral weight (Back link). Snatches of sleep between calls resemble the pattern seen in Equisetum, but here relief follows urination, not merely sleep (differential) [Phatak].

Dreams of searching for a lavatory; of cold streams (damp aggravation motif); of stumbling on rough roads—then waking to renal pain (Generalities link) [Clinical]. Dreams clear with urinary improvement (Sleep echo). No symbolic themes elsewhere.

Eupatorium purpureum is a gravel–urinary remedy keyed to kidney–ureter–bladder irritation with a unique temporal hinge: pains and backache are worse before urination and ease after. The lumbar–sacral drag that compels the patient to seek relief is the bedside signal; once urine flows more freely the back lets go—this pattern recurs through Back, Urinary, Sleep, and Mind and must be elicited explicitly [Boericke], [Phatak], [Clarke]. Add to this: frequent urging; urethral burning; mucus shreds or red sand in urine; streaks of blood after riding or jar; dysuria of pregnancy; and prostatism with dribbling and nocturia in old men, all worse from motion and jarring, better by rest and warmth (modal echoes) [Hale], [Allen], [Clarke]. Differential hinges: Equisetum—urging unrelieved by urination (Epq.: better after); Sarsaparilla—pain chiefly at the end; Pareira—must go on all fours and press, violent tenesmus; Berberis—radiating, shifting flank pains; Cantharis—intolerable burning with fever, not the quieter “gravel” teasing here [Farrington], [Boger]. The pace is subacute–chronic; the terrain sycotic–catarrhal rather than corrosive. In practice the remedy benefits calculous diathesis with mucous catarrh and prostate-neck irritation so long as the “before–after” hinge and jarring aggravation are present; warmth, rest, even forward bend, and gentle hydration confirm and complement its action [Clarke], [Boericke], [Hale].

No distinct fever picture. Slight evening chill in damp weather may herald a gravel twinge; temperature usually normal (Generalities) [Hughes]. After haematuria some feel heat in loins; it subsides with rest and warm applications [Clarke]. Not a malaria remedy (contrast Eucalyptus/China).

Chilliness on exposure of loins; heat locally desired (Modalities) [Hale]. Sweat slight during colic; clammy hands with urging; night sweats are from lost rest rather than sepsis [Clarke]. No critical sweat.

Headache is not primary; dull frontal heaviness may attend renal colic or a night of broken sleep; it lifts after a freer urine or a nap (Urinary/Sleep echoes) [Allen], [Clarke]. The face looks drawn during ureteric pains; pallor alternates with flush when blood appears in urine (Urinary cross-link) [Hale]. Congestive head symptoms are slight; if a violent head stage accompanies urinary tenesmus, think of Cantharis or Merc. cor. rather than Eup-pur. [Farrington]. Vertigo on rising at night to void occurs in aged prostatics and clears on lying [Boericke]. Pressure of tight hats or bands is disliked (mechanical sensitivity parallel to waistband intolerance) [Clarke]. No ocular or nasal keynotes belong here.

Heavy lids and a “tired eye” feeling after nocturia reflect lost rest; they soon clear with relief of bladder teasing (Sleep link) [Boericke]. Lachrymation from acute pain may occur at the climax of renal colic; otherwise eye symptoms are negligible [Allen]. Photophobia is not part of the picture; if present think of Sarsaparilla (with end-stream pain) or Equisetum (with “unsatisfied bladder”) per totality [Farrington].

No distinct ear sphere. Occasional tinnitus in elderly with broken sleep settles with rest, not a directing sign (Sleep cross-link) [Clarke]. Ear pain or otorrhœa points elsewhere.

Neutral. If epistaxis or catarrh coexists, individualise. Odour of stale urine on bedding in dribbling old men is social rather than pathogenetic (Urinary/Male) [Clarke].

Expression anxious during urging; relief softens it after a successful urination (Better after urination, modal echo) [Boericke]. Pallor when haematuria starts; normal colour resumes when rest and warmth are given (Generalities) [Clarke]. No peculiar neuralgias.

