• Stomach – persistent nausea, vomiting
• Respiratory system – spasmodic cough, asthma, mucus accumulation
• Gastrointestinal tract – colic, diarrhoea with nausea
• Uterus – post-partum haemorrhage, nausea in pregnancy
• Tongue and mouth – clean tongue with severe gastric symptoms
• Circulation – haemorrhagic tendencies with bright red blood

• Open air
• Resting still (sometimes)
• Loosening clothing
• Slight pressure on the stomach (temporary)
• Cold drinks (sometimes, during nausea)

• Warmth and heat (especially warm rooms)
• Motion of any kind
• Eating (especially rich or fatty food)
• Smell of food
• Lying down
• Suppressed eruptions

The Ipecac patient is usually quiet, irritable, and indifferent, especially during acute illness. Children become obstinate and weep without cause. There is a notable tendency toward silent suffering, interrupted only by sharp complaints of distress during nausea or spasmodic cough. [Kent] observes a kind of sullen displeasure or emotional distance. A child may slap away comfort or remain motionless in a corner during sickness. In some cases, the patient becomes morbidly sensitive, particularly to smells or oppressive warmth.

Headache is commonly accompanied by nausea and vomiting. Pain is often pressing or bursting, especially in the forehead, and worsens with motion. There is a sensation of constriction around the head. Vertigo with nausea is a classic combination. [Boericke] describes the head as hot and heavy, often with a pale face, worse in a warm room. During fevers, there may be throbbing and pulsation.

Eyes appear glassy and dull during sickness, often with pale face and sunken features. Lachrymation may accompany nausea or cough. Pupils may dilate during vomiting or fever. The orbits may show blue discolouration in children during gastroenteritis.

Buzzing, humming, or ringing noises may accompany vertigo or fever. Ears are sensitive to loud noises. In children, pulling at the ears may be seen during colic or nausea.

Bleeding from the nose (epistaxis) may occur, especially during fevers or respiratory spasms. Coryza with sneezing may be present, but is not characteristic unless linked with cough or nausea.

Face is pale, sunken, and often cold to the touch during nausea or faintness. Lips may be blue or livid in asthmatic attacks. Expression is suffering and anxious, particularly in children. Alternate redness and paleness of the face may occur during spasmodic complaints.

Notably, the tongue is clean or only slightly coated, despite severe gastric or respiratory disturbances—a keynote of Ipecacuanha. Saliva is increased during nausea. Metallic or bitter taste may be present, though not prominent. The mouth may feel cool or clammy.

Teeth may chatter during chills. No marked dental pathology, but teeth may be clenched during spasms or vomiting episodes.

Sensation of constriction or tickling leading to cough or vomiting. Throat may feel raw during spasmodic coughing. Slight redness or mucus may be present in acute catarrh. Swallowing food may provoke retching.

Ipecac is a remedy of constant, relentless nausea—the kind that is not relieved by vomiting. This is its keynote. Vomiting may follow, but the nausea persists, unlike most other remedies. Vomiting is of mucus, bile, blood, undigested food, or in pregnancy. There is often an empty, sinking feeling in the stomach, yet eating may intensify the suffering. [Clarke] describes a rising nausea that dominates all other symptoms. Even after vomiting, there is little relief. Appetite is lost. Cramping, pressure, and painful distension accompany the nausea. Gastric symptoms are worse in a warm room or after rich food.

Colic and cutting pains, especially around the umbilicus, are frequent. Distension with flatulence may occur. Borborygmi with nausea is common. Griping pain before stool, especially in dysentery or enteritis. Pressure over the stomach offers little relief. The abdomen may feel cold or soft despite spasms.

Scanty, dark, and offensive urine. Nausea may be accompanied by chilliness in the bladder region. Urinary symptoms are not prominent but may include urging during gastrointestinal upset.

Diarrhoea or dysentery, often with nausea preceding and during stool. Stools are green, frothy, or contain blood and mucus. Tenesmus may persist after evacuation. Stools are passed with much straining and discomfort. Involuntary stool may occur in children during convulsions or vomiting spells.

Not characteristic, though may be useful in cases of haematuria or urethral bleeding associated with violent spasms.

Nausea in pregnancy—violent, continuous, and unrelieved by vomiting—is a classic keynote for Ipecac. Menorrhagia or uterine haemorrhage with bright red blood, especially when accompanied by nausea and faintness. Post-partum haemorrhage with cold sweat and weak pulse. Threatened abortion with nausea and cramping. [Hering] notes excessive uterine bleeding with a clean tongue and pale face.

