Hypericum perforatum

Hypericum perforatum (Hypericaceae) is an aromatic, yellow-flowering perennial whose pellucid-dotted leaves (“perforations”) contain hypericins, hyperforin, and flavonoids. Toxicologic observation in grazing animals shows photosensitisation (“hypericism”), excitability, and nervous phenomena; pharmacognosy notes peripheral neurotrophic and anti-inflammatory activities, which accord with the homœopathic sphere—nerves, spinal cord, and areas richly supplied with sensory filaments [Hughes], [Clarke]. The mother tincture is prepared from the fresh flowering tops; triturations and potencies follow standard homœopathic methods [Allen], [Clarke]. Classical surgeons and physicians quickly learned its action in wounds: intolerable pain out of proportion to injury, shooting upward along the nerve, convulsions or tetanic threats after punctures, and the remarkable relief it affords in neuritic pains following trauma, dental extraction, and coccygeal falls [Hering], [Clarke], [Boericke]. [Toxicology] [Clinical]

Though minor provings exist, Hypericum’s pathogenesis is chiefly [Clinical] and [Toxicology]-shaped, collated by Hering and Allen from surgical experience, accidents, and poisonings: punctured wounds (nails, bites), crushed fingers/toes, falls on the coccyx, spinal concussion, after-tooth-extraction neuralgia, lacerations of perineum, and operative trauma to nerve-rich parts [Hering], [Allen], [Clarke]. Early American school confirmations established its place as “Arnica of the nerves” [Farrington], [Boericke].

Hypericum is the remedy of injured nerves. Its essence is pain out of all proportion to the visible lesion, radiating proximally from the point of injury along nerve-paths, with exquisite intolerance of touch, jar, and motion, and a marked inclination to tetanoid reaction if the wound is punctured and deep [Hering], [Clarke], [Farrington]. The organism cries for stillness and warmth: the hand hovers to prevent a footfall from shaking the bed, the patient begs you not to touch the dressing, and a cold draught on the cheek re-ignites darts to the eye or ear. This hyperaesthesia is not hysteria but the rawness of exposed nerve-ends (kingdom signature: plant acting upon peripheral and central neural tissues). Miasmatically the picture tends syphilitic—destruction of nerve integrity, convulsive arc, septic fear—tempered by sycotic recurrence of neuritis and psoric oversensitivity. Pace is brisk after trauma and may persist as chronic neuroma pains or cicatricial tenderness if untreated.
The modalities anchor the case with an almost mechanical clarity: worse touch (even light), worse jar and shock (descending, stepping, riding), worse cold and damp (especially on face/teeth), worse at night; better absolute rest and immobilisation, better warmth and soft wrapping, better gentle support that surrounds but does not press upon the raw spot. These recur line by line in Extremities (crushed fingers/toes; punctures with upward darts), Back (coccyx; spinal concussion with ascending pains), Teeth/Face (post-extraction and trigeminal neuralgia), Skin (lacerations and scars), and Generalities (shock, faintness). The nervous system proper—the cord and meninges—gives additional confirmations: prickling, crawling, threatened paralysis, and startle-excitability to noise/light after head blows. “Arnica of the nerves” is no mere epigram: Arnica meets diffuse bruised soreness; Hypericum claims the sharp, radiating, oversensitive pain left behind once soreness ebbs [Farrington], [Clarke].
Differentially, one distinguishes Hypericum from Ledum in punctures by temperature and pain quality: Ledum wounds are cold and better cold; Hypericum pains are incandescent, better warmth, with touch-jar agony and upward radiation. From Staphisagria it differs in the nature of trauma: clean incisions and moral indignation suggest Staph.; ragged lacerations and post-operative neuritis cry for Hypericum. From Bellis perennis and Ruta it is sorted by tissue involved—deep muscle/soft tissue (Bellis), periosteum and tendons (Ruta)—versus nerve-end torture (Hypericum). From Natrum sulph and Arnica in head injury, Hypericum takes the hyperaesthesia and neuralgic shoots, while the others manage the concussion and bruising. Clinically, prompt use after punctures (nails, thorns, bites), crushes of digits, dental extraction, perineal tears, falls on the coccyx, and spinal or intercostal contusions not only relieves but often prevents chronic neuritis and tetanoid drift. Practical care should match the remedy’s genius: immobilise, warm, protect from jar and cold, and avoid needless probing; when this regimen is honoured, the medicine’s action is swift and decisive [Clarke], [Boericke], [Hughes].