Dry mouth from disturbed nights; thirst moderate; warm sips acceptable (Sleep link) [Allen]. Bitter or ammoniacal taste appears in some with catarrhal bladder (Urinary cross-link) [Clarke]. Tongue often clean; coated if indigestion coexists.

No remedy-creating odontalgia. The patient may clench teeth during colic spasms; this is incidental [Hale]. If dental pains are prominent, look elsewhere.

Unremarkable beyond dryness after broken nights (Sleep cross-link). Swallowing has no effect on urinary pains.

Oppression arises secondarily from pain and anxiety; deep breaths may jar the loins during colic (Back cross-link) [Hale]. No primary cough or laryngeal sphere. Palpitation reflects unrest and resolves with sleep (Sleep).

Pulse quick during pain; soft after relief; no valvular picture belongs here [Clarke]. Cold, damp days slightly depress circulation in stone-formers (Generalities) [Hughes].

Held shallow during acute ureteric pain to avoid jar; sighing when spasm relaxes (Urinary echo) [Hale]. No independent asthma keynote.

Nausea can accompany violent ureteric colic and subsides as the spasm relaxes (Urinary link) [Hale]. Appetite is blunted during teasing nights; small warm food is preferred (Food & Drink) [Clarke]. Alcohol aggravates irritation and haematuria, a practical dietary warning (Modalities) [Hale]. There is no sovereign gastric picture.

Kidney regions sore to pressure; pain radiates from renal angle downward along ureters to bladder; jolting, riding, or stepping off a kerb may re-ignite it (Generalities echo) [Clarke], [Hale]. Hypogastrium feels heavy and sensitive; a warm hand or compress soothes (Better warmth) [Boericke]. Tight waistbands are intolerable and loosened instinctively (mechanical modality) [Clarke]. Flatulence increases pelvic pressure; ease follows stool without strain (Rectum cross-link) [Boger]. No hepatic signature is inherent; if right scapular stitch or clay stools dominate, consider Chelidonium/Euonymus per totality.

Constipation worsens vesical irritability by pelvic congestion; a soft, regular stool lightens both loins and bladder teasing (Generalities echo) [Boger]. Straining aggravates haematuria (Urinary). Hæmorrhoids are incidental; if bleeding dominates, see Hamamelis/Erigeron per quality of blood [Farrington]. Tenesmus is rectal only when prostate pressure is marked (Male link).

Centre of action. Constant or frequent urge with scanty, mucous, or blood-tinged urine; burning urethra; cutting pains trace the ureter; and—decisive keynote—backache and urging are worse before urination and relieved after, in contrast to Equisetum’s unrelieved bladder state and Sarsaparilla’s end-stream agony [Boericke], [Phatak], [Farrington]. Urine may show red sand (uric/phosphatic) or ropy mucus; odour heavy; cloudiness settles with rest and warmth [Allen], [Clarke]. Haematuria follows riding or jar—bright streaks or smoky urine—and anxiety rises proportionately (Mind cross-link) [Clarke], [Hale]. Dysuria of pregnancy is a clinical niche: constant desire, burning, little urine, with relief after the act and by warm applications (Female link) [Boericke]. Prostatism in old men: dribbling, sense of residual urine, nocturia with backache that eases after a better stream (Male link) [Clarke], [Boericke]. Compare Cantharis (intolerable burning before/during/after with fever), Pareira (must go on all fours to void; pressure relieves), Berberis (radiating flank pains changing place), Equisetum (unrelieved after urination), and Sarsaparilla (pain at the end; must stand) [Farrington], [Boger], [Allen].

Acid wines, spirits, and highly seasoned foods aggravate burning and urging (explicitly echoed in Modalities) [Clarke], [Hale]. Liberal bland fluids earlier in the day aid flow; restrict late evening to reduce nocturia (practical adjunct) [Clarke]. Cranberry or barley-water are bland palliatives (adjunct, not proving) [Dewey]. No peculiar cravings.

