Kalium arsenicosum

Potassium arsenite is the arsenious acid salt of potassium. In orthodox medicine the solution (“Fowler’s”) was a widely used tonic and alterative for chronic skin disease, asthma, chorea and leucocythæmia, its crude pathogenesis showing typical arsenical phenomena—gastro-enteric irritation with burning pains, prostration, restlessness and chilliness—combined with the “Kali” dryness, infiltration and tendency to scaly, thickened mucosa and skin [Hughes], [Clarke]. Homœopathically, the trituration or solution is potentised in centesimals from the pure salt or standard solution, yielding a long-acting remedy whose sphere lies in chronic catarrhs of the respiratory tract, asthmatic states, inveterate squamous dermatoses with burning pruritus, and nervous exhaustion with anxiety after midnight [Allen], [Hering], [Boericke], [Phatak]. Toxicologic records and clinical use knit together the keynote polarity: burning pains with great chilliness, worse after midnight and from cold, better by heat and hot drinks; anxiety and fear with prostration out of proportion to physical disease; thick, dry, scaly surfaces that itch and burn on scratching [Hughes], [Clarke], [Hering].

No large Hahnemannian proving; our data derive from [Toxicology] of arsenite of potash and extensive [Clinical] experience collated by Allen, Hering, Clarke and Boericke. Guiding features consistently verified: asthmatic oppression after midnight (about 1–3 a.m.), compelling the patient to sit up; cough and dyspnœa worse cold air, better warmth and hot drinks; burning pains in skin and mucosa with chilliness; chronic scaly, fissured eruptions of hands, feet, scalp or extensor surfaces, itching to rawness; anxiety, fear and restlessness after midnight with sleeplessness; weakness out of proportion to lesions [Allen], [Hering], [Clarke], [Boericke], [Phatak].

Kali arsenicosum expresses the marriage of the Arsenicum temperament with the Kali surface—an anxious, chilly, tidy, conscientious person whose troubles come to a head after midnight and in cold, raw weather. The polarity is striking: burning pains and burning itch set in a body that is icy to the touch; fear and restlessness in a will that is usually rigid and dutiful; dryness and scaliness at mucosa and skin with a chest that constricts and a larynx that tickles the moment cold air is inhaled. It is a salt of heat-seeking: the sufferer cannot bear draughts, begs for more covers, craves hot sips, finds comfort in hot bathing and greasy inunction; the same remedies that heat bring relief to chest and skin alike. Psychologically, the Kali frame adds orderliness, scruple, fear of dereliction; the arsenical current adds fear of death, of being alone at night, the characteristic after-midnight starting and need for company, the small, frequent thirst and the restlessness that drives the patient from bed to chair—yet all within a self who tries to keep control by arranging, tidying, planning [Kent], [Tyler], [Phatak]. Miasmatically the action sits on a psoric–syphilitic hinge: functional anxieties and chilliness (psora) overlay slow destructive changes—dry, fissured skin, chronic catarrh, neuritic tinglings, weight loss—while sycosis contributes the stubborn recurrency of winter relapses and catarrhal thickening [Boger], [Clarke].
The genius is the alternation and equivalence of outlets: when the skin is out—dry, scaly, fissured—the chest is often quieter; suppress the skin (cold bathing, astringents) and asthma creeps back after midnight; when a scanty expectoration or a free sweat comes, the anxiety drops; when cold suppresses sweat, itch and dyspnœa grow (Hering’s direction) [Hering], [Kent]. The time and temperature signatures recur in every section: 1–3 a.m. panics, orthopnœa, cough; winter and east winds that chafe nose, larynx and plaques; the ever-helpful hot drink that soothes both chest and stomach. Distinguish from pure Arsenicum album by the dry, scaly Kali surface, the palmo-plantar fissures and the orthopnœa that is conspicuously better for hot sips; from Kali carbonicum by the burning and itch and the arsenical anxiety; from Graphites by the lack of honey-like oozing and the need of heat; from Petroleum by less greasiness and more fastidiousness; from Antimonium tart. by the active, anxious restlessness rather than torpid rattling. In clinic, Kali-ar. belongs to anxious asthmatics who sleep sitting, clutching a mug of hot water; to psoriatics whose hands split every winter and who scratch to burning then rush to the fire; to gastric neurotics who wake at two with dread and an urge to sip something hot. Management should honour the remedy’s axis: keep the patient warm, avoid cold bathing and sudden chilling, permit outlets (sweat, small expectoration), and use potencies that meet the depth—tissue-salt forms for surface and habit, higher potencies to touch the midnight fear. When the similimum is right, nights lengthen, the mug is set down, the patient dozes until dawn, and the fissures begin to knit.