• Peripheral sensory nerves and their endings—exquisite hyperaesthesia; pains shoot proximally along the course of nerves from the injured point (see Extremities, Skin). [Hering], [Clarke], [Boericke].
• Spinal cord and meninges—concussion, whiplash, contusion; prickling, crawling, spasms; “ascending pains” with tendency to tetanoid states (see Back, Head, Generalities). [Hughes], [Hering], [Clarke].
• Coccyx, sacrum, sacro-coccygeal plexus—coccygodynia after falls or childbirth; cannot sit; pains shoot upward (see Back, Female). [Clarke], [Boericke].
• Cranial nerves (especially trigeminal)—neuralgias after dental work or facial trauma; pains intolerable to touch or cold (see Face, Teeth). [Hering], [Allen].
• Fingers, toes, nail-beds—crushes, lacerations, “door-slam” injuries; extreme pain with shock (see Extremities, Skin). [Boericke], [Boger].
• Punctured wounds—nails, thorns, bites, instruments; fear of tetanus; coldness and spasms (see Skin, Generalities). [Hering], [Clarke].
• Genito-urinary or rectal outlet after instrumentation/tearing—catheterisation, circumcision, episiotomy, hæmorrhoids with nerve-pain (see Urinary, Male, Female, Rectum). [Clarke], [Boericke].
• Dental sockets and alveolar nerves—after extraction; “shooting to ear/temple,” jaw trembles (see Mouth, Teeth). [Allen], [Clarke].
• Chest wall/intercostals—stitching neuritic pains after contusion or surgery (see Chest/Respiration). [Boger], [Clarke].
• Skin and scars—lacerations, ragged wounds, painful cicatrices, keloid tenderness (see Skin). [Clarke], [Boericke].
• Autonomic (vagal) reactivity—collapse, cold sweat, faintness from pain; shock from injuries (see Generalities). [Hughes], [Clarke].
• Infants and elderly—concussion, laryngismus after head-bumps; senile neuralgia after falls (see Respiration, Head). [Clarke], [Boericke].

The Hypericum mental state is dominated by shock and hyperaesthesia. Immediately after injury there may be pallor, trembling, and fear of death; the mind cannot brook the least jar or interruption, and an instinct for quiet, warmth, and immobility asserts itself (echoing Better rest/warmth) [Clarke], [Hughes]. Irritability and oversensitivity follow concussion or nerve pain: the patient startles at noises, dreads being touched, and becomes anxious that any movement will bring another shooting paroxysm (Worse jar, Worse touch) [Hering], [Clarke]. A peculiar anguish comes with coccygeal or spinal injuries: an unreasonable dread of sitting, fear of stairs or stepping down, and a foreboding of “something dreadful in the back,” proportional to pains that shoot upward toward head or chest [Clarke], [Boericke]. After dental operations, the sufferer is driven nearly frantic by neuralgic darts to ear or temple; he becomes peevish and sleepless until warmth and stillness settle the nerves (Better warmth, Better quiet) [Allen], [Clarke]. Melancholy may shadow prolonged neuritis, coloured by insomnia; when the pain is quieted, mood clears rapidly (mind follows nerve-state). Children who strike the head become unusually cross, clingy, and fearful; they will not be put down or jostled (post-concussive sensitivity) [Clarke]. With punctured wounds there is trembling, faintness, and trembling dread of tetanus; the fear fades as the exquisite pain abates and warmth is maintained (cross-link Skin/Generalities) [Hering], [Clarke]. Concentration is weak; slight mental effort aggravates head-pains after concussion (Worse noise/light/effort) [Hughes]. The mental portrait is therefore reactive rather than constitutional: oversensitive, fearful of touch and jar, craving quiet warmth until nerves regain tone [Clarke], [Farrington].

Sleep is broken by every jar of the bed and by upward-shooting nerve-pains; the patient dreads lying where the part will be touched or jolted (Worse night, Worse touch/jar) [Clarke]. After concussion he lies awake, excitable to noise and light, until quiet and warmth at length induce sleep (Better quiet/warmth) [Hughes]. Startings on dropping off, with a cry from a sudden pain-shock, are frequent. Dreams of falling from a height or of being pierced recur, waking him with a jerk (Dreams). When the injured part is well-supported and wrapped, sleep lengthens; this clinical response confirms the selection (Modalities).

Dreams of precipices, falls, and sudden shocks are common after injuries; the dream reproduces the original jar and wakens with a start [Clarke]. Stabbing, puncturing images—nails, needles—replay the trauma; the patient clutches the part on waking. Dream-content fades as pains shorten and night-sleep is secured; there are no peculiar erotic or spectral themes apart from accident-remembrance.

