Hamamelis virginiana

A deciduous shrub of the Hamamelidaceae native to North America. The tincture is prepared from the fresh twigs, leaves, and bark, macerated in alcohol and potentised per pharmacopoeial method [Hering], [Clarke]. Toxicologically and physiologically, Hamamelis shows a marked action on venous walls and capillaries, diminishing calibre and permeability, with clinical effects in venous stasis, varicosities, phlebitis, and passive dark haemorrhages from mucosae and serosae [Hughes], [Hale], [Clarke]. Its keynote is venous bleeding—dark, passive, oozing, often disproportionately weakening, with soreness as if bruised of the affected part (nose, uterus, rectum, testes, veins) [Hering], [Allen], [Boericke], [Boger].

The pathogenesis is drawn from provings, physiological tests, and wide clinical confirmations: venous haemorrhages, varicosities (legs, rectum, spermatic veins), phlebitis, epistaxis (often vicarious with menses), metrorrhagia/menorrhagia (dark, passive), post-traumatic bleeding, haemorrhoids that bleed freely with soreness, orchitis/epididymitis with sore bruised testicle, and eye haemorrhages with pain and photophobia [Hering], [Allen], [Clarke], [Boericke], [Hale], [Farrington], [Nash].

Essence: Venous remedy par excellence—when the case is painted in blues and purples: dark, passive, venous haemorrhages and soreness as if bruised in congested tissues (nose, uterus, rectum, testes, veins). The patient is pale, still, and faint rather than hot and restless; heat, standing, hanging, motion, and touch worsen; cold, pressure, elevation, rest, and cool air help. Think Hamamelis for bleeding piles, vicarious epistaxis, dark uterine floods, varicocele, phlebitis, ocular bleeds, and post-traumatic oozing—and then follow with China if debility lingers once the ooze is checked [Hering], [Allen], [Clarke], [Boericke], [Boger], [Nash], [Farrington], [Hughes].

• Veins and Capillaries. Venous stasis, varicosities, phlebitis, thrombophlebitic soreness; tendency to oozing dark blood from congested parts; worse letting limb hang, better elevation and elastic pressure [Hering], [Clarke], [Boger].
• Haemorrhage (Venous). Dark, passive, non-excited bleeding from nose, uterus, rectum, lungs, and after injury; faintness from small losses (Loss-of-fluids linkage) [Allen], [Clarke], [Boericke].
• Rectum. Bleeding piles with marked soreness; stool followed by venous gush; external piles bluish, tender, bleeding on least touch [Hering], [Boericke], [Boger].
• Uterus and Ovaries. Menorrhagia/metrorrhagia—dark flow, passive; vicarious epistaxis; after trauma or over-exertion; ovaralgia with pelvic congestion [Clarke], [Allen], [Farrington].
• Nose & Nasal Mucosa. Epistaxis easily, dark venous; with headache or as vicarious menses; soreness of bridge/root [Hering], [Allen].
• Testes & Spermatic Veins. Varicocele, orchitis/epididymitis with sore bruised testicle; darting to groin; veins distended bluish [Hering], [Clarke], [Boericke].
• Eyes. Retinal/subconjunctival haemorrhages, traumatic eye bleeds with aching, bruised pain and photophobia [Allen], [Clarke], [Hughes].
• Lungs. Haemoptysis—dark, venous; tickling cough with chest soreness; after strain [Allen], [Clarke].
• Skin & Soft Tissue. Bruises painful and oozing; bluish congested veins; ecchymoses persisting [Boericke], [Hale].
• Pelvic & Portal Congestion. Heaviness, bearing-down from congested venous plexuses (pelvic, portal) [Clarke], [Boger].