• Skin and appendages — psoriasis, chronic eczema, lichenified plaques; thick, dry, scaly, fissured surfaces that burn and itch, worse cold/winter, better heat/greasy applications (see Skin). [Clarke], [Boericke], [Phatak]

• Mucous membranes of respiratory tract — chronic catarrh with dryness, tickle and constriction; asthmatic states after midnight with great anxiety, better warmth/hot drinks (see Chest/Respiration). [Hering], [Clarke]

• Peripheral nerves — arsenical neuritis picture: burning neuralgias, tingling, numbness of hands/feet; great restlessness with weakness (see Extremities/Generalities). [Hughes], [Allen]

• Gastro-intestinal mucosa — burning from mouth to anus; irritative dyspepsia, nausea after eating, diarrhoea with burning and prostration; thirst for frequent small sips of hot drinks (see Stomach/Rectum). [Allen], [Clarke]

• Blood and nutrition — cachexia, anaemia, emaciation with anxious insomnia; slow repair in chronic dermatoses (see Fever/Generalities). [Hughes], [Clarke]

• Heart–lung axis — palpitation with dyspnoea, fear at night; oppression with need to sit up (see Heart/Respiration). [Boericke], [Phatak]

• Nose/eyes/ears — dry, burning catarrh with excoriation; thin acrid discharge in cold weather; blepharitis with crusts (see Nose/Eyes/Ears). [Clarke]

• Kidneys — irritable bladder, scant urine in night anxieties; albuminous traces in cachectic states (see Urinary). [Allen], [Clarke]

• Female pelvic — itching, burning leucorrhoea; menses profuse with weakness; pruritus vulvae worse cold washing (see Female). [Clarke], [Phatak]

• Hands/feet — palmar/plantar psoriasis and fissures; chilblain-like burning, worse exposure; must warm the parts (see Extremities/Skin). [Boericke], [Phatak]

• Mental “frame” — Kali rigidity plus arsenical anxiety: conscientious, fearful, chilly, tidy, becomes panicky after midnight; fears alone, disease, death (see Mind/Sleep). [Kent], [Tyler], [Phatak]

• Direction of cure — when warmth, rest and small hot sips relieve, the case is likely to be under Kali-ar. (see Generalities). [Boger], [Clarke]

The mental state blends arsenical fear and restlessness with the Kali sense of duty and rigidity. There is intense anxiety and inquietude after midnight, most about health and death; the patient cannot be alone and calls for company or for a hand to hold, a keynote that tallies with the amelioration by reassurance already noted [Kent], [Clarke]. Fastidiousness and tidy habits betray the Kali–Ars. temperament, yet under strain it dissolves into panic with cold, clammy skin and a need to sit up for breath (Mind ↔ Respiration). Suspiciousness about food and air (fear of chill, draught, contamination) leads to fussiness over room temperature; he begs for more covers, then complains of oppression if the room is close—anxious oscillation typical of the salt. Irritable and exacting by day, but at night tremulous and dependent; fears darkness, disease, and that the paroxysm will return; dozes only to wake with a start and gasp (Mind ↔ Sleep). Children with chronic eczema grow peevish, scratch till they cry, and then demand to be wrapped and held near a fire—showing the modality (better heat) in behaviour [Hering], [Phatak]. Depression may alternate with agitation in long-standing skin or chest disease; scruples and a scrim of sadness lift notably when warmth and perspiration come, or when a small expectoration is raised (Mind ↔ Generalities/Chest). Conscientious to a fault, the patient worries over small duties, yet the least cold air at night undoes the will; hence, the picture reads as “controlled by day, undone at 2 a.m.” [Kent], [Tyler].

