Grindelia robusta

Grindelia robusta is a resinous North American composite (Asteraceae) exuding a yellow, balsamic gum from its capitula and upper stems. Eclectic physicians used gum-weed as an expectorant and anti-asthmatic, and externally for Rhus-poisoning; pharmacologically it relaxes bronchial spasm while promoting mucous secretion, yet in excess may depress the heart–vagus axis—an observation that illuminates the homœopathic picture of asthma with embarrassed expectoration and a tendency to asphyxial spells on falling asleep when cardiac tone is weak [Hughes], [Clarke]. The tincture (from fresh, viscid tops) carries a decided action on bronchial mucosa, larynx and vagus; clinically it serves in emphysema with bronchitis, whooping-cough with “gluey” mucus, hay-asthma, and the skin effects of poison-oak/ivy (topically) [Allen], [Hering], [Boericke].

Pathogenesis chiefly clinical and fragmentary (Allen; Hale), with confirmations by Hering, Clarke, Boericke: asthma and emphysema with large mucous râles, tenacious tough mucus difficult to detach, attacks on falling asleep (must be aroused to breathe), cannot lie down, must sit up; whooping-cough with exhausted, rattling chest; hay-asthma; catarrhal laryngitis; weak, irregular pulse in chest cases; skin: Rhus dermatitis and pruritus relieved (externally). Tags: [Proving]/[Clinical]. [Allen], [Hering], [Clarke], [Boericke], [Hughes].

The essence of Grindelia is the gluey chest that cannot lie down and stops breathing on falling asleep. The organism is flooded with tenacious bronchial mucus; the cough is ineffectual, the chest full of coarse râles; the room is too warm and airless; and every time drowsiness descends, the vago-cardiac tone sinks and respiration ceases until the patient is aroused. The instant he is propped, aired, and given warm sips, the picture softens; when at last a stubborn plug gives way, the oppression relaxes and the mind steadies. This logic threads the clinical scenes: the elderly emphysematous bronchitic with a barrel chest, weak irregular pulse, purple lips, and an imperative need to sleep high; the child with whoop who drops into a doze between paroxysms only to choke and must be lifted; the hay-asthmatic of the fogs whose sneezing prefaces a drowning chest. Across all stands the modality triad: worse lying; worse on falling asleep; worse in warm, close rooms; better sitting up and in cool, steady air. [Allen], [Clarke], [Boericke], [Hering].

Kingdom signature (Asteraceae) imparts catarrhal reactivity and a resinous affinity for mucous surfaces; Grindelia’s balsamic gum foreshadows the adhesive sputum that defines it [Hughes]. Miasmatically, psora–sycosis hue the chronicity: repeated attacks, thickened mucosa, emphysematous change. The cardiac–vagal participation sets it apart: where Antimonium tart. merely drowns in mucus, Grindelia stops breathing on dozing; where Arsenicum paces with anxious chills and seeks heat, Grindelia sits, is aired, and calms with expectoration; where Sambucus explodes with dry spasm, Grindelia labours under a gluey blanket. The alternation Skin↔Chest—relief of Rhus dermatitis (externally) with a risk of chest aggravation if over-suppressed—underlines the outlet philosophy that pervades classical materia medica [Clarke], [Boericke].

Practice. Think Grindelia in emphysema with night suffocation, in elderly bronchitics who say, “If I drop off I stop breathing; I must be propped,” in whooping-cough with drowsy, cyanotic spells and coarse rattling, in hay-asthma of foggy sea-mists with chest drowning. Insist upon regimen that copies the remedy: high propping, cool steady air, avoidance of close warmth, warm demulcent sips, gentle coached breathing, and prompt arousal at the first nod of sleep until the mucus flows. When the expectoration has become free and sleep no longer threatens apnœa, constitutional supports (Senega, Digitalis, Sulphur) can be considered by totality. Potencies from θ (externally) for Rhus eruptions to 3x–6x/6C for day-to-day bronchorrhœa; 30C when the sleep-apnœa keynote is decisive; 200C sparingly in clear, reactive cases with prompt general response. Repetition is guided by attacks: closer during foggy nights and whoop-paroxysms, spacing as the need to prop and to arouse abates [Boericke], [Dewey], [Boger], [Nash].