The mental state mirrors blood loss and venous congestion. With haemorrhage there is quiet sinking, an anxiety out of proportion to the visible flow—patients dread another gush and cling to attendants, though not with the burning restlessness of Arsenicum (they lie still and pale) [Clarke], [Nash]. After epistaxis or uterine loss they grow indifferent, drowsy, and easily faint, a China-like loss-of-fluids debility that Ham. addresses on the bleeding side rather than the tonic side (Relationship: China complements) [Allen], [Nash], [Boericke]. Hypochondriacal worry centres on veins and bleeding: fear the piles “will burst,” or that the monthly flow “won’t stop” (Affinity: Rectum/Female) [Clarke]. Irritability is gentle, mostly a soreness of temper—touchy like the tissues themselves; the least interference to a tender part provokes tears or complaint (Modalities: worse touch) [Hering]. There is a heaviness of spirits with pelvic or portal congestion; they sit still and cool by a window, fearing heat or movement will kindle bleeding (Better open air; Worse heat/motion) [Clarke], [Boger]. Shock from injury is quiet, with oozing and a faint wish to be left alone; yet reassurance settles them, and cold compresses calm mind and body together (Affinity: Skin/Veins) [Hale], [Clarke]. The mental picture lacks serpent-like delirium or tragic despair; it is pale, venous, passive, governed by the state of the vessels [Boericke], [Farrington]. As oozing lessens and venous tone improves, confidence returns and the patient resumes gentle movement—an observable mind–vessel synchrony [Clarke], [Boger].

Sleep is broken by bleeding and soreness. After epistaxis or uterine oozing, the patient falls into dull sleep but wakes faint if he stirs; warmth of bed encourages renewed oozing, so they learn to keep cool and very quiet (Modalities) [Clarke], [Allen]. Piles throb and ache in the first hours of the night; cold sponging allows a return to drowse (Rectum cross-link) [Hering], [Boericke]. Varicose legs throb when dependent off the side of the bed; elevation and bandage secure sleep (Extremities) [Boger]. Dreams circle around accidents and blood, often with a start and hand pressed to a tender part; upon waking they check linen for stains (Mind/Skin) [Clarke]. Recovery nights show calmer pulse, deeper sleep, and fewer wakings once bleeding has been mastered and coolness maintained (Generalities) [Nash]. If a bleed occurs at night, the head feels clearer but the body more exhausted, mirroring the Ham. paradox—pressure eased, strength lowered (Head/Generalities) [Clarke], [Allen]. Snug but cool bedding, window ajar, and limb elevated become learned sleep hygiene in this remedy (Modalities synergy) [Clarke], [Boger].

Of falling and bruising, blood on linen, crowds and heat (worsening), and of searching for cold water; waking brings careful stillness to avoid a return of flow (Mind/Modalities) [Clarke].

Hamamelis is the archetype of venous pathology: dark, passive, venous haemorrhages and bruised soreness in congested tissues. The modal logic is exact: worse from heat, standing, dependent positions, motion, touch, straining, and warm drinks; better from cold, pressure, elevation, rest, open cool air, and gentle elastic support [Hering], [Clarke], [Boger], [Boericke]. The loss-of-fluids axis is strong: small oozings cause big weakness; yet, paradoxically, a bleed can relieve head or pelvic pressure while lowering strength (echoing the China relationship) [Allen], [Nash], [Clarke]. The organ map is veins first—rectal plexus (piles), pelvic plexuses (menorrhagia, metrorrhagia, varicocele), nasal mucosa (epistaxis), ocular bed (subconjunctival/fundal bleeds), cutaneous venules (ecchymoses)—each with soreness and dark oozing [Hering], [Allen], [Clarke]. Compared with neighbours: Aesculus has dry, burning piles with sacral backache and little bleeding; Ham. is sore and bleeds [Boericke], [Farrington]. Millefolium answers bright arterial bleeds after strain; Ham. is dark venous [Clarke]. Phosphorus bleeds bright with warmth and anxiety; Secale bleeds thin, offensive, icy and uncovered; Crotalus bleeds black, non-coagulable with sepsis—Ham. stands between, venous, passive, sore, without putridity [Farrington], [Kent], [Clarke]. When veins are the story, and cold + pressure + elevation are the patient’s crutches, Hamamelis should be front of mind.

Not a primary fever remedy. In bleeding states there may be mild chill, subjective heat in congested parts, and cool, clammy skin from loss of blood; fever remits as oozing is checked (Generalities) [Nash], [Clarke].

Chill after haemorrhage; heat of parts congested (piles, pelvis) in warm rooms; sweat cold and fainting after oozing (Loss-of-fluids) [Allen], [Clarke].