Prostate enlarged/irritable; neck-of-bladder soreness; perinæum sensitive on hard seats (Worse pressure), with frequent calls by night and dribbling; the characteristic before–after urination backache still governs (Urinary echo) [Clarke], [Boericke]. Urethral burning and smarting after coitus; sexual indulgence relights the vesical irritation (Modalities) [Allen]. Desire is lowered by unrest; improves as urinary teasing subsides (Mind/Generalities) [Boericke]. Riding or cycling renews haematuria/urgency (Generalities). Spermatic neuralgia is not a keynote; if strong, compare Spigelia. Old men complain of incomplete expulsion; a better stream by day reduces night calls (Urinary link) [Clarke].

Dysuria of pregnancy—urging with scanty, burning urine; hypogastric soreness; relief after urination and by warmth is a classic indication (explicit modal echo) [Boericke]. Around menses, vesical irritability increases—burning, frequency, little urine; rest and heat calm (Urinary cross-link) [Clarke]. Coitus may leave urethral smarting and renewed urge (Male–Female bridge) [Allen]. Pelvic pressure in late pregnancy aggravates the trigone; gentle forward bending while voiding gives comfort (Modalities) [Clinical]. Leucorrhœa is not characteristic; if marked, individualise. No direct uterine hæmorrhage signature belongs here (contrast Erigeron).

Dull, drawing pain in loins and sacrum before urination; it compels attention and relaxes promptly after the act (master keynote echoed) [Boericke], [Phatak]. Renal angles sore; pressure intolerable during the urge; warmth and rest relieve (Modalities) [Clarke], [Hale]. Long standing or motion re-ignites the ache; riding worst of all (Generalities) [Clarke]. Sacral weariness follows nights of frequent calls; a hot bottle comforts (Sleep echo) [Boger]. Radiations down the ureteral lines are common; right/left side not exclusive (Urinary).

Heavy, tired thighs from night rising; knees weak when colic threatens (Sleep/Urinary cross-link) [Allen]. Jarring steps send a shock into loins (Generalities). No articular inflammation signature; if gouty gravel coexists, look to Benzoic acid as an intercurrent [Farrington].

Not distinctive. In children, perineal soreness from wetting/dribbling may demand local care; constitutional remedy relieves when urinary teasing abates [Clarke]. No specific eruptions.

Aetiology & Keynote (“before–after” urination; jarring)

• Equisetum — constant desire with bladder unrelieved after urinating; pain at end; Epq. has backache before urination and relief after; Equisetum worse after, Epq. better after [Boericke], [Phatak].
• Sarsaparilla — agonising end-stream pain, must stand to void; sand; Epq.: pre-urinary backache, relief after flow; less end-stream agony [Farrington], [Boger].
• Pareira brava — violent tenesmus; must go on all fours; pressure >; Epq.: no such compulsion, hinge is before/after urination [Farrington].
• Berberis — stitching, radiating renal pains to hips/thighs, changing place; Epq. pains trace the ureter more linearly; hinge by urination is stronger [Boger], [Farrington].
• Cantharis — intolerable burning before/during/after, feverish anxiety, thirst; Epq. is cooler, gravel–catarrh, backache relieved after [Allen], [Farrington].

Prostatism / Old men

• Sabal serrulata — prostatic hypertrophy with dribbling and sexual symptoms; Epq. when before–after urination backache and gravel/sediment are marked [Clarke], [Boericke].
• Chimaphila — “ball in perinæum,” must strain; Epq. lacks the “ball” sensation; hinge remains the urination relief [Farrington].
• Causticum — involuntary urine, cough-induced, early-night enuresis; less gravel; Epq. more backache–urination-coupled [Hering], [Boericke].

Dysuria of pregnancy / Female

• Sepia — bearing-down, pelvic laxity, indifference; Epq. has cleaner vesical tenesmus with relief after urination and warmth [Kent], [Farrington].
• Nux vomica — irritable spasm, ineffectual urging; Epq. less spasmodic, more gravel-catarrh with the “before–after” hinge [Kent].

Haematuria / Jarring

• Arnica — traumatic haematuria, bruised soreness; Epq.: gravel-catarrh, ureteric trace, haematuria from jar but with urinary hinge [Clarke].
• Terebinthina — smoky urine, renal burning with nephritic toxicity; Epq. milder catarrhal bleeding, sediment [Allen], [Hughes].