Hypericum is the great nerve-wound remedy: exquisitely painful injuries of nerve-rich parts; upward-radiating pains; hyperaesthesia, shock, and tetanoid tendency after puncture, crush, laceration, or concussion [Hering], [Clarke], [Boericke], [Farrington]. Modalities are decisive—worse touch (even the weight of a sheet), worse jar, shock, motion, cold and damp, night; better absolute rest/immobilisation, warmth, gentle surrounding support, elevation of digits, quiet dark room. Affinities focus spine/coccyx, fingers/toes/nail-beds, cranial nerves (especially after dental work), punctured wounds, perineal and urethral outlets after instrumentation, and scars that remain painfully sensitive (explicit echoes across Back, Extremities, Teeth, Skin, Rectum/Urinary). The pace is acute to subacute; used early after injuries Hypericum often prevents chronic neuritis and the tetanic arc (syphilitic pole) while quieting oversensitivity (sycotic/psoric tones). Compare Arnica (muscular soreness/bruising) and Bellis (deep soft tissues) for the gross trauma; Hypericum “picks up the nerves” that these leave behind [Farrington], [Clarke].

Fever is not characteristic. Chilliness with cold sweat from pain and shock is common; in infected wounds other remedies are required. A slight evening heat may accompany neuritis; the thermometer otherwise stays near normal [Clarke], [Boericke]. Hypericum’s storm is neuralgic rather than pyretic.

Coldness of injured part with clammy sweat on face and hands during paroxysms is typical (shock) [Clarke], [Hughes]. External cold aggravates pains; dry warmth soothes (modal master-pair). Heat of bed may first excite twitching then quiet as warmth steadies. Sweating is not profuse unless faintness threatens.

Ill effects of concussion, whiplash, and blows to head find a mainstay in Hypericum. Head feels stunned yet exquisitely sensitive; pains shoot from nape or occiput upward and forward, worse from the least motion, jar, or stepping down, and better lying quiet in a warm room (modal echo) [Clarke], [Hughes]. Scalp is tender to touch; even combing aggravates; cold air on the head provokes neuralgic lightning to face or eye (Worse cold) [Allen], [Clarke]. Vertigo on rising after head injury appears with nausea; the room seems dazzling and noisy, and he must lie down again (Mind/Generalities linkage). Headaches follow dental extraction—temporal or auricular darts that come in waves, especially at night; hot applications and steady support around the jaw relieve (Teeth/Mouth). After a fall on the tailbone, pains mount the spine to the head with a strange sense that the skull will burst if he coughs or jars; he holds the head with both hands to prevent the shock (Back ↔ Head). Insomnia after concussion is common; sleep arrives only when quiet, warmth, and immobilisation are secured (Sleep). Hypericum thus complements Arnica in head trauma, governing the nerve-pain and hyperaesthesia while Arnica meets soreness and bruising [Farrington], [Clarke].

Twitching of lids and supraorbital neuralgia may follow head blows or dental work, with lancinating pains radiating from malar region to eye, worse cold air and touch, better warmth and darkness [Clarke], [Allen]. Photophobia is not intense but the eyes feel strained and sore; the patient avoids reading and light after concussion (Mind/Head). Vision may blur transiently with pains that shoot up from face or teeth; when the neuralgic paroxysm ends, sight clears. Eyeballs are tender to pressure; any jar pains them (Worse jar). Traumatic irritable eye without frank inflammation may be quieted when the injury was to surrounding nerve tissue (peri-orbital contusion). The ocular picture mirrors the cranial: shock, hyperaesthesia, and intolerance of cold/touch [Clarke].

Sharp, shooting pains to the ear after extraction of lower molars or from facial trauma are characteristic; they come in darts, worse at night and cold draughts over cheek, better warmth and stillness [Allen], [Clarke]. Noise intolerance follows head injury; sudden sounds provoke a start and aggravate pains (Mind link). Ringing occurs with concussion; it subsides as quiet is enforced. No primary otitis belongs here; the ear symptoms are neuralgic and referred. Children cry and clutch the ear after jaw injury; a warm cloth relieves quickly (Better warmth).

Traumatic neuralgia across the root of the nose or along the nasal bones after a blow shows sharp, upward-shooting pains, worse from touch and cold, better warmth and immobility [Clarke]. Epistaxis is incidental in concussion and ceases with rest. Sneezing jars the head painfully; the patient stifles it (Worse jar). No coryzal picture belongs to Hypericum; the nasal notes are traumatic-neuralgic.

