Kalium bichromicum

An inorganic salt of potassium and chromic acid, historically used in dyeing, tanning, and chemical laboratories; in crude workers’ exposure it is notorious for “chrome-holes” (deep, punched-out ulcers) on skin and mucosae, especially nasal septum, and for corrosive gastritis—clear toxicological lines that foreshadow the homœopathic sphere of round, perforating ulcers and tenacious catarrh [Hughes], [Allen], [Clarke]. In pharmacy the pure salt is triturated and potentised; clinical use rapidly established its keynote of thick, stringy, tough, ropy secretions adherent to mucous membranes, whether from nose, throat, bronchi, stomach or uterus [Hering], [Boericke]. A second keynote is localisation: pains and ulcers are in “small spots,” as if bored with a gimlet, and rheumatic pains wander from one small place to another [Kent], [Boger], [Hering]. Alternation of complaints—gastric and rheumatic, skin and respiratory—is another hallmark repeatedly charted in the literature [Clarke], [Kent].

Primary data come from [Toxicology] and provings collated by Allen and Hering, with abundant [Clinical] confirmations: boring pain at the root of nose; frontal sinusitis with thick, stringy, yellow-green plugs; post-nasal tough masses; croup/diphtheritic exudations; cough with viscid, tenacious sputa drawn out in long strings; “mapped” tongue; gastric catarrh with ropy mucus and stone-like weight; round, punched-out ulcers; wandering rheumatism alternating with gastric or catarrhal symptoms; modalities—worse cold, damp, open air; better warmth and pressure [Allen], [Hering], [Clarke], [Boericke], [Farrington], [Phatak].

Kali bichromicum unites a “glue and gimlet” signature. Its secretions are glue—tenacious, ropy, elastic strings; its pains and ulcers are gimlet—boring, stitching, precisely localised in a small, round spot with sharp edges. This dual image runs through the entire materia: the root-of-nose boring pain with frontal sinus clog; the nasal and post-nasal masses that hang and must be drawn out in threads; the laryngeal membranes that detach in stringy shreds; the bronchial mucus that needs a long effort and then comes in ropes; the “stone in stomach” relieved after ropy vomit; the round, punched-out ulcers of mouth, septum, skin and cornea with a yellow base and clean cut; and the wandering, spot-fixed rheumatism that alternates with catarrh or gastric trouble [Hering], [Allen], [Clarke], [Farrington]. The thermal state is chilly and the environment matters: cold, damp, foggy weather and east winds consolidate the glue and deepen the spot-pains; warmth, steam, hot drinks and pressure soften and relieve (modalities continually echoed throughout Nose, Throat, Chest, Head and Stomach). The miasmatic colour is syphilitic (destructive ulceration, perforation) riding a sycotic tide (hypersecretion) with psoric periodicity and alternation; hence the relapsing spring–autumn sinusitis, the seasonal bronchitis, the exchange of gastric heaviness for joint pains and back again [Kent], [Boger], [Clarke].
Psychologically the patient is oppressed rather than excitable—a heavy, dull mood that lifts perceptibly as outlets open: after hawking a plug, after a ropy vomit, after a good warm steam. The constitution is often fat, fair, flabby, with a catarrhal tendency; children fret when anyone approaches the “sore spot” of nose or throat, mirroring the localisation theme [Boericke], [Hering]. The clinical art lies in recognising the duet of ropiness plus roundness. Many remedies have thick catarrh (Hydrastis) or ulceration (Merc., Ars.), but few have both the viscous thread and the punched-out border. Many have sinus headache (Sticta, Sang.), but not the coin-sized boring spot relieved by firm pressure and by expelling stringy clinkers. Many have croup (Spong., Hepar), but not the stringy shreds and the relief from warm steam with a preference for warmth in general. Gastrically, Nux has irritability and over-indulgence; Lyc. has evening flatulence; Kali-bi. has “stone after little,” mapped tongue, beer intolerance and ropy vomit. The pace is slow and obstinate, with morning oppression and night croup, yet with swift relief when outlets are freed. Management aligns to the remedy: keep the patient warm and dry; use steam and warm saline to loosen; permit and encourage dislodgement—never suppress the discharge; feed small, warm, bland meals; and watch the alternation of spheres to guide sequencing. In such terrain, Kali-bi. acts not only as a reliever but as a governor of direction, opening outlets, rounding down the sharp ulcers, and ungluing the stuck places of the mucous system.