Two pearls at the bedside: The Pillow Test—if extra pillows alone markedly lessen attacks, think Grindelia; The Arousal Test—if “wake him and he breathes,” Grindelia leads.

• Bronchi & smaller air-tubes — catarrhal bronchorrhœa with tenacious, stringy sputum that the patient cannot raise; coarse râles, dyspnœa; see Chest/Respiration. [Clarke], [Boericke].
• Vagus–cardiac axis — spells of breathing stops on falling asleep; cannot lie down; weak, irregular pulse with dyspnœa; asphyxial tendency; see Heart/Sleep/Respiration. [Hering], [Allen], [Clarke].
• Larynx — hoarseness, adhesive mucus; tickling with ineffectual cough; see Throat/Chest. [Allen], [Boericke].
• Emphysema (old people) — over-distended chest, little air-entry, much rattling; must sit propped; see Chest/Generalities. [Clarke], [Boericke].
• Whooping-cough — exhausted, “drowns in mucus,” cyanotic tendency; see Chest/Respiration. [Hering], [Allen].
• Hay-asthma / Naso-pharynx — paroxysmal sneezing, coryza with chest oppression; see Nose/Respiration. [Clarke], [Hughes].
• Skin (Rhus dermatitis) — vesicular, oozing, itching eruptions; gum-weed lotion palliates burning/itch (external); see Skin. [Clarke], [Boericke].
• Sleep centres — apnœic starts as soon as drowsy, must be waked to breathe; see Sleep. [Allen], [Hering].
• Elderly, cardiac–bronchitic constitutions — broken wind, weak heart, night suffocation; see Generalities. [Boericke], [Boger].

The Grindelia patient is anxious about breath rather than about fate: a practical fear that sleep will steal his respiration and that lying down is equivalent to drowning. He dozes, starts, clutches the bed, begs to be propped—this behaviour exactly mirrors the modality (worse lying, worse on falling asleep; better sitting up) already emphasised [Allen], [Hering], [Clarke]. Irritability rises with the accumulation of mucus he cannot expel; as soon as a glob of tough expectoration comes away, he grows calmer (Chest cross-link). Panic is worse in a warm, close room and less in quietly aerated air (Respiration). The mental dulness of hypoxia appears in old emphysematous subjects—confusion, slow answers—which clears with air and sitting posture (Generalities). Children with whooping-cough look frightened before the paroxysm and then exhausted and drowsy afterwards, yet they cannot keep asleep for the chest rattling—again the Sleep link [Hering]. The temper is not fastidious and fearful like Arsenicum; it is the mechanical fear of smothering. When skin eruptions (Rhus poisoning) are suppressed, he grows more chesty and fretful—an alternation noticed by Clarke (Skin↔Chest). He is tractable, grateful for being propped and fanned; despair belongs only to the height of asphyxia and passes with relief.

Sleep is the battleground: as soon as he dozes, breathing stops; he must be waked; cannot lie down, must sleep half-sitting with pillows; starts with choking; dreams are of drowning and of trying to call for air—this is the Grindelia signature [Allen], [Hering], [Clarke]. First sleep about midnight is worst; 1–2 a.m. paroxysms frequent (Modalities). Children in whoop drop asleep between paroxysms and quickly rattle and choke until raised. After relief, sleep falls but remains light and propped. The bed in a warm room ensures a bad night; a cool, well-ventilated room helps if draughts are avoided (Respiration). Contrast Opium (deep sleep with stertor and insensibility) and Sambucus (child sits up suddenly with suffocation but without the gluey mucus).

Dreams of water, drowning, being smothered by a pillow; of crying for help but breath fails (Sleep cross-link). Dream-fragments of being unable to wake until shaken. After a good expectoration the dreams lighten. Children dream of a long cough they cannot finish—an echo of the ineffectual effort.

