• Mucous membranes of air-passages (larynx–trachea–bronchi). Harsh, croupy coughs, laryngeal spasm, tenacious mucus, choking at slightest draft; worse cold dry wind, better damp/wet weather. See Throat/Chest/Respiration. [Hering], [Clarke], [Kent]
• Glands & cellular tissue. Suppuration of tonsils, submaxillary, cervical, mammary, and axillary glands; quinsy with imminent abscess; felons and boils. See Throat/Back/Extremities/Skin. [Hering], [Allen]
• Skin & appendages. Acne with pustulation, boils/carbuncles, ingrown nails, hangnails with throbbing pain; splinter-like pains; unhealthy skin that suppurates from slightest injury. See Skin/Extremities. [Clarke], [Boericke]
• Ears & mastoid. Otitis media with stitching, offensive otorrhoea, excoriating discharge; mastoid tenderness. See Ears. [Hering], [Allen]
• Nose & sinuses. Fetid, thick coryza, acrid crusts, bleeding on removal; sinusitis with tenderness of nasal bones. See Nose/Head. [Clarke], [Boger]
• Mouth & throat. Peritonsillar abscess, splinter pains, saliva ropy, breath offensive; gagging cough from little exposure. See Mouth/Throat. [Hering], [Allen]
• Rectum & anus. Fistula, fissure, piles with suppuration, splinter pains on stool; peri-anal abscess. See Rectum. [Boger], [Clarke]
• Genito-urinary mucosa. Fetid leucorrhoea, balanitis with phimosis tendency to suppurate; cutting, splinter-like urethral pains. See Urinary/Female/Male. [Allen], [Clarke]
• Bones/periosteum (secondarily). Nightly pains with splinter/needle sensation around ulcers and caries in scrofulous subjects. See Back/Extremities/Skin. [Hering]
• Nerves—sensory reactivity. Extreme oversensitivity to pain, touch, and cold (wants to be wrapped up); irritable, hasty temper. See Mind/Generalities. [Kent], [Hering]

• Warmth in general; wrapping up; warm room; warm drinks. Cannot bear a draft; wants head and throat wrapped; ameliorates pain and spasm. [Hering], [Kent], [Clarke]
• Damp or humid weather. Paradoxically many respiratory symptoms ease in wet; worse dry cold wind. [Clarke], [Tyler]
• After perspiration (gentle), especially when induced by warmth. [Boger]
• Covering the affected part (ears, throat, ulcers) and avoiding uncovering. [Hering]
• Rest; quiet; avoidance of touch or jarring. [Allen]
• Eating hot foods/drinks for throat/larynx; warm milk, soups. [Clarke]
• Moist applications to ulcers when not yet discharging; once pus forms, free drainage relieves. [Hering]
• Being left alone when irritable; soft answers reduce anger spikes. [Kent]
• Careful, gentle pressure (bandage) around felons/boils. [Clarke]

• Least draft; cold dry wind; uncovering any part (especially head, throat, ear). [Hering], [Clarke]
• Touch; even slight pressure; jarring; the bed feels hard—pain sharpens to splinter-like. [Allen], [Kent]
• Night (after midnight toward 2–4 a.m.); morning on waking for croupy cough. [Hering], [Boger]
• Sweating then exposure—chill to bone, catarrh flares. [Clarke]
• Anger, vexation, and hurry—irritable, hasty; pains and spasms intensify. [Kent]
• Cold drinks (laryngeal spasm, cough), cold foods, icing. [Clarke]
• Suppression of discharges (pus, sweat, eruptions) → deeper irritation. [Boger]
• Stimulants (alcohol) and very spicy food—fetor and catarrh worsen. [Clarke]
• Lying on painful side (ear/throat/abscess), stooping (sinus pressure), deep inspiration (stitches). [Allen], [Clarke]
• Coitus in sensitive urethral conditions—cutting pains. [Allen]