Trigeminal neuralgia from dental manipulation or facial injuries is a strong sphere: darts shoot along infraorbital or mental branches, upward to eye or temple; touch, cold air, and motion aggravate; warmth, wrapping, and quiet ameliorate [Hering], [Allen], [Clarke]. The face looks drawn with pain; the jaw quivers. After a cut or puncture in the lip/cheek there is burning, tingling, and out-of-proportion pain, with dread of the wound being touched (Skin). Facial muscles twitch in paroxysms; the least jar renews pain (Worse jar). Swelling is slight compared with agony—the Hypericum paradox (pain > lesion).

Tongue and mucosa feel sore and pricking after dental operations; saliva may be blood-streaked; taste is metallic from oozing sockets [Allen], [Clarke]. Prolonged mouth-opening for dentistry leaves jaws trembling and painful, worse cold air; sipping warm water soothes (Better warmth). The mouth is healthy apart from trauma; exploding pains shoot to ear/temple on talking or chewing (Worse motion). Hypericum often spares narcotics when given promptly after extraction, by moderating nerve-pain and preventing neuritis [Clarke], [Farrington]. Aphthæ are not part of its core image.

After extraction, pain is “frightful”; it shoots along the nerve to ear, eye, or nape, worse from the least draught, touch, or movement, better warmth held to the cheek and lying still (keynote) [Allen], [Clarke], [Boericke]. Teeth feel too long and sore after blows to the jaw; tapping is intolerable (dental concussion). Cold drinks, cold air, or rinses renew pangs; tepid sips ease (Modalities). Bruxism or jaw-clenching occurs during paroxysms. Spontaneous neuralgia of teeth also appears after exposure to cold following exertion; choose Hypericum if the pains shoot upward and touch is exquisite (vs. Cham., Mag-p.) [Farrington], [Clarke].

Stitching, upward-shooting pains in pharynx after forceful gagging, intubation, or instrumentation suit Hypericum; swallowing is painful chiefly at the moment the bolus touches a raw spot (touch aggravation) [Clarke]. Laryngeal nerves feel prickled after whiplash; speaking jars the throat. There is no croupal picture; it is traumatic or neuritic soreness. Warm drinks relieve more than cold (Better warmth). In punctured wounds near the throat (animal bites, thorns), pain radiates up to ear on swallowing.

Intercostal neuralgia after contusion or surgery shows stabbing pains running along a rib toward sternum or axilla, worse motion and deep breath, better warmth and steady wrapping (Respiration link) [Clarke], [Boger]. Sternal blows produce “empty, sore” feeling with tearing pains upward to throat on jar. Palpation over intercostal spaces is intolerable; the patient splints the chest with hands (Worse touch). Cough aggravates by jolting the injured intercostals; pillow-pressure helps.

Palpitations and sinking may follow shock and pain, with cold sweats and faintness (vagal storm) [Hughes], [Clarke]. Anginal-like neuralgic darts occur after chest trauma but organic cardiac disease is not Hypericum’s centre; choose it when pain is neuritic from an injury, worse touch/jar. Pulse may be small and quick during paroxysms. Anxiety about the heart is proportional to pain; it recedes with relief.

Respiration is painful when injured intercostal nerves are jarred; the patient breathes shallowly to avoid shocks; a deep breath sends a darting stitch (Chest linkage) [Clarke]. Dyspnœa after head injury is from fear and pain rather than pulmonary disease. Laryngismus non-traumatic belongs elsewhere; yet a sudden catch of breath from sharp nerve-pain is frequent. Fresh warm air is preferred to cold draughts that excite facial and dental nerves (Worse cold air).

Nausea and faintness after injury or exquisite nerve pains are common; the epigastrium feels empty and sinking, relieved by warmth and quiet (shock state) [Hughes], [Clarke]. Pain may shoot upward from stomach after abdominal blows, worse motion, better lying still. Hiccough has been observed after thoraco-abdominal contusions, renewed by touch or jar; calming the nerves quiets it. Appetite flags during neuralgic nights; it returns as pains subside. There is no gastric catarrh proper; Hypericum’s stomach is a barometer of shock and pain.

Abdominal wall neuralgia after puncture, hernia repairs, or lacerations shows stinging, shooting pains along cutaneous nerves, worse from the least touch, better warmth and splinting [Clarke]. After falls the sacral plexus pains may track to hypogastrium with dragging. Flatus jars the tender nerve-ends; gentle pressure around (not on) the wound steadies (Better gentle support). Peristalsis itself is not disordered; pain is peripheral and neuritic.