Grindelia gathers its case around three converging generals: (1) gluey, tenacious bronchial mucus with coarse râles that are hard to detach; (2) a vago-cardiac depression which declares itself as apnœa on falling asleep—the patient cannot lie down, must be propped and often must be aroused to breathe; (3) environmental and positional law—warm, close rooms worse; cool, steady air and quiet sitting better; relief follows when expectoration becomes free. These laws repeat in Chest, Respiration, Sleep, Heart and even in Mind (practical fear of suffocation). The constitutional type is commonly an elderly emphysematous bronchitic, or a child with whoop, or a hay-asthmatic in foggy seasons. Antimonium tart. is nearest for rattling and inability to raise, but Ant-t. lies back half stupefied and drowns in mucus without the peculiar sleep-apnœa start; Arsenicum is restless, chilly, and wants warmth (not cool air), with burning; Ipecac. has incessant nausea with wheeze; Sambucus has nocturnal suffocation in sleep but without viscous bronchorrhœa; Senega and Kali bich. share tenacity but lack the apnœa-on-sleep keynote [Farrington], [Boger], [Clarke], [Boericke]. Topically Grindelia soothes Rhus dermatitis; suppressing such eruptions may worsen the chest—respect the skin outlet (Skin/Generalities). Management should copy the remedy: prop, air, warm drinks, steady arousal at sleep-onset until the mucus is dislodged, avoid warm, close rooms, and in hay seasons avoid fog and dust.

No distinct pyrexia, save in acute bronchitis: slight evening heat with sweat on face during paroxysm; chill after the strain; heat worse in warm rooms; better with free air (Generalities). In whoop, fever is mild; the danger is asphyxia (Chest).

Chill in damp fog; heat flush in stuffy rooms; sweat cold on forehead in asphyxial moments; perspiration after relief with some weakness (Generalities). Getting chilled after sweat renews rattling (Modal echo).

Headache is secondary—heavy, congestive when the chest is oppressed; face dusky, veins turgid during paroxysm; cool air and expectoration clear it (Chest/Generalities) [Clarke]. Vertigo occurs on lying down, from sudden want of air; he sits up quickly with gasping (Sleep cross-link). Hay-asthmatics suffer frontal weight with sneezing fits, worse in fog and warm rooms; a steady, cool current helps. In whoop, the head throbs and the eyes water, but there is less haemorrhage than under Drosera. Cyanotic lips in elderly bronchitics warn of cardiac weakness (Heart link). After attacks a dull narcotic stupefaction may follow—not the Opium profundity but a hypoxic fog that resolves with air and uprightness.

Smarting, watery eyes in hay-asthma; lids stick from catarrh; conjunctival injection with sneezing—an extension of the mucous action [Clarke], [Hughes]. Vision dims for a moment at the crest of the asphyxial wave and clears as air returns. Children rub their eyes after a whoop. No deep photophobia; if extreme lacrimation with fluent coryza dominates, Euphrasia outranks. In Rhus dermatitis around the eyes, the external lotion soothes burning (Skin).

Roaring in ears with cyanosis and breath-holding; passes as cough loosens. No otorrhœal tendency. Deafness from Eustachian catarrh accompanies hay-asthma in some, worsening in damp fog and better in dry air (Nose/Respiration).

Paroxysmal sneezing with watery discharge at onset of attacks; later, posterior mucus thick, stringy, drops into larynx provoking the ineffectual cough—the nasal–laryngeal bridge of Grindelia [Clarke]. Odours and dust irritate; warm rooms increase coryza and oppression; cool, moving air helps if not draughty (Modal link). Hay-asthma is worse in fog, sea-mist and autumnal pollen; the chest is the focus—sneezing is a prelude to dyspnœa (Respiration). Discharge may glue at night, adding to the “cannot lie down” distress. If bland tears with corrosive nasal discharge lead, think Allium cepa; Grindelia adds chest suffocation and apnœa on drowsing.

Dusky, cyanosed face in paroxysm; sweat on forehead; anxious lines; jaw drops as the patient starts from sleep to catch breath (Sleep/Chest). Children whoop until the face is bluish; a tenacious plug is finally ejected and colour returns [Hering]. Flush in warm room; pallor on exhaustion. Lips dry yet patient dares not lie back to drink.

Sticky mucus adheres to palate and fauces; the tongue feels thick, speech slow in hypoxic elderly; thirst for warm sips that loosen phlegm (Throat/Chest). Mouth-breathing predominates at night; the mouth dries and cough tickles. No stomatitis keynote. Teeth clench during the suffocative start, then relax.