Hyper-reactive, peevish, and hasty. The Hepar-s. patient is irritable at the least cause, answers snappishly, and can be vindictive—yet this temper springs from a raw, nerve-stripped sensitivity; the world feels too cold, too sharp, too loud. Anxiety of health is marked, with a dread of pain, suffocation, or impending suppuration; fear of drafts verges on phobia—windows must be shut, the head wrapped. Startles easily, is oversensitive to pain (even touch), and displays impatience and hurry, especially in acute illnesses of children who scream before each cough. Weepiness with self-pity alternates with anger; the least contradiction offends. Hepar’s cowardly irritability contrasts with Nux-v. (combative, driven), Cham. (anger from pain but heat-seeking), and Sil. (quieter, obstinate chilliness without the violent, fetid suppuration). Case: a boy with quinsy shrieked at spoon touch, demanded a hot scarf, and raged at an opened window; Hep. 200C aborted suppuration overnight. [Hahnemann], [Hering], [Kent], [Clarke], [Nash]

Headache from slightest draft, worse cold wind, better wrapping. Scalp exquisitely tender; combing hair hurts; pustules along margins with offensive oozing. Frontal heaviness with sinus pressure and splinter pains at root of nose; stooping increases weight. Throbbing temporal pains in warmth of bed after chill exposure. Compare Bell. (throbbing with redness/heat), Sil. (sinus with chilliness but less fetor), Merc. (sweaty, offensive but more salivation and fluctuation with night sweats). [Allen], [Clarke], [Boger], [Kent]

Phlyctenular and suppurative blepharitis; lids agglutinated, stye tendency, splinter-like pain at canthi; photophobia in cold wind. Thick, acrid, yellow discharge excoriates lids; eyes itch burn, better warm compress. Ulcers of cornea threatened—Hepar arrests when chill-exposure precedes. Compare Staph. (styes from vexation), Merc. (purulent with profuse sweat), Calc-s./Sil. (indolent). [Hering], [Allen], [Clarke]

Otitis media after cold wind; intense stitching, mastoid tenderness; cannot bear touch of the auricle; offensive, thick otorrhoea; hears own pulse. Parotid glands enlarge and suppurate. Child wakes screaming at night, grabs the ear, insists on warm wraps. Compare Puls. (bland, tearful, < warmth), Merc. (fetid discharge with sweating), Sil. (slow, thin discharge, less pain). [Hering], [Allen], [Clarke]

Coryza with thick, fetid discharge, raw nostrils, and crusts; blowing causes blood; inside nose pain as from a splinter; smell diminished. Left-to-right obstruction common; sneezing on least draft. Sinusitis with bone tenderness at nasal bridge; headache on stooping; patient wraps face outdoors. Compare Kali-bi. (stringy plugs), Merc. (profuse, offensive with salivation), Sil. (chronic, scanty discharge, chilliness). [Clarke], [Boger], [Allen]

Pale, sallow or pasty; acne pustules with yellow heads; carbuncle tendencies; offensive sweat about lips and chin. Facial neuralgia splinter-like, < cold, > warmth/covering. Lips crack in dry cold; corners fissured and suppurate. [Hering], [Clarke], [Allen]

Offensive breath; saliva tenacious; gums swollen, bleed easily, abscess at root with splinter pain on touch; toothache < cold air/drinks, > warmth. Tongue mapped or coated yellow, edges painful to touch; taste sour or metallic. Aphthae that ulcerate and are exquisitely sensitive. Compare Merc. (salivation with flabby tongue prints), Staph. (crumbling caries), Sil. (chronic fistula). [Allen], [Clarke], [Hering]

Pustular gingivitis, dental abscess; throbbing; splinter pain on biting; cannot bear cold water to touch a tooth. Children cry with tooth-brushing unless water is warm. [Allen], [Hering]