Lacerations and fissures are painfully sensitive; after hæmorrhoidectomy the patient cannot bear the part to be touched; spasmodic closing from pain may prevent stool (Worse touch/motion) [Clarke], [Boericke]. Needles of pain shoot upward toward sacrum and spine during and after stool; warmth and very gentle cleansing ameliorate (Better warmth). Coccygodynia causes rectal tenesmus-like sensations when sitting (Back link). Pruritus is secondary to fissure and oversensitive edges; scratching is intolerable. Once nerves quieten, function becomes easier.

After catheterisation or urethral dilatation, intense smarting and shooting along urethra occur, worse during micturition when urine touches raw nerve-ends, better warm sitz and rest (instrumental neuralgia) [Clarke]. Urgency from pain rather than infection may appear. Tenesmus vesicæ is reflex from perineal wounds; patient dreads voiding for fear of the nerve-pang. Colour and odour of urine are unremarkable; this is peripheral nerve-pain at outlet.

Aversion to cold drinks that shock dental/facial nerves; desire for warm sips after dental work (Teeth) [Allen], [Clarke]. Appetite is low after concussion; nausea from pain subsides with rest. No characteristic cravings. Alcohol aggravates post-concussive states (Worse stimulants) [Hughes].

After circumcision or perineal lacerations there is burning and upward-shooting pain, out of proportion to lesion, with dread of touch and movement (Skin/Generalities) [Clarke]. Neuralgia along spermatic cord may follow blows to perineum; the pain shoots to groin and abdomen, worse walking or riding, better lying still and warm. Sexual desire is reduced by fear of pain. Orchitic pains after trauma belong here only when nerve-pain dominates over inflammatory swelling (compare Arn., Ruta).

Perineal tears, episiotomy, and cervical lacerations are followed by intolerable, darting pains radiating upward to sacrum, loins, or even head; sitting is impossible; the part cannot bear touch; warmth and support bring relief (central sphere) [Clarke], [Boericke]. Coccygodynia post-partum is a keynote: least jar shoots pain up the spine; stepping down makes her cry; she chooses soft cushions, avoids stairs, and improves lying on side (Worse jar/descending; Better rest) [Clarke]. Painful scars of the vulva or perineum remain exquisitely tender years after injury; Hypericum softens nerve oversensitivity. Dysmenorrhœa is uncommon unless following instrumentation or tearing. Milk let-down and breast are not primary spheres.

Spinal injuries—from falls, whiplash, concussion of cord—are cardinal. There is bursting pain on the least motion, with crawling, prickling, and ascending shoots toward head; the back is so sensitive that the patient fears turning in bed or stepping down (Worse jar/motion/descending) [Hering], [Clarke], [Boericke]. Coccyx pain is extreme: sitting on a hard seat is torture; stool or cough sends a shock up the spine; warmth, soft cushions, and side-lying help (Better warmth/rest) [Clarke]. Tender points along spinous processes correspond to bruised or stretched nerves. After blows, a sense of paralysis threatens; Hypericum averts neuritis and tetanoid tendency when given promptly (Affinities). Night aggravation is marked; he sleeps little for pain (Sleep).

Crushes and lacerations of fingers/toes, nail-bed injuries, and door-slam accidents are the classic Hypericum scenes: agony out of scale, shooting up the limb, worse touch and movement, better warmth, elevation, and stillness [Hering], [Boericke]. Punctures (nails, thorns, fish-hooks) are followed by tingling, numbness, and sharp pains; the patient fears tetanus; the limb is icy cold yet hyperaesthetic (Skin/Generalities) [Clarke]. After amputations or nerve cuts, phantom pains and stump neuromas produce intolerable jolts from the least bump; padding and Hypericum often soften these (Clinical). Jarring the heel sends lightning to hip or spine; descending stairs dreaded (Worse descending) [Clarke]. Shooting neuralgia travels from palm to shoulder after a palm puncture; passive support helps. Trembling follows paroxysms; weakness is out of proportion to swelling.

Wounds of all kinds that involve nerves—punctured, lacerated, crushed, ragged—are Hypericum’s province; pain is excessive, darting, and radiating upward along the nerve [Hering], [Clarke], [Boericke]. The wounded part is cold, pale, and numb yet exquisitely sensitive to touch; the patient cannot tolerate dressing changes (Worse touch/cold). Bites (human/animal) with laceration produce burning and shooting; fear of lockjaw is marked; early Hypericum reduces pain and tetanoid tendency (compare Led., Lach.) [Hering], [Clarke]. Scars remain tender and throbbing long after healing; Hypericum softens and desensitises cicatrices (Affinities). Chilblain-like lesions on fingers are intolerably sore to cold touch (Worse cold/damp). Suppuration is not its keynote—Calendula or Hepar lead there; Hypericum governs the nerve-pain and shock.