• Mucous membranes of nose and sinuses—thick, stringy, yellow-green discharge; clinkers and plugs; frontal headache at root of nose; septal ulceration/perforation (see Nose/Head). [Hering], [Clarke], [Allen]
• Naso-pharynx and posterior nares—post-nasal tough masses, hawked in opaque, elastic strings; cacosmia; gagging (see Throat). [Hering], [Boericke]
• Larynx and trachea—croupous/diphtheritic exudation; hoarseness; barking cough with adherent, tenacious expectoration “drawn out in long strings” (see Throat/Respiration). [Allen], [Hering], [Farrington]
• Bronchi—chronic bronchitis with ropy, viscid sputa; winter aggravations; asthma with gastric load, better warmth (see Chest/Respiration). [Clarke], [Boericke]
• Gastro-intestinal—gastric catarrh, “stone in stomach,” vomiting of ropy mucus, diarrhoea with gelatinous, stringy mucus (see Stomach/Rectum). [Allen], [Clarke]
• Skin and ulcers—round, punched-out ulcers with sharp edges and yellow base; sluggish healing; “chrome-holes” signature (see Skin). [Hughes], [Hering], [Clarke]
• Periosteum and fibrous tissues—wandering, shifting rheumatism in small spots; pains appear and disappear suddenly; alternation with gastric or catarrhal complaints (see Extremities/Generalities). [Kent], [Boger]
• Eyes—ophthalmia with stringy, tenacious discharge; phlyctenulae; corneal ulcers round, punched out (see Eyes). [Hering], [Clarke]
• Ears—gluey otorrhoea; catarrh of Eustachian tube with tenacious threads (see Ears). [Clarke]
• Female pelvic—thick, stringy, yellow leucorrhoea; erosion of cervix with round ulcers (see Female). [Clarke], [Boericke]
• Liver and portal system—congestive dyspepsia with coated “mapped” tongue, worse beer; heaviness after small quantities (see Stomach). [Allen], [Clarke]
• Direction/alternation—gastric ↔ rheumatic; skin ↔ respiratory; pains localised in coin-sized spots (see Generalities). [Kent], [Clarke], [Boger]
• Do you want me to continue re-setting all earlier system/affinity lists (Iodum, Jaborandi, Jalapa, Jatropha, Justicia, etc.) into this same clean bullet format so that your entire Materia Medica set is consistent?

A sluggish, oppressed mentality accompanies the heavy catarrhal and gastric states; the patient is dull, indifferent, and dissatisfied, with an irritable intolerance of disturbance during headache localised to one spot—the least movement seems to scatter the focus and worsen it, which tallies with the modality (worse motion) already noted [Clarke], [Allen]. Anxiety is practical and centred on obstruction—fear of choking when thick plugs accumulate, fear of strangling during croupous attacks; yet in open air the dread is greater because the cold air increases tenacity and oppression (Mind ↔ Throat/Respiration) [Hering]. Children are fretful and averse to being touched on the nose or throat; they push the hand away as if guarding their “sore spot,” a behavioural echo of localisation. During gastric crises adults are taciturn, focused on the “stone” in the stomach, with an aversion to conversation or movement; the relief that follows vomiting or expelling a plug alters the mood rapidly—another example of outlet-determined affect (Mind ↔ Stomach/Nose). Obsessive picking of crusts in ozæna has a compulsive tinge and provokes bleeding and deeper ulceration, reinforcing the syphilitic stain [Clarke], [Hering]. Fat, fair, flabby subjects—particularly children—show peevishness in damp seasons and become lively in warm, dry weather, mirroring the general modalities (better warmth, worse cold damp) [Boericke]. Sleep loss from night cough produces daytime apathy; irritability heightens at meal times when even a little food renews weight and nausea (Mind ↔ Sleep/Stomach).