Cardinal sphere. Quinsy/peritonsillar abscess with knife/splinter pains on swallowing, stitching to ear, excessive salivation, breath offensive, uvula oedematous; worse cold air, worse uncovering neck, better warm drinks and wrapping. Croup: harsh, barking, choking cough, suffocative attacks after midnight, child starts and grasps larynx, > damp weather, < cold dry wind—progression to rattling mucus if unchecked. Chronic laryngitis in speakers—voice husky, cough from slightest draft. Compare Spong. (sawing sound, wants warm drinks but less fetor), Acon. (early dry croup < midnight, fear but little pus), Merc. (saliva and foulness with perspiration but less “splinter” and less draft-phobia). [Hering], [Clarke], [Allen], [Kent], [Farrington]

Craves sour and pungent yet regrets after; aversion to fat; nausea from mucus; empty sinking with chill; pain on swallowing cold drinks travels to larynx with cough. Gastralgia < cold, > warm food. [Allen], [Clarke]

Tympany with catarrh; mesenteric gland tenderness in scrofulous children; cutting, splinter-like pains along colon before stool. Liver region sensitive to touch, > warmth. [Hering], [Clarke]

Frequent urging with burning at meatus; cutting as from a splinter in urethra; cloudy urine with mucus threads; fetid odour. Chilliness while urinating. Cystitis after chilling, > warmth. [Allen], [Clarke]

Fissures and fistulae, peri-anal abscess, suppurating piles with splinter pain “as if a fish-bone”; stool painfully difficult though soft from spasm; discharge fetid, bleeds easily. After stool, chill and exhaustion. Compare Nit-ac. (splinter pains, but < touch of cloth and < acids), Sil. (fistula but less extreme draft-sensitivity), Aes. (dry piles without suppuration). [Boger], [Clarke], [Allen]

Balanitis with purulent, fetid discharge; phimosis/paraphimosis tendencies; scrotal eruptions that suppurate; sexual desire irritable, coitus provokes urethral cuts. [Allen], [Clarke]

Leucorrhoea thick, yellow, fetid, < cold, > warmth; labial abscess, Bartholin gland suppuration. Mastitis with threatened abscess—Hepar can abort if given early; once pus is well-formed, hastens pointing and discharge (manage with surgical prudence). Dysmenorrhoea with splinter pains to rectum; vulvar fissures. Compare Phyt. (mastitis with shooting pains, firm nodules), Sil. (slow, indolent suppuration), Merc. (profuse sweat/saliva). [Hering], [Clarke], [Farrington]

Short, anxious, must be wrapped; sighing after paroxysms; cough excited by uncovering any part, by talking, touching throat, or cold air entering larynx. Worse 2–4 a.m.; > warm, moist air. [Hering], [Clarke], [Boger]

Palpitation with anxious chill on the least draft; stitching precordial pains < deep inspiration, < uncovering; pulse reactive in fevers with suppurative focus. [Allen], [Clarke]

Tightness in laryngo-tracheal tree with suffocative cough from the least draft; rattling mucus; choking on exposure of hand or foot from the bed; pain as of a splinter in chest on deep breath; stitches to scapulae. Croupous/bronchitic states with thick, tough, fetid expectoration. Asthma from cold dry wind; > damp weather. Compare Spong., Acon., Kali-bi. (stringy, ropy). [Hering], [Clarke], [Allen], [Kent]

Nuchal stiffness from cold; cervical glands enlarged and tender; splinter pains between scapulae on breathing; lumbar soreness around suppurating carbuncles. [Allen], [Clarke]

Felons (whitlows)—throbbing, exquisitely sensitive, > hot soaks, hastens pus; hangnails, ingrown nails; arthritic stitches < cold; child won’t uncover hands/feet; cramps in calves after chill. Compare Sil. (chronic slow felons), Myr-v. (ingrown nails). [Hering], [Clarke], [Allen], [Phatak]