• Aetiology—Trauma & Wounds
– Arnica montana: bruised, sore, fear to be touched but pain is muscular; Hypericum when pain is neuralgic, shooting upward, and touch/jar is intolerable [Farrington], [Clarke].
– Bellis perennis: deep soft-tissue trauma, pelvic blows; less nerve shooting; Hypericum for nerve-end agony and coccyx [Clarke], [Boericke].
– Ledum palustre: punctured wounds cold to touch, better cold; Hypericum with extreme pain and warm-amelioration; Led. more for septic tendency, coldness [Hering], [Clarke].
– Calendula officinalis: lacerations needing granulation and antisepsis; pain less out of proportion; Hypericum for nerve-pain; the two often complement [Clarke], [Boericke].
– Staphisagria: clean incised wounds and surgical cuts with smarting, indignation; Hypericum for post-operative neuritis and touch-intolerance [Kent], [Clarke].
– Ruta graveolens: periosteum/tendon strain, bruised bones; Hypericum for nerve-ends and spinal concussion [Farrington].
• Spine & Coccyx
– Natrum sulphuricum: depression and headaches after concussion with photophobia; Hypericum more for shooting pains and hyperaesthesia [Clarke], [Kent].
– Kali carbonicum: coccyx pain stabbing, worse sitting; Kali-c. more stitching/burning constitutional; Hypericum centre is recent trauma with upward radiations [Clarke], [Boericke].
– Rhus toxicodendron: better hot applications, restlessness, sprains; Hypericum stillness-and-warmth without the Rhus “must-move” [Kent], [Clarke].
• Dental/Facial Neuralgia
– Plantago major: toothache shooting to ear, touch-sensitive; Plantago has salivation and odour; Hypericum after extraction with upward darts [Allen], [Clarke].
– Chamomilla: tooth pain with anger, oversensitivity; Cham. heat-worse; Hypericum is trauma-linked, better warmth, with extreme touch intolerance [Kent], [Clarke].
– Spigelia: trigeminal neuralgia, sun-agg., left supraorbital; Hypericum trauma-triggered, touch-jar-agg. [Farrington], [Clarke].
• Puncture → Tetanus Threat
– Cicuta virosa: opisthotonos, frightful distortion; less local nerve-end keynote; Hypericum earlier stage, preventing tetanoid arc [Hering], [Clarke].
– Nux vomica: spinal irritability and convulsions; Hypericum more peripheral nerve-wound causation [Kent].
– Carbolic acid/Anthracinum (sepsis): if septic change dominates; Hypericum when pain-disproportion guides [Clarke].
• Intercostal/Chest Wall
– Bryonia: stitching pains worse motion, better pressure, dry pleurisy; Hypericum is traumatic neuritis after blows or surgery, touch intolerable [Clarke], [Boger].
– Arnica: contused chest soreness; Hypericum when shooting intercostal darts persist [Farrington].
• Post-surgical Neuritis / Scars
– Graphites: keloid/oozing fissures; Hypericum for cicatricial tenderness and shooting pains [Clarke].
– Thuja: warty scars, vaccination; Hypericum when pain is the index and touch is impossible [Kent], [Clarke].
• Micro-comparisons
– Hypericum vs Ledum: both punctures; Ledum cold better cold; Hypericum warm better warmth with intolerable nerve-pain [Hering], [Clarke].
– Hypericum vs Arnica: both after injury; Arnica “bruised, sore”; Hypericum “nerves on fire,” upward darts, touch/jar unendurable [Farrington], [Clarke].
– Hypericum vs Bellis: both trauma; Bellis deep pelvic soft tissues; Hypericum nerve-ends and coccyx [Clarke], [Boericke].

• Complementary: Arnica—initial bruising/shock; Hypericum follows for nerve-pain and hyperaesthesia (classic sequence) [Farrington], [Clarke].
• Complementary: Calendula—surface repair/antisepsis; Hypericum for pain of nerve-ends in lacerations [Clarke], [Boericke].
• Complementary: Bellis perennis—deep soft-tissue contusion; add Hypericum when radiating neuralgic pains persist [Clarke].
• Complementary: Ledum—punctures; use Hypericum when pain is extreme and warm-amel.; Ledum when wounds are cold and septic tendency threatens [Hering], [Clarke].
• Complementary: Plantago—dental pains; Plantago for tooth nerve, Hypericum for post-extraction upward darts and touch-intolerance [Allen], [Clarke].
• Follows well: Aconitum—panic and shock calmed; Hypericum then controls nerve-pain [Kent].
• Follows well: Staphisagria—after incisions once indignation settles but neuritis remains [Clarke].
• Precedes well: Silicea—when foreign body remains or fistulises after pains abate [Clarke], [Boger].
• Precedes well: Hepar sulphuris—if suppuration supervenes after initial Hypericum stage [Clarke], [Boericke].
• Related: Ruta (periosteum/tendons), Symphytum (periosteal blows, fractures), Nat-s. (concussion), Rhus-t. (sprains) for trauma panorama [Farrington], [Clarke].
• Antidotes: Camph. and coffee may interfere with action; Nux may meet drugging effects; in toxic hypericism remove light exposure (classical cautions) [Hughes], [Clarke].
• Inimical: Not well established; avoid routinism and select by nerve-pain signature [Clarke], [Boericke].