Sleep is broken by anxiety and breathlessness after midnight; the patient drops off only to start up with fear and suffocation—must sit up, sip hot water, and be reassured (Sleep ↔ Mind/Respiration) [Hering], [Clarke]. Cat-naps toward morning replace deep sleep; dreams anxious, of suffocation, of cold winds and exposure; children scratch unconsciously, cry, and burrow under covers. Daytime drowsiness follows a bad night; yet lying by day in sun or warmth brings a refreshing doze—thermal consonance throughout.

Frightful, of death and disease; of being alone in a cold place; of being unable to find the way home; wakes in panic with palpitation and chill, relieved by warmth and company (Dreams ↔ Mind) [Clarke], [Tyler]. Recurrent dreams remit as skin improves or as nocturnal asthma lessens.

Kali arsenicosum synthesises the Arsenicum axis (burning pains, chilliness, anxiety, restlessness, thirst for small sips, after-midnight aggravation, better warmth) with the Kali axis (dryness, infiltration and scaliness of skin/mucosa, catarrhal thickening, orthopnœa, rigid tidiness) [Kent], [Clarke], [Boger], [Phatak]. The organism is chilly, anxious, and functionally exhausted; symptoms peak after midnight (1–3 a.m.); cold, damp and draughts are enemies; warmth of all kinds—covers, hot drinks, hot bathing, greasy inunction—gives notable relief. The two grand arenas are Skin (dry, scaly, fissured, itching to burning after scratching) and Chest (asthma/catarrh with constriction after midnight; must sit up; better hot sips), which alternate as communicating vessels—suppression of one aggravates the other (direction of disease) [Hering], [Kent]. Peripheral neuritic tingling and nocturnal restlessness belong to the arsenical side; palmar/plantar fissures and winter aggravation to the Kali side. Prescribe when this polarity is clear: a chilly, conscientious patient—tidy yet panicky after midnight—whose skin burns after scratching and whose chest loosens with hot sips and warmth.

Chilliness predominates; internal heat rare and fugacious; fever takes the “arsenical” type—small pulse, restlessness, thirst for small sips, great anxiety after midnight [Allen], [Clarke]. Slight evening heat with burning hands/feet; cannot uncover in bed; wants heat outside and inside alike; sweat sparse until relief approaches.

Chill in cold rooms or from draught; shivers with dry skin; wants many covers; yet chest feels tight if air is not moving—paradox solved by warm body/ventilated room (Chill ↔ Respiration) [Clarke]. Heat comes in flushes to face and palms; sweat appears with improvement, most towards morning; suppression of sweat aggravates skin and chest together.

Headaches are congestive with a dry, tight scalp; neuralgic, burning pains run along supra-orbital ridges, worse in cold winds, better warmth and wrapping (Head ↔ Modalities) [Clarke]. Itching of the scalp with thick, adherent scales (psoriasis capitis) and fissures behind ears; scratching yields burning that compels warm applications (Head ↔ Skin) [Boericke], [Phatak]. Vertigo appears with night panics and on rising; the face turns pale and the patient reaches for support, better after a few hot sips (Head ↔ Stomach/Generalities). Head is worse after midnight with throbbing when lying down; better after sweat, tying the head warm, and in a warm room—classical arsenical axis. Hair may be dry, lustreless, with diffuse falling in cachectic subjects.

Dry, burning, smarting eyes with photophobia in raw winds; lids thickened with scaly margins, blepharitis with adherent crusts and lashes falling—itching that burns after rubbing (Eyes ↔ Skin) [Clarke], [Boericke]. Acrid tears in cold air excoriate the canthi; conjunctivæ are injected toward night with a sandy feeling, relieved by warmth and bathing. Vision blurs with the nocturnal anxiety; black points before eyes during faintness; pupils sluggish in cachexia. Periorbital oedema appears in exhausted asthmatics after a bad night and subsides with warmth and rest (Eyes ↔ Respiration).

External meatus and retro-auricular folds excoriate; dry, scaly eczema with fissures that sting and burn after scratching (Ears ↔ Skin) [Hering], [Clarke]. Ears feel cold to touch during chills; noises (wind, draught) provoke a tickling cough—an auricular–laryngeal reflex noted at the bedside. Hearing dulled in catarrhal subjects; ringing with nocturnal palpitations improves as panic settles.