Unhealthy; suppurates from slightest injury; boils/carbuncles with great sensitiveness and fetid, thick discharge; acne conglobata; eczema fissured and oozing, < cold, > warmth; ulcers with undermined edges, splinter pains, excessive fetor; sweat sour/offensive, but exposure after sweat → chill/flare. Hepar can abort early suppuration or promote resolution once pus is ripe—stage-sensitive. Compare Hepar vs. Silica: both chilly; Hepar extremely touch/cold sensitive with fetor and haste; Sil. slower, deeper, less offensive. [Hering], [Clarke], [Allen], [Kent], [Boericke]

Unrefreshing, frequent waking from choking cough or pain on uncovering; dreams of quarrels, of knives/splinters, of suffocation. Child sleeps with head wrapped, sweats, and wakes screaming if air touches skin. Worse after midnight (2–4 a.m.); drowsy by day after night-torments. [Hering], [Allen], [Clarke]

Of being stabbed by splinters/needles; of being exposed to cold; of filth and offensive things (fetor theme); of angry disputes. Wakes angry and chilled. [Allen], [Clarke]

Chill from slightest uncovering, even of a hand; heat with thirst, irritability, and sweat offensive; suppurative fevers with pointing abscess. Typhoid tendency when discharges are excessively fetid, yet patient demands warmth. Sweat does not relieve if followed by draft. [Clarke], [Boger], [Allen]

Chill: on least draft, while urinating, or on moving in bed. Heat: burning of parts yet cannot bear to uncover. Sweat: profuse, sour/offensive, especially toward morning; exposure after sweat aggravates all. [Allen], [Clarke], [Hering]

Craves sour and pungent; aversion to fat; desires warm drinks; cold drinks provoke cough/laryngeal spasm. Milk warm tolerated; ice cream dangerous trigger. [Clarke], [Allen]

Extreme chilliness and hypersensitivity define Hepar-s.: worse cold, worse draft, worse touch, better warmth and wrapping, better humid weather, with fetid, thick discharges and a must-suppurate tendency—splinter-like pains everywhere. Reactivity is explosive: pain out of proportion, temper hasty, tissues quick to inflame and form pus. Stage management is central: at the threshold, Hepar can abort suppuration; when pus is formed, it can hasten pointing and drain, after which the oversensitivity calms. [Hahnemann], [Hering], [Kent], [Clarke], [Boger], [Boericke], [Phatak], [Tyler]

Suppuration / Abscess

• Sil. Chilly, slow, delicate; indolent suppuration; less fetor, less explosive sensitivity. Hepar is quicker, more fetid, more touch-cold intolerant. [Hering], [Kent]
• Merc. Profuse salivation/sweat, fetor, bone pains, nightly aggravation; Hepar has draft-phobia and splinter pains with better humidity. [Clarke], [Allen]
• Bell. Hot, red, throbbing; no fetid pus or draft-phobia; more vascular storm. [Kent]
• Lach. Dark, bluish, septic, < after sleep, intolerance of tight collars; less “splinter” keynote. [Clarke]
• Pyrogen. Septic fever out of proportion to local signs; pulse-temp discordance; Hepar more local hypersensitivity. [Boger]

Croup/Laryngeal

• Spong. Sawing, as if breathing through a sponge; warm drinks help; less fetor, less irritable mind. [Clarke]
• Acon. First dry stage after exposure with fear; no pus tendency; Hepar later. [Farrington]
• Kali-bi. Ropy, pluggy expectoration; sinus strings; Hepar more splinter, fetid, draft-phobic. [Boger]

Otitis

• Puls. Mild, weepy, bland discharge, > cool air; Hepar < cold, fetid, touch-intolerant. [Clarke]
• Ferr-phos. Early congestive otalgia without pus; Hepar for suppurative turn. [Tyler]

Skin (boils/carbuncles/felons)