Typical indications: punctured wounds (nail/thorn/bite) with intolerable, upward-shooting pain and tetanus anxiety; crushed fingertips/toes and nail-bed injuries; falls on coccyx and coccygodynia; concussion/whiplash with hyperaesthesia and startle; post-extraction dental neuralgia; perineal tears/episiotomy; neuritis of scars and stumps; intercostal neuralgia after blows/surgery [Hering], [Clarke], [Boericke], [Farrington], [Boger]. Potency/posology: In acute trauma many use tincture/3X–6X locally and internally (few drops of Ø in sterile water for external dressing; 3X/6X q2–4h), moving to 12C–30C when pain is dominantly neuralgic across regions; 200C for severe concussion, coccygodynia, or post-extraction neuritis when the keynote is striking; repeat according to pain-return, then lengthen intervals as paroxysms shorten [Clarke], [Dewey], [Kent], [Boericke]. Repetition strategy: frequent in the first 12–24 hours, then taper; in chronic cicatricial neuralgia, periodic 30C–200C doses at increasing intervals often soften sensitivity. Adjuncts: immobilisation and soft support; dry warmth; avoidance of cold air over face/teeth; remove foreign bodies; surgical repair where necessary—Hypericum is a friend to judicious surgery, not a substitute [Clarke], [Farrington].
Case pearls:
• “Door-slam fingertip with agony shooting to axilla—Hypericum 200C; pain abated in minutes; sleep obtained with finger wrapped warmly” [Clinical], [Clarke], [Boericke].
• “Fall on coccyx postpartum, cannot sit, stairs impossible—Hypericum 30C q4h; within two days, could sit on cushion; upward shoots ceased” [Clarke].
• “Post-extraction neuralgia to ear/temple, cannot bear draught—Hypericum 6X + warm rinses; night pains ended” [Allen], [Clarke].
• “Nail puncture of sole, dread of lockjaw, icy foot but part exquisitely sensitive—Hypericum 200C; shooting pains ceased; wound healed without tetanoid signs” [Hering], [Clarke].