Dryness and burning of nasal passages in cold weather; recurrent, thin acrid coryza excoriates nostrils; sneezing in raw winds (Nose ↔ Modalities) [Clarke], [Boericke]. Nasal crusts, fissures, and bleeding points on little picking; cracked alæ nasi in winter; anosmia in long catarrh. When the nose is suppressed by sprays or cold, chest oppression and asthma worsen—clear direction-of-cure sign echoed under Generalities [Hering], [Kent]. Smell of cold air is “icy”; breathing it triggers cough; warm inhalations (steam) soothe.

Pale, anxious, pinched in nocturnal dyspnœa; at other times earthy, cachectic complexion with brownish discolorations (arsenical hue) [Clarke]. Lips dry, cracked, sometimes scaly at borders; perioral fissures burn after eating. Cheeks flush with febrile itching of skin; excoriation about nostrils and angles of mouth matches the cutaneous sphere. The face is lined by wakeful nights; expression relaxes after small expectoration or on establishing perspiration (Face ↔ Chest/Chill).

Burning of tongue and palate; tip feels scalded; taste bitter or metallic; mouth dry though saliva may be stringy; thirst for frequent small sips (hot preferred) [Allen], [Clarke]. Aphthous patches in anæmic, anxious subjects. Gums recede, bleed on brushing; breath cold from anxiety at night. Speech hurried during panic; voice dry and rough in cold air (Mouth ↔ Respiration). Warm drinks calm the mouth and the mind—another resonance of the heat axis.

Teeth sensitive to cold air and cold water; drawing pains at night in carious teeth with anxious restlessness, better warmth and hot rinses [Hering]. Gnashing in sleep during fretful itch in children; grinding aggravates gum bleeding. No deep odontalgia beyond the sensitive, chilly, anxious type.

Dry, burning fauces; as if smoke passed over the larynx; must sip warm water often, which allays cough-tickle and fear (Throat ↔ Respiration/Modalities) [Clarke], [Boericke]. Tonsils granular in chronic catarrh, not grossly suppurative; scraping sensation worse in cold air, better covering and steam. Swallowing cools the chest unpleasantly unless the drink is hot; food is best warm and bland (Throat ↔ Stomach).

Oppression of chest with constriction; cannot lie down; must sit up and lean forward; worse after midnight; better warmth and hot drinks—signature of Kali-ar. asthma [Hering], [Clarke], [Boericke]. Cough dry, teasing, then scanty expectoration, often salty or slightly blood-streaked; cough worse cold air and on lying; better warmth, sipping hot water. Burning behind sternum; stitching with deep breath in cold air; chest walls tender after many nights of coughing. Chronic catarrh exhibits dryness with little mucus and great irritability; in emphysematous elderly, tiny expectoration brings disproportionate relief (Chest ↔ Generalities).

Palpitation with fear at night; pulse quick, small; precordial anxiety compels sitting up; better warmth and company (Heart ↔ Mind) [Clarke], [Boericke]. Occasional stabbing with breath-catching in cold; no gross valvular picture is essential—rather functional cardio-respiratory distress in a chilly, anxious organism.

Short breath; dyspnœa extreme after midnight, from 1–3 a.m.; must open chest and sip hot drink; chilly despite many covers (Respiration master-rubric) [Hering], [Clarke]. Inhalation of cold air instantly provokes spasm; warm vapour calms; sighing from fear alternates with panting. Asthma alternates with skin eruptions (when skin is out, chest is easier; suppression of skin brings chest) [Hering], [Kent].

Anxious gastralgia with burning as from live coals; nausea after eating; retching from mere odour of food when cold (Stomach ↔ Mind/Modalities) [Allen], [Clarke]. Thirst for frequent small sips; hot drinks sit; iced drinks aggravate at once. Appetite little; yet small warm food often—“little and often”—benefits; fear of food provoking night panic is common. Flatulent distension after cold foods; acidity and sour risings; better warmth on epigastrium. Emptiness with faintness about 2–3 a.m. relieves by hot milk or water—a bedside pointer to the salt.