• Myristica seb. “Knife-like” promoter of suppuration; less global hypersensitivity. [Clarke]
• Tarent-c. Furious, restless, burning; less chilliness; different temperament. [Kent]
• Sulph. Burning/itching, morning aggravation, offensive but heat-loving with open-air desire; Hepar cannot bear air on skin. [Clarke]

Rectal fissure/fistula

• Nit-ac. Splinter pains, bleeding; < touch of clothing, craves fat/salt; Hepar fetid, draft-chilly, > warmth. [Boger]
• Sil. Long-term fistula with thin discharge; less “knife” pain. [Hering]

Dental abscess

• Staph. Caries from indignation; sensitive teeth; Hepar more fetid, draft-chilly, splinter pains. [Clarke]
• Plantago (tooth neuralgia), Hecla-l. (periosteal swellings)—adjacent use-cases. [Tyler]

• Complementary: Sil. (chronic suppuration), Calc-s. (skin and glands), Merc. (when salivary/septic pole dominates), Sulph. (constitutional psoric base), Spong. (larynx), Kali-bi. (ropy catarrh), Ferr-phos. (early inflammation). [Kent], [Clarke], [Boger]
• Follows well: Acon. (after first chill), Bell. (after vascular storm), Bry. (after dry to moist bronchitis) when suppurative trend appears. [Farrington], [Clarke]
• Precedes well: Sil. (if abscess lingers), Calc-s./Graph. (eczema fissures), Nit-ac. (fissures), Myr-v. (ingrown nails). [Hering], [Clarke]
• Antidotes: Cham. (oversensitivity to pain), Nux-v. (drugging/stimulants), Sulph. (constitutional) as needed. [Kent], [Clarke]
• Inimical/Use with caution: Rapid alternation with Merc. in septic states—let the case declare; avoid crude topical caustics that confuse the picture. [Clarke], [Boger]

• Quinsy/peritonsillar abscess: Hep. 200C at the threshold (knife/splinter pains, chill on uncovering neck, fetor) can abort suppuration; if fluctuation appears, continue to promote pointing and ensure drainage. [Hering], [Clarke], [Kent]
• Croup (after midnight, cold dry wind exposure): harsh croupy cough, < uncovering, > warm humid air—alternate Acon. → Spong. → Hep. by stage; Hepar when rattle and pus-risk enter. [Farrington], [Clarke]
• Felons/ingrown nails: early Hep. with hot soaks; if pus exists, accelerate discharge and pain relief. Follow with Sil. if indolence persists. [Hering], [Phatak]
• Otitis media with fetor and draft-phobia: Hep. often prevents mastoid extension; keep ear warm, avoid cold irrigation. [Hering], [Allen]
• Anal fissure/fistula: splinter pain, fetor, chilliness—Hepar > warmth, while Nit-ac. if clothes-touch is unbearable and bleeding profuse. [Boger], [Clarke]
• Mini-pearls

• • Child with post-midnight croup, worse uncovering, gags with cold air → Hep. settled by dawn. [Hering], [Farrington]
  • Breast mastitis “about to abscess”: Hep. + warm support avoided incision; second case with fluctuation—Hep. hastened clean pointing. [Clarke]
  • Carbuncle with exquisite tenderness and fetid oozing—pain fell by half within hours of Hep., discharge became free, patient slept. [Kent], [Boericke]

Mind

• Irritable, hasty, peevish from the least cause; vindictive. Hepar temperament in acute pain. [Kent], [Clarke]
• Anxiety about health; fear of drafts; wants doors/windows shut. Draft-phobia. [Hering]
• Oversensitive to pain and touch; cries out before being touched. Hyperalgesia. [Allen]
• Capricious, contradicts; anger from trifles. Emotional reactivity. [Kent]
• Child screams before cough; fear of suffocation. Anticipatory dread. [Hering]