Mind
• Fear—of being touched—pain from, after injuries. Guides the bedside handling of nerve-wounds [Clarke], [Hering].
• Anxiety—after accidents—oversensitive to noise/light. Post-concussive hyperaesthesia [Hughes], [Clarke].
• Irritability—pain from—cannot bear contradiction or disturbance. Pain-reactive temper [Farrington], [Clarke].
• Startled—easily—noise from—aggravates pains. Reflex excitability marker [Hughes], [Clarke].
• Rest—desire for—immobility amel. Craves stillness in neuralgic states [Clarke].
• Delusion—something dreadful will happen—on descending stairs (coccyx pain). Behavioural flag for coccygodynia [Clarke].
Head
• Head—Injuries—effects of—concussion—oversensitive, jar agg. Core indication post-head blow [Hughes], [Clarke].
• Head—Pain—shooting—upward—from nape/occiput—motion/jar agg. Signature ascent of pain [Clarke].
• Scalp—Sensitive to touch—combing agg. Touch-intolerance rubric [Allen], [Clarke].
• Vertigo—on rising—after concussion—must lie down. Post-traumatic orthostatic sign [Hughes], [Clarke].
• Head—Light—agg.; Noise—agg.—after injury. Environmental management cue [Hughes].
Mouth/Teeth
• Teeth—Pain—after extraction—shooting to ear/temple—cold air/water agg.—warmth amel. Dental keynote [Allen], [Clarke].
• Teeth—Sensitive to touch—tapping intolerable—after blows. Dental concussion indicator [Clarke].
• Face—Neuralgia—infraorbital—traumatic—touch/cold agg. Facial trauma rubric [Hering], [Clarke].
• Mouth—Opening—long—after—jaw trembling—painful. Iatrogenic jaw strain [Allen].
• Tongue—Sore—after dental work—warm rinses amel. Supportive measure rubric [Clarke].
Throat/Chest/Respiration
• Throat—Pain—stitching—traumatic—touch/swallowing agg. Instrumental sore-throat rubric [Clarke].
• Larynx/Trachea—Injury—after intubation—neuralgic pain. Post-procedure guidance [Clarke].
• Chest—Neuralgia—intercostal—after contusion/surgery—motion agg., warmth amel. Traumatic intercostal rubric [Boger], [Clarke].
• Respiration—Deep inspiration—agg.—intercostal neuralgia. Splinting needed [Clarke].
• Cough—aggravates chest-wall pains—after contusion. Clinical handling cue [Clarke].
Back
• Coccyx—Pain—after fall—sitting/jar agg.—warmth/soft seat amel. Capital Hypericum rubric [Clarke], [Boericke].
• Spine—Concussion—effects of—ascending pains—startle agg. Spinal signature [Hughes], [Clarke].
• Back—Pain—on descending—stairs—jar agg. Distinguishes from muscular backache [Clarke].
• Back—Tingling/crawling—after injury. Neural sequela rubric [Hering].
• Back—Cannot bear touch along spine. Hyperaesthesia stripe [Clarke].
Extremities
• Fingers—Crushed—pain excessive—shooting upward—touch/jar agg. Classic indication [Hering], [Boericke].
• Nails—Injuries—door-slam—pain intolerable. Practical emergency rubric [Clarke].
• Wounds—punctured—hand/foot—neuritic pain—warmth amel. Distinguishes from Ledum [Hering], [Clarke].
• Lower limbs—Jar from stepping—agg.—pains shoot to spine. Stairs/descending caution [Clarke].
• Amputation stumps—neuralgia—touch agg. Chronic sequel rubric [Clarke].
Skin
• Wounds—lacerated—ragged—pain out of proportion—touch agg. Hypericum wound type [Clarke], [Boericke].
• Bites—animal/human—lacerated—shooting pains—tetanus fear. Early selection flag [Hering].
• Scars—tender—neuralgic—weather/cold agg. Cicatricial sensitivity rubric [Clarke].
• Chilblains—touch/cold agg.—oversensitive. Peripheral hyperaesthesia [Clarke].
• Thorn/splinter—injuries—nerve pains until foreign body expelled. Foreign-body interplay [Hering], [Clarke].
Generalities
• Generalities—Injuries—after—nerve—wounds. Master rubric of scope [Hering], [Clarke].
• Generalities—Touch—agg.—even light touch intolerable. Central modality [Hering], [Boericke].
• Generalities—Jar—agg.—stepping down/riding. Bedside management [Clarke].
• Generalities—Cold—damp—agg.; Warmth—amel. Thermal key [Clarke], [Boericke].
• Generalities—Tetanus—threat—after punctures. Prophylactic indication (historic) [Hering], [Clarke].
• Generalities—Rest—absolute—amel.; Motion—least—agg. Handling rule [Clarke].
Sleep
• Sleep—Sleepless—from pain—every movement renews. Night-care rubric [Clarke].
• Sleep—Starting—on falling asleep—pain-shock. Neural startle marker [Clarke].
• Dreams—Falling—from heights—after injuries. PTSD-like replay [Clarke].
• Position—Cannot lie on injured part—even sheet hurts. Contact intolerance [Boericke].
• Night—agg.—neuralgia—warmth amel. Timing modality [Allen], [Clarke].

Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): core clinical picture of nerve-wounds, punctures, tetanic tendency, ascending pains.
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): dental and traumatic neuralgia data; modality and regional details; preparation notes.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): comprehensive trauma indications (coccyx, concussion, crush injuries), modalities, relationships.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): substance background (hypericism), physiological tendencies (nervous system), concussion handling.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—punctured wounds, crushed fingers, coccygodynia, touch-intolerance, warm-amel.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): repertorial cues (jar-agg., descending-agg.; intercostal after blows); differentials.
Farrington, E. A. — Clinical Materia Medica (1890): “Arnica of the nerves” doctrine; trauma panorama comparisons (Arnica, Bellis, Ruta, Ledum).
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): miasmatic analysis; relationships (Staph., Arn., Acon.) in surgical/traumatic sequencing.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): posology and trauma group therapeutics; concussion and coccyx chapters.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): vivid clinical vignettes of Hypericum injuries and bedside management pearls.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): comparisons in collapse/tetanus spectrum (Led., Cic., Nux) and trauma insights.
Bæhr, B. — The Science of Therapeutics (19th c.): discussions on traumatic neuralgia and peripheral nerve remedies applied to Hypericum.