Disturbed by hawking at early morning; children wake choking with croupous stridor; adults start with the feeling of a plug in throat. Dreams of suffocation or of picking something out of the nose or mouth (Sleep ↔ Throat/Nose) [Hering]. Sleepiness by day after a heavy, foggy morning; dozing in warm room brings some refreshment.

Of choking, thick ropes, or of being tied or stuck; of dirty cellars and damp basements—environmental representation of modalities (worse damp/cold) [Clarke]. Relief-dreams after successful expectoration or vomiting are reported—outlet psychology.

Kali-bi. is the remedy of string and spot: stringy, ropy, viscid secretions adhering like glue, drawn out in long threads; and pains, ulcers, and congestions localised in round, coin-sized spots with clean, punched-out edges [Hering], [Clarke], [Allen]. The organism is chilly and worse from cold, damp, fog and east winds; better for warmth, hot drinks, pressure and rest. Timing clusters in the early morning (hawking, nausea) and night for croupous states. Discharges relieve—when plugs are expelled or ropy mucus is brought up, head, chest and mood lighten (the “outlet” law echoed across Nose, Throat, Chest, Stomach). Alternation is characteristic: gastric and rheumatic complaints change places; nasal and chest symptoms see-saw; suppression in one area aggravates another—confirming its sycotic–syphilitic hinge [Kent], [Hering], [Clarke]. Compare Ant-t. (rattling, prostration but sputa not so stringy); Kali-c. (stitching pains, 3 a.m., but lacks ropiness and “spot” localisation); Merc. (salivation, mouth ulcers irregular, not clean-cut); Hepar (pus, exquisite chilliness, but exudates less stringy); Hydrastis (thick catarrh, less localisation); Cistus/Calc-s. in ozæna; and Lach./Phos. in membrane-disease—each lacks the perfect duet of “ropiness + roundness” that marks Kali-bi. [Farrington], [Boericke], [Boger], [Kent].

Catarrhal fever in damp seasons; chilliness predominates; slight heat with full head; sweat comes with relief after expectoration or discharge of plugs [Clarke], [Allen]. Evening rise with frontal heaviness; little thirst unless from mouth dryness; heat less burning than Ars., more congestive.

Chill in fog or draught; heat local to head/face with sinus pressure; sweat moderate and relieving (Chill ↔ Head/Nose) [Clarke]. Cold air excites cough and nose pain; warmth softens exudates. Night sweats when chest improves; suppression of sweat may usher in rheumatism—alternation.

Headache centres at the root of the nose and over the frontal sinuses, described as boring, pressing, or stitching in a coin-sized spot; stooping or motion aggravates; firm pressure or tight bandaging relieves—precise modalities echoed already (Head ↔ Modalities) [Hering], [Allen], [Clarke]. Pain often alternates sides or shoots from one small point to another; the coryza is thick, tough, and stringy, and the headache abates as plugs are expelled (Head ↔ Nose) [Hering]. A “helmet” or “weight” sensation fits the congestive sinus picture; mornings are worst; cold, damp weather and fog provoke attacks, whereas warmth softens and lessens pain. Occipital pain may supervene when frontal pressure is relieved—migratory signature. Visual brightness aggravates, but true photophobia is less marked than in Kali-c. or Nat-m.; the outstanding feature remains localisation in a small spot and relief by pressure. Mini-case: a clerk with recurring 10 a.m. boring pain over right supraorbital ridge, relieved only by firm band and nasal douche of warm saline; discharge thick, elastic; Kali-bi. cured the periodicity [Clinical], [Clarke].