Burning and soreness along the intestinal tract; colicky griping in cold air; must wrap belly warmly [Clarke]. Abdomen distended with gas toward evening; anxiety increases with meteorism; relief after passing wind and after applying heat. Chronic catarrhal states show alternating constipation and loose, irritating stools; perianal skin is dry, fissured, burns on wiping—skin ↔ rectum link.

Stools may be small, offensive, excoriating; burning at anus persists after stool; diarrhœa at night with coldness and fear (Rectum ↔ Generalities) [Allen], [Clarke]. Fissures about anus and perineum in dry-skinned subjects; pruritus ani worse undressing, < cold washing, > warmth and grease. Constipation with dry, crumbling stool in winter alternates with irritative looseness in anxiety spells.

Urging at night during panic; urine scant, high-coloured; burning in urethra on voiding, better warm applications [Allen], [Clarke]. Albuminous trace in cachexia; oedema of ankles in exhausted asthmatics after many wakeful nights; diuresis improves with sleep restored and anxiety eased.

Thirst for frequent small sips, hot preferred; aversion to cold drinks that “chill the chest” and excite cough (Food ↔ Chest) [Allen], [Clarke]. Appetite small; desires warm, bland, slightly seasoned food; milk only if hot; fat and cold sweets aggravate dyspepsia and itch. Some crave warm milk at 2–3 a.m. which quiets panic—mini-case pointer.

Pruritus scroti with dry, scaly eruption; burning after scratching, relieved by warm bathing and in warm room (Male ↔ Skin) [Clarke], [Phatak]. Sexual desire low in exhausted, chilly subjects; nocturnal emissions with anxiety and palpitation.

Vulvar pruritus burning, worse cold washing and undressing, better warm applications (Female ↔ Skin) [Phatak]. Menses too early, too profuse in anæmic patients; weakness and restlessness worse at night; catarrhal leucorrhœa excoriating. Asthmatic and cutaneous complaints often worsen about menses, confirming the cyclic, syco-syphilitic tone.

Cold along the spine at night; burning between shoulders that craves a hot bottle; stiffness of cervical muscles in draughty rooms (Back ↔ Modalities) [Clarke]. Lumbar aching with fatigue of anxious nights; better warmth and rest.

Hands and feet cold as ice with burning inside; chilblain-like plaques in winter; palmar/plantar fissures bleed and burn on washing cold, soothed by greasing and heat (Extremities ↔ Skin) [Phatak], [Boericke]. Tingling, numbness—peripheral neuritis type—with weakness and restlessness; cannot keep still yet is exhausted (Arsenicum stamp). Night cramps of calves in chilly rooms; socks/bed-warmers relieve. Nails brittle, ridged; skin around nails fissured and tender.

A long-acting cutaneous remedy: dry, thick, scaly plaques with sharp borders; extensor surfaces, scalp, palms/soles; cracks that bleed; burning and itching < undressing, < cold air/water, > warmth, oiling and hot bathing [Clarke], [Boericke], [Phatak]. Scratching gives momentary delight followed by fierce burning that sends the sufferer to the fire—an emblematic cycle (Skin ↔ Modalities). Chronic eczema lichenifies; margins excoriate; secondary infection rare if warmth and dryness are preserved—cold, damp relapses. Psoriatic nails pit and crumble; palmo-plantar fissures are keynote. Skin and lungs alternate: when skin is suppressed, asthma returns; when eruptions flourish, chest quiets—directional law (Skin ↔ Respiration) [Hering], [Kent].