Venous fullness and heaviness characterise the head symptoms, often with epistaxis that relieves the oppressed feeling—a classic vicarious outlet in girls with delayed or suppressed menses (Nose/Female links) [Hering], [Allen], [Clarke]. The bridge of the nose and root feel sore to touch; frontal pressure mounts in warm rooms and abates with cool air or cold sponging (Modalities) [Clarke]. After nosebleed there is faintness and sleepiness, yet renewed bleeding follows the least motion or warm drink (Worse motion/heat) [Allen], [Clarke]. Headache may alternate with uterine or rectal bleeding; as pelvic congestions drain, the head clears (System cross-link) [Clarke]. Following eye strain or trauma, ocular haemorrhage with aching, bruised pain and photophobia rounds out the cephalic picture (Eyes) [Allen], [Hughes]. In chronic venous subjects the scalp shows easy ecchymoses from trivial knocks (Skin/Affinity) [Hering], [Boericke].

Subconjunctival and retinal haemorrhages with aching, bruised or sore sensation; light hurts, lids feel heavy; vision is misty until extravasation recedes (Affinity: Veins/Capillaries) [Allen], [Hughes], [Clarke]. After trauma a dark suffusion spreads under the conjunctiva; cold bathing and rest soothe and limit oozing (Better cold/rest) [Allen]. Fundal bleeds with venous stasis may accompany arteriosclerotic or portal congestion; time and coolness favour absorption (Generalities) [Clarke]. Tears are not acrid; the signature is passive bleeding and soreness [Boericke]. Eye effort (reading) in a warm room revives fullness and soreness; fresh air steadies (Modalities) [Clarke].

A dull venous humming or fullness may attend head congestion, easing after epistaxis or in cool air (Head/Nose cross-link) [Clarke]. Auricular bruises ooze darkly after trivial knocks; tenderness to touch persists (Skin/Affinity) [Hering].

Epistaxis with dark, venous flow, sometimes clotted, often vicarious of menses; starts on washing the face with warm water, in warm rooms, or on slight exertion; stops with cold applications and pressure (Modalities) [Hering], [Allen], [Clarke]. Soreness at bridge and septum; picking renews oozing [Allen]. After flow, faintness and drowsiness [Clarke], [Nash].

Pale, venous, sometimes bluish hue about lips and lower lids in venous stasis; blushes easily in heat and then feels faint (Generalities) [Clarke]. Cheeks bruise and mark easily; ecchymoses linger (Skin) [Hering]. Expression grows relieved after a bleed that removes pressure (though strength sinks) [Allen].

Taste of blood after the least gum trauma; gums bleed darkly on brushing (Haemorrhagic diathesis) [Allen], [Clarke]. Mouth and tongue generally clean; thirst after bleeding for cool water in sips (Loss-of-fluids) [Allen].

Slight dental work provokes dark oozing; sockets tender as if bruised; pressure and cold rinses relieve (Modalities) [Allen], [Boericke].

Venous congestion with mottled, dusky mucosa; oozing from small erosions; soreness to touch and swallowing, better cold; no diphtheritic character (contrast serpent group) [Clarke], [Boger].

Haemoptysis—dark, venous—after strain, cough, or over-exertion; chest feels sore as if bruised; cool air easier than warm room (Affinity/Modalities) [Allen], [Clarke]. Tickling cough with venous oozing; no great heat or anxiety as in Phos. (bright) [Farrington].

Palpitation from blood loss and weakness; small, soft pulse after bleeding; oppression in warm rooms relieved by cool air (Generalities) [Clarke], [Nash]. The heart sphere is secondary to vessel tone; as haemorrhage stops, pulse steadies [Boericke].

Short breath on exertion following loss of blood; sighing; better rest and cool air (Loss-of-fluids modality) [Clarke], [Nash].

Nausea chiefly after blood loss or from the sight of blood; faint sinking at epigastrium relieved by cold sips and lying quiet (Generalities) [Allen], [Clarke]. Appetite small during congestive phases; heavy meals aggravate pelvic/portal congestion (Abdomen) [Clarke].

Sense of pelvic and portal fullness, bearing-down in hypogastrium and anus with venous throbbing; heat or prolonged standing aggravates; cool applications and lying down relieve (Rectum/Female cross-links) [Clarke], [Boger].