Head / Nose / Sinuses

• Headache from cold air/draft; better wrapping. Weather signature. [Clarke]
• Sinusitis with bone tenderness at bridge; crusts and fetor. Hepar catarrh. [Boger]
• Coryza thick, fetid, with bleeding on removing crusts. Offensive discharge. [Allen]
• Pain in nose as from a splinter. Keynote. [Clarke]

Ears

• Otitis with stitching pains, cannot bear auricle touched. Extreme tenderness. [Hering]
• Otorrhoea, offensive, thick, after cold wind. Etiology and fetor. [Allen]
• Mastoid region sensitive and swollen. Early warning. [Clarke]

Throat / Larynx

• Quinsy with splinter pains on swallowing; tendency to suppurate. Signature. [Hering]
• Croup after midnight; worse cold dry wind; better warm, moist air. Stage cue. [Farrington]
• Cough excited by uncovering any part; by touching throat. Hyperreactive larynx. [Clarke]

Chest / Respiration

• Rattling, choking cough from least draft; must be wrapped. Modal key. [Hering]
• Stitches in chest on deep breathing. Splinter pains. [Allen]
• Asthma from cold dry wind; better damp weather. Paradoxical humidity >. [Clarke]

Skin

• Suppurates from slightest injury. Tissue tendency. [Hering]
• Boils/carbuncles with exquisite tenderness and fetor. Offensive pus. [Clarke]
• Felons; ingrown nails; hangnails—throbbing relieved by heat. Extremity focus. [Allen], [Phatak]
• Ulcers with splinter-like pains; very sensitive to touch/cold. Pain quality. [Hering]

Rectum / Anus

• Fissure/fistula with splinter pains; peri-anal abscess. Anal sphere. [Boger]
• Piles suppurating; fetid discharge; soreness after stool. Offensive theme. [Clarke]

Generalities

• Worse from least draft; worse uncovering; worse cold dry wind. Core modalities. [Hering], [Clarke]
• Better warmth; better wrapping; better damp weather; better after gentle perspiration. Relief logic. [Boger]
• Excessive sensitiveness to pain and touch (hyperalgesia/allodynia). Essence. [Kent]

Hahnemann — Chronic Diseases (1828–1830): original proving; core modalities (cold, drafts), suppurative tendency.
Hering, C. — The Guiding Symptoms of our Materia Medica (1879–1891): quinsy, croup, otitis, skin suppuration; “splinter” keynotes.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–1879): sensory hypersensitivity, mucosal catarrh, glandular abscess data.
Hughes, R. — A Manual of Pharmacodynamics/Pharmacography (1867–1868): crude sulphide actions; antiseptic–suppurative polarity.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): modalities (humid >, dry wind <), fetor, stage management in suppuration.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): mental portrait (hasty, irritable), hyperalgesia, winter draft phobia.
Boger, C. M. — Boenninghausen’s Characteristics & Repertory (1905); Synoptic Key (1915): generalities (draft <, warmth >), rectal fissure/fistula rubrics.
Boericke, W. — Pocket Manual of Homoeopathic Materia Medica (1901): clinical keynotes—felons, croup, quinsy, offensive discharges.
Farrington, E. A. — Clinical Materia Medica (1887): croup staging (Acon.–Spong.–Hepar), comparisons with Merc., Sil.
Nash, E. B. — Leaders in Homoeopathic Therapeutics (1899): quick, sensitive, “must be wrapped,” clinical brevities.
Tyler, M. L. — Homoeopathic Drug Pictures (1932): “damp weather better,” practical bedside picture.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (1977): distilled pointers—felons, ingrown nails, splinter pains, fetor.
Dunham, C. — Lectures on Materia Medica (1879): suppuration management and constitutional chilliness commentary.
Vithoulkas, G. — Materia Medica Viva (1990s): modern essence of oversensitivity and stage-of-suppuration guidance.
Morrison, R. — Desktop Guide to Keynotes & Confirmatory Symptoms (1993): clinical clinchers—splinter pains, draft-cough, fetor, warmth craving.