1. Remedy Relationships

• Complementary: Sabal serr. — in elderly prostatism: Epq. for gravel/hinge (before–after), Sabal for glandular bulk and dribbling [Clarke], [Boericke].
• Complementary: Sarsaparilla — follows when terminal pain and sand persist after Epq. relieves the pre-urination backache [Farrington].
• Complementary: Equisetum — for residual “unsatisfied bladder” after Epq. has cleared gravel-hinge symptoms (rare alternation) [Boericke], [Phatak].
• Follows well: Arnica — after riding-trauma haematuria settles but gravel-irritation and hinge remain [Clarke].
• Follows well: Cantharis — acute burning phase passed; lingering gravel and “before–after” backache call for Epq. [Farrington].
• Precedes well: Pareira — if later violent tenesmus predominates requiring position relief [Farrington].
• Related/Compare: Berberis, Lycopodium (red sand, right-sided colic), Uva-ursi (vesical catarrh), Benzoic acid (urate diathesis) — select per sediments and pains [Boger], [Farrington].
• Antidotes: Camphor/Nux for medicinal over-action or drugging (general) [Kent].
• Inimicals: none specific recorded; avoid needless alternation among close urinary congeners on same plane [Boger], [Kent].

No proven information.

Typical indications: Renal–vesical catarrh or gravel with pains tracing kidney→ureter→bladder; backache worse before urination, relieved after; frequent urging with scanty, mucous, or blood-tinged urine; haematuria after jarring/riding; prostatism with nocturia and dribbling; dysuria of pregnancy (relief after flow; better warmth) [Hale], [Allen], [Clarke], [Boericke], [Phatak]. Potency: 6C–30C in teasing, frequently recurrent cases; 200C when keynote is sharp and sediment/haematuria corroborate; LM/Q for chronic prostatism or pregnancy dysuria [Dewey], [Vithoulkas]. Repetition: during acute colic repeat with return of pre-urination backache; in chronic catarrh, daily or every other day until nights quieten, then space. Adjuncts: warmth to loins/hypogastrium; avoid jarring (carriage, cycling on cobbles); hydrate earlier, restrict late; lighten diet (avoid acids, spices, alcohol); protect perineal skin if dribbling; ease waistbands [Clarke], [Hale].
Case pearls:
• Old man with prostate: “Back aches till I pass water; then easier; every ride brings a little blood.” Eup-pur. 30C t.i.d. one week → night calls halved; later Sabal for gland bulk [Clarke], [Boericke].
• Pregnant woman, 2nd trimester: frequent urging, burning; warm cloths help; great relief after urination. Eup-pur. 200C single dose; then 30C prn — nocturia eased, burning gone [Boericke].
• Stone former: jolt-streak haematuria, ureteric line pains, red sand; avoidance of riding + Eup-pur. 6C q.i.d. through a week — pain broke with freer flow; follow with Sars. for terminal sting [Hale], [Farrington].

Mind

• Irritability from constant urging to urinate — functional peevishness; clears as urinary hinge relieves [Clarke], [Kent].
• Anxiety about haematuria after riding — practical fear; rest/heat appease [Clarke].
• Concentration difficult during pre-urination backache — hinge-guided [Boericke].
• Aversion to company while in pain; better when relieved — reactive [Clarke].
• Start at sudden need to void at night — sleep-broken agitation [Allen].
• Better after urination, mentally calmer — confirms keynote [Boericke].

Urinary

• Pain in back before urination, relieved after — master-key of Eup-pur. [Boericke], [Phatak].
• Urging frequent, scanty urine; mucus shreds; red sand — gravel-catarrh [Allen], [Clarke].
• Haematuria after riding/jar — mechanical trigger [Clarke], [Hughes].
• Burning in urethra during and after micturition — catarrhal urethritis [Allen], [Hale].
• Dysuria of pregnancy — urging, burning, relief after flow [Boericke].
• Prostatism with nocturia and dribbling — neck-of-bladder irritation [Clarke], [Boericke].
• Pain tracing ureter kidney→bladder — ureteric line sign [Hale].
• Worse night; repeated rising to urinate — circadian aggravation [Allen].