Cardinal sphere. Haemorrhoids—external, bluish, tender, exquisitely sore to touch—bleed freely with dark venous blood, especially after stool or least exertion (Affinity: Veins/Haemorrhage) [Hering], [Boericke], [Boger]. Oozing may continue in warm bed; cold bathing, pressure, and elevation palliate (Modalities) [Clarke]. Sensation as if bruised in anus and perineum; pricking or burning less than soreness (contrast Aesculus) [Boericke], [Farrington]. Faintness and languor follow small losses (Loss-of-fluids) [Nash].

Haematuria of dark blood in venous subjects (rare); more often pallor and faintness after rectal or uterine losses with scant urine until tone returns (Generalities) [Clarke].

Warm drinks tend to renew epistaxis; cold water in sips steadies (Modalities) [Clarke], [Allen]. Alcohol dilates vessels and aggravates congestion; light diet avoids portal engorgement (Abdomen) [Clarke].

Varicocele—veins distended, bluish, scrotum sore, bruised, worse standing or letting hang, better support and cold (Affinity) [Hering], [Clarke]. Epididymitis/orchitis with aching soreness; local cold relieves (Modalities) [Boericke]. Sexual desire depressed during venous congestion; returns as soreness abates [Clarke].

Menorrhagia/metrorrhagia—dark, passive flow with pelvic soreness and faintness; heat, motion, and standing increase flow; cold and rest check it (Modalities) [Clarke], [Allen]. Vicarious epistaxis at menses; ovaralgia from pelvic congestion; leucorrhoea thin and irritating less characteristic than bleeding [Hering], [Farrington]. Post-partum oozing, after miscarriage, and climacteric floods (dark) are classic clinical fields (Differentials: Trillium, Sabina, Secale) [Clarke], [Boericke].

Lumbosacral aching and fullness from pelvic congestion; standing aggravates, lying and cooling relieve (Female/Rectum) [Clarke], [Boger].

Varicose veins of legs—bluish, distended, tender, worse standing/hanging, better elevation, compression, cold (Affinity) [Hering], [Boger]. Ecchymoses and bruises ooze and remain sore long; slight knocks leave marks (Skin) [Boericke].

Ecchymoses, purpura tendency of a venous type; cold compresses and rest soothe; heat renews oozing (Modalities) [Hering], [Clarke]. Veins enlarged, tortuous, bluish under thin skins (legs, hands, scrotum) [Boger].

• Aesculus — Piles dry, burning, severe sacral backache, little bleeding; Ham. piles bleed dark, are sore/bruised [Boericke], [Farrington].
• Millefolium — Bright red active bleeding after lifting/strain; less local soreness; Ham. is dark, venous, passive [Clarke], [Farrington].
• Phosphorus — Bright, copious haemorrhage with anxiety, desire for cold drinks; Ham. dark venous and passive with soreness [Kent], [Clarke].
• Crotalus horridus — Black, non-coagulable, septic oozing with icterus; Ham. lacks sepsis; blood is venous-dark, less fetid [Clarke], [Boericke].
• Secale — Thin, offensive bleeding with icy coldness, wants to be uncovered; Ham. prefers cold, but the bleeding is venous-passive, not gangrenous [Boger], [Clarke].
• Trillium — Uterine haemorrhage with gushing on movement, faintness; more obstetric; Ham. wider venous sphere with piles, epistaxis, varices [Clarke], [Nash].
• Sabina — Uterine bright blood with clots and sacral pains; Ham. dark passive with soreness [Farrington], [Clarke].
• Vipera — Vein inflammation worse letting limb hang; intense bursting pains; useful comparator in phlebitis; Ham. has more bleeding keynote [Boger], [Farrington].
• Arnica — Trauma with bruised soreness but not the same venous haemorrhage signature; Ham. where oozing dark blood persists [Clarke], [Boericke].
• Bellis perennis — Deep tissue trauma; pelvic congestion postpartum; less bleeding key; Ham. if oozing predominates [Clarke].
• Collinsonia — Pelvic venous congestion with constipation, cardiac pile; less bleeding than Ham. [Boger], [Clarke].
• Ferrum — Anaemia with easy bleeding, flushing alternates with pallor; Ham. bleeding is venous with soreness and strong cold modality [Kent], [Clarke].
• China — Collapse after loss of fluids; Ham. to check oozing, then China to restore tone (relationship rather than differential) [Nash], [Boericke].