No special odontalgia. Children may gnash teeth in the anxiety of the paroxysm. Jaw fatigue after repeated struggling coughs is incidental.

Fauces and larynx lined with adhesive mucus; frequent clearing, scant effect; sensation of a gluey mass that “will not start” [Allen], [Boericke]. Hoarseness in the evening; short broken voice; reading aloud breathless. Warm drinks and steam ease; dry heated rooms aggravate—exactly mirroring the modalities (better warm sips, worse warm rooms) [Clarke], [Hughes]. Laryngeal tickle precedes the asphyxial doze; as soon as he nods, breathing stops until shaken—laryngeal collapse with vagal depression (Sleep link). No croupous membrane; if membranous exudate rules, think Kali bichromicum.

The centre of Grindelia. Large, coarse mucous râles, tenacious, glutinous sputum that will not detach, with exhausting, ineffectual cough; cannot lie down; on falling asleep the patient stops breathing and must be shaken or must sit up; when expectoration at last becomes free the oppression abates—these are the combined keynotes [Allen], [Hering], [Clarke], [Boericke]. Old emphysematous chests are barrelled, air-hunger visible, pulse soft and irregular; fog and warmth of rooms aggravate; cool, steady air and warm drinks palliate (Modalities). In whooping-cough, cyanosis and drowsiness are marked; the child slides into sleep only to start choking, classic for Grindelia and distinguishing it from Drosera (less tenacity), Coral. (more spasmodic whoop), and Antimonium tart. (rattles louder, more collapse) [Hering], [Farrington]. Chest soreness from coughing is common; palpitation accompanies struggling for breath (Heart). If the sputa are ropy strings with sinus-coryza, Kali bichromicum may surpass; if rattling with inability to raise, Antimonium tart. is nearest; Grindelia bridges the two with the sleep-apnœa keynote.

Pulse weak, irregular during attacks; palpitation from slight effort; breath and heart sink together in the hypoxic, emphysematous elderly—vago-cardiac depression [Clarke], [Hughes]. Cyanosis and cold sweat in night spells point to cardiac share; the patient improves sitting, in cool air (Modal echo). There is no tight iron band of Cactus; no piercing cardiac pain; this is weakness with air-hunger. Syncope threatens as he dozes (Sleep). When heart signs dominate without much mucus, compare Digitalis (slow, weak pulse, blue face; but less gluey expectoration).

Slow, laboured, arrests on falling asleep; must be aroused; cannot lie down; must sit up and be propped; warm, close air worse, cool air better, gentle fanning felt as mercy—this rubric repeats through the case [Allen], [Hering], [Clarke], [Boericke]. Inspiration catches on mucus; expiration prolonged; râles loosen only late. In fog and damp, hay-asthma supervenes with sneezing; in dry weather he manages better (Nose). Talking, ascending, and bending produce panting; after a warm drink and a hawk, the breath is freer. Compare Arsenicum (anxious, restless, wants warmth), Ipecac. (suffocation, incessant nausea), and Sambucus (child suffocates on sleep, but with dry spasm rather than gluey mucus).

Nausea only as a corollary of suffocation, in the exhausted and in whoop; vomiting may follow the paroxysm with relief (Chest link) [Hering]. Appetite small in the chronic bronchitic; heavy meals aggravate night oppression. Desire for warm drinks; cold iced drafts shock the chest (Food and Drink). Epigastric sinking accompanies vagal depression and weak pulse (Heart). The stomach is not the aim, but its reflexes show the system’s low tone during spells.

Abdomen moves with each forced breath; epigastrium drawn in with retraction during dyspnœa. Flatulence worsens chest oppression at night; after belching the breathing eases a little (Generalities). No enteric colic; if morning watery diarrhœa accompanies the attack, think Gnaphalium; Grindelia is a chest remedy with abdominal accessory.

Constipation of the elderly bronchitic from inactivity; straining worsens dyspnœa and palpitation (Heart/Generalities). In whoop, stool may be involuntary at the height of the paroxysm (Children) [Hering]. Rectum otherwise negative.

Urging from cough-pressure; urine scant during acute spells and fuller as relief comes—hydration and cardiac output linked (Heart). In enfeebled old men a little dribbling occurs after long paroxysms—fatigue, not a vesical disease. No burning tenesmus.