Aetiology / Constitution

• Arsenicum album: Burning pains, great anxiety after midnight, thirst for small sips, profound prostration. Ars. alb has more acrid discharges and general acridity; Kali-ar. adds dryness, scaliness, and “Kali” orthopnoea with cutaneous alternation. [Kent], [Clarke]

• Kali carbonicum: Stitching chest pains, 3 a.m. aggravation, need to sit up. Kali-c. shows more oedema and back weakness; Kali-ar. has burning, psoriasis, and cutaneous–respiratory alternation. [Kent], [Boger]

• Psorinum: Filthy, offensive skin, despair, wants warm clothes even in summer. Kali-ar. is cleaner, fastidious, and ameliorated by hot drinks; psoriasis and fissures are more prominent. [Clarke], [Phatak]

Skin (Psoriasis/Eczema)

• Graphites: Oozing honey-like discharge, cracks in folds, obesity, chilly habit. Kali-ar. is drier, more scaly, with burning after scratching and winter aggravation. [Clarke], [Boericke]

• Arsenicum iodatum: Scaly catarrh with emaciation and heat; more glandular involvement and discharge. Kali-ar. is drier, more anxious, and nocturnal. [Farrington], [Clarke]

• Petroleum: Winter cracks, fissures, worse washing, greasy and offensive. Kali-ar. has burning, is better from hot drinks, and has less greasiness. [Clarke], [Phatak]

• Mezereum: Thick crusts with pus beneath, intense itching. Kali-ar. has thinner, drier scales, burning after scratching, with strong anxiety component. [Allen], [Clarke]

• Sulphur: Burning feet, itch, lazy and unwashed type, aggravated by heat. Kali-ar. loves heat, improves from it, and is more anxious; Sulph. may follow later to arouse reactivity. [Kent], [Nash]

Asthma / Catarrh (after midnight)

• Antimonium tartaricum: Great rattling with little power to expectorate, drowsy, cyanotic. Kali-ar. has more anxiety, is chilly, improves with warmth and hot sips, with less torpor. [Boger], [Boericke]

• Ipecacuanha: Spasmodic wheeze with persistent nausea, clean tongue. Kali-ar. has less nausea, more anxiety, and clear skin alternation. [Farrington]

• Lachesis: Cannot bear tight clothes, worse on falling asleep, left-sided predominance. Heat aggravates Lach.; Kali-ar. craves and improves from heat. [Kent], [Clarke]

• Aralia racemosa / Arsenicum iodatum: Aral. has first-lying down cough; Ars-i. catarrh with emaciation. Kali-ar. has central midnight aggravation and stronger skin–respiratory link. [Boericke], [Farrington]

Gastric Burning / Anxious Dyspepsia

• Nux vomica: Irritable, chilly, better in warmth of bed (though not markedly), craves stimulants, wakes 3–4 a.m. Kali-ar. has stronger burning axis, thirst for hot sips, and more nocturnal anxiety. [Kent], [Clarke]

• Phosphorus: Burning with thirst for cold drinks, which are vomited. Kali-ar. is aggravated by cold drinks and ameliorated by hot. [Farrington]

Neuralgia / Neuritis (Burning pains)

• Capsicum: Burning as of pepper, sluggish, chilly but worse from heat. Kali-ar. has nocturnal burning with anxiety, always seeking warmth. [Clarke]

• Secale cornutum: Burning with icy coldness, wants to be uncovered. Kali-ar. is opposite—always wants covering and heat. [Kent], [Clarke]

Complementary:

• Arsenicum album — acts on a deeper constitutional plane; Kali-ar. often follows Ars. in chronic catarrh and psoriasis when dryness and the “Kali” orthopnoea predominate. [Kent], [Clarke]

• Graphites — cracks and fissures of hands and soles; Graph. follows Kali-ar. when oozing replaces dryness. [Clarke], [Boericke]

• Antimonium tartaricum — in elderly asthmatics; Kali-ar. controls anxious midnight spasm, Ant-t. clears residual rales. [Boger], [Boericke]

• Psorinum — intercurrent to rouse reactivity in winter relapses; follows Kali-ar. in torpid skin states. [Kent], [Nash]

Follows well:

• Sulphur — after Sulph. has awakened reactivity, Kali-ar. consolidates the case with its heat-craving dryness. [Kent]

• Arsenicum iodatum — when discharges subside into dry scaling and midnight anxiety persists. [Farrington]

Precedes well:

• Thuja / Natrum sulphuricum — in sycotic, damp-weather catarrhs when mucus later returns; Kali-ar. often lays the groundwork. [Boger]

Related:

• Kali carbonicum, Kali bichromicum (the catarrhal “Kali”s); Petroleum, Mezereum, Hepar sulphuris, Lycopodium (the winter skin–chest cycle). [Clarke], [Boger]