• Complementary: China (post-haemorrhagic debility), Aesculus (rectal plexus congestion without much bleeding), Vipera (phlebitis with hanging aggravation), Collinsonia (pelvic venous stasis with constipation), Bellis-per. (deep trauma) [Clarke], [Boger], [Boericke], [Nash].
• Follows well: Millefolium (after bright arterial bleeding gives way to venous oozing), Arnica (after trauma when bruised soreness persists with dark bleeding) [Clarke], [Farrington].
• Precedes well: China (rebuild after loss), Ferrum (anaemic reconstitution), Calc-flu. (venous wall tone) [Kent], [Nash], [Clarke].
• Related: Phos., Secale, Trillium, Sabina, Crot-h., Aesculus, Vipera, Collinsonia, Bellis-per., Arnica—see differentials.
• Antidotes/Notes: Heat and alcohol antagonise Ham.’s sphere by dilating veins; cold, pressure, elevation act as natural adjuvants [Clarke], [Boericke].
• Inimical: None classically fixed; avoid indiscriminate alternation with deep haemorrhagics without indication [Kent], [Clarke].

• Venous haemorrhage — dark, passive bleeding from nose, uterus, lungs, or rectum; blood flows freely but without much effort or pain [Clarke], [Boericke].
• Varicose veins — tender, sore, bruised veins in legs, vulva, or rectum; veins feel like cords, sensitive to touch and pressure [Hering].
• Haemorrhoids — bleeding piles with soreness, burning, fullness in rectum, and passive venous oozing; especially when veins feel engorged and bruised [Allen].
• Bruised soreness — after injuries or trauma, especially of veins, muscles, or contusions; complementary to Arnica where venous system is affected [Clarke].
• Epistaxis — nosebleed of dark blood, often profuse and without exertion; particularly in children and adolescents with venous plethora [Boericke].
• Menorrhagia and metrorrhagia — passive uterine bleeding, dark, with pelvic fullness and soreness; valuable in menopausal flooding or uterine fibroids [Clarke].
• Phlebitis and thrombosis — locally and internally, relieves pain and soreness of inflamed veins [Hering].
• Ocular haemorrhage — subconjunctival bleeding, retinal haemorrhages, bruised soreness of eyeball [Boericke].
• Modalities — worse from motion, touch, damp cold; better from rest and gentle pressure [Clarke].
• Clinical dosing — tincture or low potencies (mother tincture, 3X, 6X) for haemorrhages and local venous states; higher potencies (30C, 200C) where constitutional picture predominates [Boericke].

Case Pearls

• Bleeding haemorrhoids — A middle-aged man with bleeding piles, sore bruised veins, and fullness in rectum improved greatly on Hamamelis Ø internally, along with local application [Clarke].
• Post-partum uterine haemorrhage — A woman with dark, passive uterine flow, no contractions, and great soreness of pelvis recovered quickly with Hamamelis 3X [Allen].
• Subconjunctival haemorrhage — An elderly patient developed bright subconjunctival effusion after strain; Hamamelis Ø locally and 6X internally hastened absorption [Boericke].
• Varicose veins in pregnancy — A woman with large, painful varices in legs and vulva was relieved by Hamamelis 30C, taken daily, reducing soreness and swelling [Hering].
• Nosebleeds in adolescent — Recurrent, dark, passive epistaxis with pallor and fatigue stopped under Hamamelis Ø, a few drops in water, three times daily [Clarke].

Mind

• Anxiety and fear of bleeding during oozing; lies quiet.
• Faintness after small losses of blood.
• Indifference, drowsy after epistaxis/menorrhagia.
• Aversion to warm room; seeks cool air.
• Irritable from touch of tender parts.
• Clings to attendants during flow; reassured by cold compress.

Head / Nose

• Epistaxis, dark, venous, worse warm room, better cold applications/pressure.
• Head fullness relieved by epistaxis.
• Sore bridge of nose; touch renews oozing.
• Vicarious nosebleed at menses.
• Drowsy after epistaxis with pallor.
• Warm drink renews nasal flow.