Desire for warm drinks that loosen mucus; cold iced beverages aggravate chest shock (Throat/Chest) [Hughes]. Appetite small at night; better in the morning after a decent expectoration. Tobacco smoke, kitchen vapours and dust excite cough (Nose/Throat). Alcohol in the evening increases night oppression via vascular relaxation (Heart).

Sexual desire low in emphysematous, cardiac subjects. Coitus aggravates breathlessness in the weak-hearted; he must rest sitting afterwards. No specific prostatism; compare Kali carb for nocturnal dyspnœa after coitus.

Asthmatic oppression increases around menses in sensitive women; lying is impossible; anxiety drives them upright (Sleep). Pregnant women with cough feel smothered in the second half of night; propping helps. In hay-asthma of young women, sneezing alternates with tight chest, especially in fog (Nose/Respiration). No uterine keynotes.

Oppression forces him to lean forward, supporting the elbows; interscapular ache after paroxysms; dorsal muscles sore from the labour of breathing (Chest). Warmth to back comforts; lying back is impossible (Modal echo). No marked lumbago; if board-like morning stiffness appears, think Formica rufa.

Cold, bluish hands in an attack; finger-ends clubbed in old emphysema (chronic sign). Trembling after paroxysm; oedema of ankles in the weak-hearted elderly (Heart). Children stretch hands in air-hunger during whoop. Cramps in calves after long sitting propped at night occur.

Rhus dermatitis (poison-oak/ivy) with burning, vesicles, oozing: external grindelia lotion soothes and checks vesiculation—an established empirical use endorsed by Clarke and Boericke [Clarke], [Boericke]. Pruritus in scattered eczematous patches improved by topical application. Urticaria from foggy weather may accompany hay-asthma; heat aggravates itch. Note: the internal picture is primarily chest; the skin is palliated from without. If suppression of a Rhus-like eruption precedes chest aggravation, restore the skin (Generalities).

Apnœa on falling asleep / cannot lie down

• Opium — heavy, stertorous sleep with insensibility; pupils contracted; less mucus tenacity; Grind.: mechanical choking relieved by arousing and expectoration. [Hering], [Clarke].
• Sambucus — child sits up suffocating after sleep; dry spasm; Grind.: gluey mucus with coarse râles and elderly bronchitic types. [Boericke], [Farrington].
• Lachesis — worse after sleep, cannot bear pressure; cyanotic; less adhesive mucus; more congestive throat picture. [Kent], [Clarke].

Rattling chest, cannot raise

• Antimonium tart. — loud rattling, drowsy, blue, weak; lying aggravates, but no on-dozing apnœa keynote; Grind.: must be waked to breathe, better cool air. [Hering], [Farrington].
• Senega — tough mucus of aged people, must work to raise; no sleep-apnœa; more chest soreness; Grind.: adds vago-cardiac spells. [Clarke].
• Kali bichromicum — ropy strings, sinus connection; more localized plugs; Grind.: broader bronchorrhœa with sleep-starts. [Boger], [Clarke].

Asthma / hay-asthma

• Arsenicum — midnight asthma, anxious restlessness, wants warmth and sips; Grind.: wants cool air and sleep-propping. [Kent], [Farrington].
• Ipecacuanha — spasmodic wheeze with persistent nausea, clean tongue; sputum not necessarily gluey; Grind.: nausea secondary, tenacity primary. [Boericke].
• Blatta orientalis — basement/damp asthma, fat subjects, better fan; rattles; less sleep-apnœa hallmark. [Clarke], [Boger].
• Naphthalinum — hay-asthma remedy; more violent sneezing and coryza; Grind.: milder nasal, stronger bronchial tenacity. [Clarke].

Whooping-cough

• Drosera — violent, tearing cough, epistaxis, hoarseness; less gluey mucus; Grind.: coarse râles, apnœa on dozing between whoops. [Hering], [Farrington].
• Corallium rubrum — rapid, explosive fits, purple face; Grind.: slower, drowning-in-mucus type. [Clarke].

Skin (Rhus dermatitis)

• Rhus toxicodendron — the disease picture; Grindelia useful externally to soothe; internally scant skin indications. [Clarke], [Boericke].
• Anacardium — more bullous, burning; mental features; Grindelia is topical, chest-centred internally. [Farrington].