Ophthalmia with thick, stringy muco-purulent discharge gluing the lids; conjunctivæ injected; photophobia moderate; corneal ulcers are round, “punched-out,” with sharp edges and little surrounding haze—an ocular mirroring of the chrome ulcer [Hering], [Clarke]. Tenacious threads can be drawn from the canthi; biting, acrid lachrymation excoriates the cheeks; morning agglutination marked. In phlyctenular disease of scrofulous children, attacks relapse in damp weather and improve in warmth (Eyes ↔ Generalities). Pain is stitching or boring in small points around the orbit, matching sinus involvement; pressure over the brow relieves both eye and head symptoms (Eyes ↔ Head).

Gluey, stringy otorrhœa from chronic middle-ear catarrh; Eustachian tube blocked with viscid mucus; popping on swallowing may be scant because the threads are too tenacious [Clarke], [Hering]. Otalgia is stitching, in a fixed small spot; often synchronous with throat or sinus pain (Ears ↔ Throat/Nose). Hearing duller in damp weather; better in a warm, dry room—modal echo.

Master sphere: thick, stringy, yellow-green discharge forms clinkers and elastic plugs; patient hawks them with difficulty; post-nasal masses hang and must be drawn out in long strings (Nose axis) [Hering], [Allen], [Clarke]. Sense of dryness internally with crusts over raw surfaces; smell offensive (cacosmia); septum ulcerates to perforation—“chrome-hole”—with round, clean-cut edges [Hughes], [Clarke]. Coryza alternates with chest or gastric symptoms; when nasal flow is checked, frontal pain or bronchial oppression returns (Nose ↔ Head/Chest). Boring pain at root of nose; pressure and warm applications relieve; cold air aggravates. Ozæna with fetor and bleeding on picking is prominent; mornings are worst; spring and autumn relapses frequent.

Face heavy, earthy, with bluish beneath the eyes in chronic catarrhs; alæ nasi sore; upper lip excoriated by discharge [Clarke]. Expression is dull and oppressed during frontal attacks; the child’s mouth hangs open with post-nasal obstruction. Cheeks may flush with heat in warm rooms while the nose remains cold and tender—thermal split common to catarrh. In chrome ulceration the nasal bridge may be tender; sneezing painful.

Tongue often “mapped”: smooth, red, denuded patches with sharply defined borders amid a coated surface—“punched-out” look in miniature [Hering], [Clarke]. Mouth and palate present round, clean-edged ulcers with yellow base and viscous coating; saliva stringy; breath foul in ozæna states. Taste is reduced or clay-like; thirst for warm drinks that loosen mucus aligns with the Better For list (Food & Drink).

Toothache localised to one tooth or a tiny area, stitching in damp cold; better warmth and firm pressure; gums ulcerate in rounded patches with yellow base (Teeth ↔ Skin) [Hering], [Clarke]. Odontalgia often accompanies sinus flares; chewing aggravates; hot applications give relief.

Fauces red, glazed, and œdematous with adherent, tough exudation; diphtheritic or croupous membranes—grey, stringy—detach in shreds; attempts to remove bring raw bleeding surface beneath [Hering], [Allen], [Farrington]. Sensation of a plug or sticky rope in the throat; constant hawking of tenacious masses; choking from “sticky straps.” Sore spots shift from side to side or fix in a coin-sized area; warm drinks and steam soothe, while cold air and cold drinks aggravate (modalities echoed). Voice hoarse, deepens toward night in damp weather; singers lose upper register when strings adhere to the folds (Throat ↔ Respiration).

Bronchitis with viscid, tenacious expectoration “drawn out in long strings”; difficult to raise; relief when a portion is expelled (Chest axis) [Hering], [Allen], [Farrington]. Rattling is less coarse than Ant-t.; oppression worse cold damp; better warmth and leaning forward. Pain retrosternal in a small spot; cough tearing at a fixed point; sensation of a plug moving with respiration. Winter catarrhs—stubborn, adhesive sputa; in croup/diphtheria, shreds of membrane come away leaving rawness (Chest ↔ Throat).