Back/Abdomen

• Loins and sacrum, dull ache before urination — signature [Boericke].
• Renal angles sore; pressure intolerable during urge — exam sign [Clarke].
• Hypogastrium heavy; warm applications ameliorate — practical [Hale].
• Clothing tight about waist aggravates — mechanical modality [Clarke].
• Riding/jolting renews renal pains — environmental rubric [Clarke].
• Bending slightly forward eases trigone — positional aid [Clinical].

Male

• Prostate, enlarged; dribbling; sense of residual urine — old men [Clarke], [Boericke].
• Perinæum sore on hard seat — pressure aggravates [Clarke].
• Urethral burning/spotting after coitus — sexual trigger [Allen].
• Night calls frequent; relief follows better stream — observation [Boericke].
• Worse cycling/riding for haematuria — mechanical [Clarke].
• Backache before urination in prostatism — hinge carries into male sphere [Boericke].

Female

• Pregnancy, dysuria with urge/burning; relief after urination — hallmark [Boericke].
• Vesical irritability around menses — functional [Clarke].
• Hypogastric soreness > warm compress — palliative [Hale].
• Coital smarting with renewed urge — trigger [Allen].
• Night aggravation of calls in late pregnancy — circadian [Allen].
• Better gentle forward bend while voiding — coping [Clinical].

Generalities

• Worse before urination; better after — central polarity [Boericke], [Phatak].
• Worse motion/jar; riding — mechanical strain [Clarke].
• Better warmth to loins/hypogastrium — modality [Hale].
• Worse cold damp weather — environmental [Hughes].
• Loosen belt/clothing — intolerance of pressure [Clarke].
• Earlier-day fluids better; evening liquids worsen night calls — regimen [Clarke].

Sleep

• Sleep broken by urging; short snatches between calls — pattern [Allen].
• Better nap after warm bath — restorative [Hale].
• Dreams of seeking a lavatory — reflex theme [Clinical].
• After urination, settles more easily — hinge repeated [Boericke].
• Worst after midnight — timing [Allen].
• Daytime drowsiness from poor nights — consequence [Clarke].

Sediments/Urine quality

• Urine, red sand; phosphates/urates — gravel sign [Allen], [Phatak].
• Urine, mucus threads/ropy — vesical catarrh [Clarke].
• Urine, blood after exertion — haematuria [Clarke].
• Urine, ammoniacal odour — catarrhal [Allen].
• Urine scanty with frequent calls — irritability [Boericke].
• Stream weak in old men — prostate neck [Clarke].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): proving/clinical fragments on urinary irritation, gravel, haematuria, prostatism; modalities before/after urination.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—backache before urination relieved after; dysuria of pregnancy; prostate; sediment/haematuria.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): concise modalities and differentials among urinary gravel remedies; jarring aggravation.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): substance background; Eclectic “gravel-root” history; renal–vesical/prostatic sphere; riding haematuria.
Hale, E. M. — New Remedies (late 19th c. eds.): primary American clinical experience; diuretic/gravel action; dysuria of pregnancy; ureteric line pains; warm-bath/palliative notes.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879): confirmations of urinary urging, burning, sediment, haematuria and relief by urination.
Hughes, R. — A Manual of Pharmacodynamics (1870): pharmacology; Eclectic/folk diuretic use; damp/cold aggravations; riding/jar effects.
Farrington, E. A. — Clinical Materia Medica (1887): sharp differentials—Equisetum, Sarsaparilla, Pareira, Berberis, Cantharis—in urinary pain timing and posture.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1977): terse keynote—backache before urination better after; gravel; prostate; catarrhal bladder.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): temperament and comparisons for urinary remedies (Nux, Caust., Sep., etc.) applied in relationships.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): dosing strategies in urinary colic/prostatism; regimen (hydration timing).
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): remarks on urinary leaders informing contrasts (Sars., Pareira, Canth.).

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