Short, sighing, gasping breathing. Threatened suffocation from mucus or spasm. Particularly useful in asthmatic attacks with gagging and vomiting, especially in children. [Boericke] highlights the rattling, obstructive quality of the breath, yet little expectoration. Cough and dyspnoea come in paroxysms. Patient desires fresh air.

Palpitations with faintness, especially in uterine haemorrhage. Cold sweat and fluttering. Pulse is weak, soft, and rapid during acute vomiting or haemorrhage. Faintness with clean tongue and pale face is diagnostic.

Ipecac is one of the most important remedies in bronchitis, asthma, and spasmodic coughs. There is rattling of mucus in the chest, but very little is expectorated. The cough is violent, suffocative, and ends in gagging or vomiting. Worse in warm room, at night, and lying down. The patient may clutch the chest, bend forward, and retch violently. Children with bronchiolitis who become cyanotic and vomit phlegm often respond to Ipecac. The chest feels tight or constricted. Shortness of breath, wheezing, and anxious gasping are marked. Blood-streaked sputum may occur in pertussis.

Chilliness runs along the back. Weakness in the lumbar region during gastric disturbances. Pain in the sacrum after prolonged coughing. Shuddering up and down the spine with nausea.

Trembling of hands and limbs during vomiting or bleeding. Coldness of feet and fingers with weakness. Cramps in calves or thighs during spasms. Children may stiffen or arch during convulsive coughs.

Pale, cold, and clammy during acute attacks. Cold sweat accompanies nausea, bleeding, and faintness. Urticaria or red spots during fever or gastric complaints. Not primarily a skin remedy, but useful in acute exanthemata with nausea.

Drowsy but restless. Sleep disturbed by nausea or cough. Children moan or startle in sleep. Dreams unpleasant or anxious.

Vague, oppressive dreams related to suffocation or drowning. Dreams of illness or vomiting. Nightmares in sick children.

Fever with chill, nausea, and vomiting. Skin is hot and dry, face flushed or pale. Heat alternates with chill. Pulse is rapid, especially during nausea or cough. Fever may accompany gastroenteritis, bronchitis, or uterine haemorrhage.

Chill with shivering, especially along the back. Heat of face or head may alternate with chills. Cold sweat with faintness or haemorrhage. Sweat is clammy, cold, and often unsupportive.

Aversion to all food, especially to rich, fatty dishes. Smell of food induces nausea. May desire cold drinks, but these may be vomited. Sweet things, meat, and warm food aggravate. [Kent] remarks on the patient’s inability to take anything without nausea.

Symptoms often appear suddenly and violently, especially in children. Persistent nausea with clean tongue is diagnostic. Worse from heat, motion, and the smell of food. Better in open air. Marked haemorrhagic tendencies with bright red blood. Sudden vomiting, spasmodic cough, and asphyxiation-like episodes are the hallmark.

• Nux vomica – More irritable; nausea relieved by vomiting; tongue coated
• Antimonium tart. – Rattling chest, great weakness, but with more sleepiness
• Phosphorus – Nausea with thirst for cold drinks; anxiety and burning
• Arsenicum – Restlessness, thirst, vomiting, more chill and fear
• Veratrum album – Profuse vomiting and cold sweat; great collapse

• Complementary: Arnica (after injury with nausea), Belladonna, China
• Antidotes: Nux vomica, Arsenicum
• Follows well: Aconite, Antimonium tart.
• Precedes well: Phosphorus, Pulsatilla

• Think of Ipecac when vomiting does not relieve nausea
• Essential in infantile bronchiolitis with rattling cough and no expectoration
• Useful in nausea of pregnancy and post-partum haemorrhage
• Cough that ends in vomiting is a classic indication
• Responds well to early stage of whooping cough, especially in children

Stomach

• Nausea, constant, not relieved by vomiting
• Vomiting, of bile, mucus, blood
• Clean tongue with gastric symptoms

Chest

• Cough, spasmodic, ends in vomiting
• Cough, with suffocation
• Asthma, with gagging and nausea

Female

• Menses, excessive, bright red blood
• Nausea during pregnancy
• Haemorrhage after delivery, with faintness

Mind

• Irritability during nausea
• Weeping, children, without cause

Fever

• Chill with nausea
• Cold sweat with faintness

Samuel Hahnemann – Materia Medica Pura: Original proving; persistent nausea and vomiting

James Tyler Kent – Lectures on Homoeopathic Materia Medica: Mental state, clean tongue, obstetric indications

John Henry Clarke – Dictionary of Practical Materia Medica: Confirmed gastric and haemorrhagic tendencies

William Boericke – Pocket Manual of Homoeopathic Materia Medica: Asthma, bronchitis, and spasmodic cough

C. Hering – Guiding Symptoms of Our Materia Medica: Violent spasms, uterine bleeding, paediatric focus