Vago-cardiac weakness

• Digitalis — bluish face, slow weak pulse, least motion causes faintness; little tenacious bronchorrhœa; Grind.: respiratory mucus chief, with sleep-apnœa. [Clarke], [Hughes].
• Carbo vegetabilis — collapse, cold sweat, wants to be fanned; sputum not especially gluey; Grind.: less collapse, more mucus plug. [Boger], [Farrington].

• Complementary: Antimonium tart. — follows Grind. when rattling persists without sleep-apnœa; or precedes when stupefaction dominates before Grind. clears gluey plugs. [Hering], [Farrington].
• Complementary: Senega — aged with tenacious mucus and chest soreness after Grind. relieves apnœic spells. [Clarke].
• Complementary: Blatta orientalis — damp-basement asthma; alternates seasons with Grind. in hay fogs. [Boger].
• Follows well: Euphrasia/Allium cepa in hay catarrh when chest suffocation supervenes, Grind. taking over bronchial tenacity. [Clarke].
• Follows well: Aconite at onset of acute bronchitis to calm vascular storm, then Grind. for mucus–apnœa phase. [Dewey].
• Precedes well: Digitalis or Carbo veg. if cardiac collapse remains after mucus is freed. [Clarke], [Boger].
• Related/Compare:, Ipec., Ant-t., Senega, Kali-bi., Blatta, Samb., Op., Lach., Naphth., Drosera, Coral. (see Differentials).
• Antidotes: Fresh air, arousal, warm drinks (physiologic); Camphor for medicinal over-action (classical). [Allen], [Hering].
• Inimicals: none recorded; avoid alternation with near congeners without a fresh keynote. [Boger].

• Emphysema with night suffocation; “stops breathing on falling asleep; cannot lie down; must sit up; coarse râles; tough mucus.” 6C–30C at bedtime and during night spells; prop high; cool steady air. [Allen], [Clarke], [Boericke].
• Whooping-cough with cyanosis, drowsy spells between whoops, coarse rattling, relief after a warm drink and being propped: Grind. 6C t.i.d.–q.i.d. during paroxysmal stage. [Hering], [Farrington].
• Hay-asthma in fog/sea-mist—sneezing → drowning chest; warm rooms <; cool air >: Grind. 6C before bed and on exposure days. [Clarke], [Hughes].
• Rhus dermatitis (poison-oak/ivy): lotion of θ in water (external) for burning/itch; do not suppress violently if chest is unstable. [Clarke], [Boericke].

Mind

• Fear of suffocation on falling asleep; begs to be propped — mechanical, not metaphysical fear; Grindelia-congruent. [Allen], [Clarke].
• Anxiety in warm, close rooms; cool steady air calms — environment mirrors lungs. [Clarke].
• Irritability until tough sputum is detached; calmer “after expectoration” — outlet law in mind. [Clarke].
• Child frightened before the whoop, drowsy afterwards — whoop temperament. [Hering].
• Confusion from hypoxia in elderly; clears when sitting aired — cardiac–pulmonary link. [Boericke].
• Panic at lying down; trusts the chair and pillows — positional signature. [Allen].

Head

• Headache congestive with chest oppression; better in cool air and after expectoration — chest–head hinge. [Clarke].
• Vertigo on lying down; must sit up to breathe — positional. [Allen].
• Dusky face, cyanotic lips during paroxysm — asphyxial sign. [Boericke].
• Frontal weight with hay sneezing — catarrhal overlap. [Clarke].
• Sweat on forehead with choking fit — autonomic sign. [Hering].
• Head clearer after warm drink loosens mucus — management cue. [Hughes].

Nose / Throat

• Sneezing paroxysms with chest oppression (hay-asthma) — prelude to dyspnœa. [Clarke].
• Posterior, adhesive mucus dropping into larynx — tickle with ineffectual cough. [Allen].
• Warm rooms < coryza/hoarseness; cool air > — thermal rubric. [Clarke].
• Dust, smoke, pollen excite cough — trigger rubric. [Allen].
• Voice breaks from gluey mucus; reading aloud exhausts — laryngeal fatigue. [Boericke].
• Warm drinks loosen; dry air < — remedy management. [Hughes].