Antidotes:

• Heat and warm drinks; Nux vomica (for drugging or gastric irritability); Camphora (in toxic or arsenical states). [Clarke], [Hughes]

Inimical:

• None fixed; avoid mechanical alternation with Arsenicum album unless new indications arise. [Kent], [Clarke]

Typical indications:

• Asthma with after-midnight aggravation, compelled to sit up; better warmth and hot sips. [Clarke], [Boericke]

• Chronic dry, scaly dermatoses (psoriasis, palmo-plantar fissures) with burning after scratching and winter aggravation. [Phatak], [Clarke]

• Anxious insomnia after midnight with thirst for small hot sips. [Allen], [Clarke]

• Gastric burning, better for hot drinks. [Clarke], [Boericke]

Potency:

• In chronic skin and catarrhal states, low triturations/tissue-salt form (3X–6X) twice or thrice daily is classical. [Boericke]

• For constitutional prescribing and asthmatic night attacks, 30C–200C in single or spaced doses, adjusted to vitality. [Dewey], [Tyler]

• In anxious midnight crises, a cup of hot water between doses reinforces the modality. [Boger]

Repetition:

• Acute paroxysms — repeat every 20–60 minutes until intervals appear, then lengthen.

• Chronic states — dose once daily or less.

• Stop on clear improvement and resume only on relapse.

Sequencing:

• In stubborn psoriasis, interpose Sulphur or Psorinum by indication to rekindle response. [Kent], [Nash]

• In elderly asthmatics, finish with Antimonium tartaricum if rales and weakness remain. [Boger]

Case pearls:

• Case 1: “Sits bolt upright 2 a.m., clutches a hot mug, afraid to be alone; cough tight in cold air; palmar fissures.” Kali-ar. 200C hs broke the night panic and softened the hands. [Clinical], [Clarke]

• Case 2: “Psoriasis palmar-plantar, winter splits; scratches then burns, stands by fire.” Kali-ar. 6X t.i.d. with emollients; later a single 30C carried healing. [Phatak], [Boericke]

• Case 3: “Gastric burning at 3 a.m., sips hot milk, cannot lie down; anxious, tidy, chilly.” Kali-ar. 30C nocte restored rest in a week. [Clinical], [Allen]

Mind

• Anxiety – midnight – after – 1–3 a.m. – wants company; fears death. Bedside key to the “hot-sips” asthmatic. [Kent], [Clarke]

• Fastidious – tidy – anxious about small things – Kali-ar. temperament. Guides the salt choice over pure Ars. [Kent], [Tyler]

• Fear – alone – at night – cannot be left – wakes in panic. Matches sitting-up orthopnœa. [Clarke]

• Restlessness – compels motion – yet weakness great. Arsenical stamp. [Allen]

• Hypochondriasis – about health – air/food – fear of chill/draught. Management pointer. [Clarke]

• Despair – during chronic skin disease – winter. Intercurrent hints (Psorinum, Sulph.). [Nash], [Clarke]

Head

• Headache – cold air – agg.; wrapping – amel. Thermal axis. [Clarke]

• Itching scalp – thick scales – burning after scratching. Psoriasis capitis clue. [Boericke], [Phatak]

• Vertigo – on rising – with anxiety – hot drinks – amel. Night-crisis pointer. [Allen]

• Ears – behind – fissures – eczema – burning. Cutaneous sphere. [Hering]

• Eyes – blepharitis – scaly margins – itch burn after rubbing. Surface–salt mark. [Clarke]

Nose / Throat

• Coryza – thin – acrid – winter – agg.; warm room – amel. Seasonal modality. [Clarke]

• Nose – cracks – alæ – fissured – burning. Dry-skin nose. [Phatak]

• Smell – of cold air – provokes cough – laryngeal tickle. Laryngeal reflex. [Boericke]

• Thirst – small sips – warm drinks – amel. Signature. [Allen], [Clarke]

• Throat – dry – burning – better hot drinks/steam. Regimen cue. [Boericke]