Eyes

• Subconjunctival/retinal haemorrhage with aching, bruised pain.
• Photophobia with ocular bleed.
• Better cold bathing and rest.
• Eye suffusion after trivial trauma (dark).
• Misty vision until extravasation absorbed.
• Venous stasis signs about lids.

Rectum

• Haemorrhoids: bluish, tender, bleed dark after stool.
• Oozing in warm bed; better cold sponging.
• Soreness as if bruised in anus.
• Bleeding from slight touch/strain.
• Faintness after small rectal loss.
• Better pressure/elevation.

Female

• Menorrhagia/metrorrhagia, dark, passive, worse heat/standing/motion.
• Vicarious epistaxis at menses.
• Post-partum/miscarriage oozing, dark.
• Pelvic bearing-down from venous stasis.
• Ovaralgia with congestion.
• Climacteric dark floods with faintness.

Male

• Varicocele, veins bluish, distended, sore testis.
• Orchitis/epididymitis with bruised pain.
• Worse standing/hanging; better support/cold.
• Scrotal veins tender to touch.
• Post-coital pelvic congestion with soreness.
• Darting to groin with congested vein.

Chest / Lungs / Heart

• Haemoptysis dark, venous, after exertion/cough.
• Chest sore as if bruised.
• Better cool air, worse warm room.
• Palpitation after bleeding; pulse soft, weak.
• Oppression with venous fullness.
• Tickling cough with dark streaks.

Extremities / Veins / Skin

• Varicose veins worse standing, hanging; better elevation, compression, cold.
• Phlebitis with soreness, throbbing.
• Ecchymoses persist; easy bruising.
• Bruises ooze dark blood.
• Bluish venous networks under skin.
• Night warmth aggravates venous aching.

Generalities / Modalities

• Worse: heat, warm rooms, standing, letting part hang, motion, touch, strain, warm drinks, night warmth in bed.
• Better: cold, pressure, elevation, rest, open cool air, elastic support, small cold sips after loss.
• Loss-of-fluids weakness out of proportion to visible loss.
• Bleeding relieves pressure yet exhausts.
• Venous congestion first, symptoms follow vessel state.
• Passive temperament, quiet sinking with oozing.

Hering — The Guiding Symptoms of Our Materia Medica (1879–91): venous haemorrhages (nose, uterus, rectum, lungs), piles with soreness, varicocele/orchitis; ocular haemorrhages; modalities (cold/pressure/elevation).
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): epistaxis vicarious of menses, ocular bleeds, haemoptysis, post-haemorrhagic faintness.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): remedy portrait—venous stasis, haemorrhage quality, modalities; pelvic/portal congestion; differentials (Aesculus, Millefolium, Phosphorus, Trillium, Secale, Crotalus).
Boericke, W. — Pocket Manual of Homeopathic Materia Medica (1901): keynotes—dark venous bleeding, piles sore and bluish, varicose veins, eye and lung haemorrhages; cold/pressure better.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): modalities (worse standing/hanging/heat; better elevation/pressure/cold); varicosities and phlebitis.
Hughes, R. — A Cyclopaedia of Drug Pathogenesy (1895): physiological astringency on veins/capillaries; ocular haemorrhage reports.
Hale, E. M. — New Remedies (late 19th c.): witch-hazel as vascular astringent; trauma with oozing; topical and internal uses.
Farrington, E. A. — Clinical Materia Medica (1887): comparative haemorrhagics (Millefolium, Phosphorus, Trillium, Secale); rectal and uterine notes.
Nash, E. B. — Leaders in Homeopathic Therapeutics (1899): loss-of-fluids debility, China relationship; dark venous bleeding; bedside guidance.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): haemorrhagic constitutions; comparisons with Phosphorus/Secale/serpents; miasmatic setting.
Tyler, M. L. — Homoeopathic Drug Pictures (20th c.): practical bedside hints—piles, epistaxis, pelvic venous states; cold vs heat nuances.
Dunham, C. — Homoeopathy, the Science of Therapeutics (1877): clinical management of haemorrhage and convalescence (contextual).
Burt, W. H. — Physiological Materia Medica (late 19th c.): venous system emphasis; trauma and capillary extravasations.