Chest / Respiration

• Cannot lie down; must sit up to breathe — master posture rubric. [Clarke], [Boericke].
• Breathing stops on falling asleep; must be aroused — pathognomonic Grindelia sign. [Allen], [Hering].
• Coarse râles with tenacious sputum difficult to detach — chest texture. [Clarke].
• Warm, close rooms <; cool, steady air > — environment law. [Clarke].
• Dyspnœa of emphysema (old people) with weak pulse — constitutional chest. [Boericke].
• Expectoration brings relief — outlet note. [Clarke].

Heart

• Pulse weak, irregular during dyspnœa — vago-cardiac. [Clarke], [Hughes].
• Palpitation from slight exertion in chest cases — exertion link. [Boger].
• Cyanosis with cold sweat in night spells — danger sign. [Boericke].
• Syncope threatens on dozing — sleep–heart hinge. [Allen].
• Better sitting propped, worse lying — positional. [Clarke].
• After warm drink and air, heart steadier — management. [Hughes].

Sleep

• Apnœa on falling asleep; must be shaken to breathe — keynote. [Allen], [Hering].
• Cannot lie; sleeps sitting propped — positional law. [Clarke].
• Night attacks after first sleep; 1–2 a.m. — timing. [Boericke].
• Dreams of drowning/smothering — symbolic. [Clarke].
• Child dozes and chokes in whoop — paediatric pointer. [Hering].
• Warm room < sleep; cool air > — environment rubric. [Clarke].

Skin

• Rhus dermatitis (poison-oak/ivy): burning, vesicles, oozing — external Grindelia soothes. [Clarke], [Boericke].
• Pruritus better lotion; beware suppression if chest unstable — management caveat. [Clarke].
• Eczema patches itch in warmth — thermal parallel. [Boericke].
• Skin pallor/blue tinge in attacks — systemic anoxia sign. [Boericke].
• Sweat cold on face during choking — autonomic. [Hering].
• Alternation skin↔chest observed — constitutional note. [Clarke].

Generalities

• Worse lying down; worse falling asleep — grand generals. [Allen], [Clarke].
• Better sitting up; better cool, steady air — grand ameliorations. [Boericke], [Clarke].
• Warm, close rooms aggravate — thermal law. [Clarke].
• Relief when expectoration becomes free — outlet law. [Clarke].
• Fog, sea-mist, autumn < in hay-asthma — weather rubric. [Hughes].
• Exertion aggravates; rest steadies — kinetic law. [Boger].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–79): proving/clinical fragments—apnœa on falling asleep, cannot lie down, coarse râles, tenacious sputum.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879): confirmations—whooping-cough with cyanosis and drowsy spells; necessity to arouse; sleep-start suffocation.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): substance background, hay-asthma, emphysema of the aged, Rhus dermatitis (external), modalities (cool air, sitting up).
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—cannot lie; stops breathing on falling asleep; tough mucus; emphysema; relationships and external use.
Hughes, R. — A Manual of Pharmacodynamics (1870): eclectic notes—expectorant, antispasmodic; cardiac–vagal depression; management (warm drinks, cool air).
Farrington, E. A. — Clinical Materia Medica (1887): differentials—Antimonium tart., Arsenicum, Ipecac., Sambucus, Senega, Kali bich.; whoop/bronchitis distinctions.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): miasmatic tones; exertion/warm-room aggravations; emphysema in the aged; relationships (Blatta, Digitalis, Carbo veg.).
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): constitutional hints—after-sleep aggravations (Lachesis) contrasted; anxious/restless Arsenicum vs mechanical fear Grindelia.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): practical bedside remarks in bronchitis/emphysema and whoop; dosing/repetition notes.
Dewey, W. A. — Practical Homœopathic Therapeutics (1901): sequencing—Aconite at onset → Grindelia for mucus/apnœa; general management of acute bronchitis/whoop.
Tyler, M. L. — Homœopathic Drug Pictures (1942): vivid portraits of the “cannot lie—must be waked to breathe” asthmatic; comparisons with Ant-t., Arsenicum, Sambucus.
Hale, E. M. — New Remedies (1875): early clinical experiences—asthma, whooping-cough, Rhus dermatitis; confirmations quoted by later authors.