Stomach / Abdomen / Rectum

• Gastralgia – burning – hot drinks – amel.; cold drinks – agg. Decisive rubric. [Allen], [Clarke]

• Nausea – after eating – fearful at night. Mind–gut loop. [Allen]

• Abdomen – chilled – colic – wrap warm – amel. Practical tip. [Clarke]

• Stools – excoriating – burning after. Arsenical end. [Allen]

• Pruritus ani – worse undressing/cold washing – better grease/heat. Skin–gut bridge. [Phatak]

Respiration / Chest / Heart

• Asthma – after midnight – must sit up – hot drinks – amel. Crown rubric. [Hering], [Boericke]

• Cough – cold air – agg.; warmth – amel.; sipping – amel. Thermal and sipping axis. [Clarke]

• Dyspnœa – lying – agg.; sitting – amel. Posture law. [Hering]

• Constriction – chest – burning behind sternum. Sensation rubric. [Clarke]

• Palpitation – with anxiety – night – amel. by warmth and company. Mind–heart link. [Clarke]

Skin

• Psoriasis – palms/soles – fissures – winter – agg. Hallmark. [Phatak], [Boericke]

• Itching – burning after scratching – wants heat. Signature sensation. [Clarke], [Phatak]

• Eczema – dry – lichenified – < cold; > warm bathing/oils. Regimen key. [Boericke]

• Cracks – fingers – heels – bleed – burn. Surface token. [Clarke]

• Alternation – skin ↔ asthma – suppression – chest worse. Direction of disease. [Hering], [Kent]

Extremities / Generalities / Sleep

• Coldness – extremities – with internal burning. Paradox. [Allen]

• Numbness – tingling – peripheral neuritis – night worse. Nerve edge. [Hughes], [Allen]

• Weakness – out of proportion – anxiety with prostration. Arsenical. [Clarke]

• Worse – cold – draught – winter – after midnight; Better – heat – hot drinks – wrapping – sitting up. Master polarity. [Boger], [Clarke]

• Sleep – wakes 1–3 a.m. – panic – orthopnœa – sips hot water – amel. Bedside picture. [Hering], [Clarke]

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): toxicology and clinical observations of potassium arsenite; gastric burning, thirst in sips, night aggravation; respiratory notes.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): confirmations—after-midnight asthma, alternation of skin and chest, burning pruritus, prostration with restlessness.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): remedy portrait of Kali arsenicosum; Fowler’s background; modalities; skin–respiratory alternation; regimen.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—chilly, anxious, better heat; asthma after midnight; psoriasis with fissures; therapeutic hints and relationships.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): substance background—Fowler’s solution; crude pharmacology; arsenical cachexia informing homœopathic sphere.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): generalities—worse cold/after midnight; better heat; asthmatic posture; repertorial pivots for Kali salts.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): concise essence—psoriasis dry/fissured; burning after scratching; winter aggravation; hot-drink relief.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): miasmatic framing; “Kali” and “Arsenicum” generals; comparisons with Ars. alb., Kali-c., Sulph., Psor.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): clinical colour—fastidious anxious type; midnight panic; hot-sip habit; surface vs. depth in Kali–Ars. subjects.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): relationships—Sulph., Psor., Ars. series; sequencing in chronic dermatoses and catarrh.
Farrington, E. A. — Clinical Materia Medica (1890): comparisons—Ars-i., Ant-t., Ipec., Phos.; respiratory and skin therapeutics.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): dosing and repetition; bedtime prescribing for nocturnal asthma; supportive measures.
Bœnninghausen, C. von — Therapeutic Pocket Book (1846 and later editions): repertorial scaffolding—time (after midnight), thermal modalities, skin/respiratory rubrics.
Dunham, C. — Homœopathy, the Science of Therapeutics (1877): reflections on direction-of-cure and management in chronic catarrh and skin disease.
Vithoulkas, G. — Materia Medica Viva (late 20th c.): modern essence—Arsenicum–Kali blend; anxiety axis; practical differentiation from Ars. alb.
Morrison, R. — Desktop Guide to Keynotes and Confirmatory Symptoms (late 20th c.): keynotes—after-midnight asthma, hot-sip amel., dry fissured psoriasis; cross-checks.