Palpitation secondary to respiratory struggle or gastric weight; anxious oppression without deep cardiac lesion; pulse full in congestive catarrhs, softer after expectoration [Clarke]. Stitching at the cardiac apex in a coin-sized area in damp weather—a rheumatic echo. Warmth and rest ease; open air with fog aggravates.

Short breath with viscid “glue” in the trachea; cough in violent paroxysms to dislodge strings; dyspnœa worse in fog, cellars, cold damp; better in warm room, by sipping hot drinks, and by leaning forward (Respiration ↔ Modalities) [Hering], [Farrington], [Boericke]. Croup and diphtheritic states at night; hoarseness by day. Asthma alternates with gastric symptoms—on days of stomach relief the chest tightens less.

Cardinal: “stone in the stomach” after small quantities; distress out of proportion to intake; heaviness with nausea and vomiting of ropy mucus and undigested food [Allen], [Clarke]. Tongue mapped; appetite variable; beer and cold drinks aggravate at once; hot drinks soothe (Food & Drink). Gastric symptoms alternate with rheumatic pains (Generalities). There is gnawing pain in a small spot at the epigastrium; pressure and warmth ease; motion and stooping aggravate. Morning nausea common with thick post-nasal drip; relief after vomiting or after expelling pharyngeal masses (Stomach ↔ Throat/Nose).

Fullness and tympany after little food; cutting colic in small points; tendency to hepatic congestion with muddy stool and coated tongue (Abdomen ↔ Stomach) [Clarke]. Alternating with diarrhœa of stringy jelly-like mucus; soreness about umbilicus. Cold, damp weather increases abdominal gloom; warmth and rest bring ease.

Stools slimy, gelatinous, “sago-like,” stringy mucus—sometimes without much fæcal matter; tenesmus may be slight compared with weight and nausea [Allen], [Hering]. Early morning diarrhœa with ropy slime; alternates with constipation when catarrh is suppressed. Burning at anus in rounded patches; fissures round-edged; pruritus less than soreness.

Mucus threads in urine in catarrhal states; scanty urine during gastric oppression; red sand less characteristic than in Lyc. (differential). Dysuria may localise—“one small sore spot”—at urethral meatus [Clarke].

Aversion to beer or beer aggravates profoundly; cold drinks and cold food offend; desire for warm food and hot drinks, which loosen mucus and lighten the stomach (Food ↔ Stomach/Throat) [Allen], [Clarke]. Appetite small; weight after little; sweets not markedly craved; nausea on empty stomach in the morning from post-nasal slime.

Gleet with tenacious, stringy threads; round ulcers on prepuce or glans (clean-cut edges) [Hering]. Sexual desire low in heavy catarrhal phases; emissions with thick mucus threads.

Leucorrhœa thick, stringy, yellow, adherent; cervical erosions round with sharply cut edges; dysmenorrhœa with pains in small spots—sacral coin-sized aching [Clarke], [Boericke]. Morning sickness with ropy vomit; better warm sips. After suppression of leucorrhœa, bronchial tenacity increases—alternation.

Cervico-dorsal aching in a small spot, worse damp; sacral coin-sized pain; better hot applications and rest [Clarke], [Boger]. Stiffness between scapulæ, as if glued; movement tears the “adhesions”—a subjective kinship to its mucus tenacity.

Wandering rheumatism—pains shift from one small place to another; stitching and boring localisations; worse cold, damp; better warmth and rest [Boger], [Kent]. Knees and small joints especially affected; bursæ may fill with viscid fluid; tendons feel tight. Alternate with gastric or nasal troubles (Extremities ↔ Generalities).

Round, punched-out ulcers with clean, sharp edges and yellow base; sluggish granulation; chrome-workers’ “holes” are the toxic prototype [Hughes], [Hering], [Clarke]. Eruptions with thick, honey-yellow, tenacious crusts adhering strongly; beneath, a sharply defined ulcer. Cracks in corners (nostrils, mouth) with round-edged fissures. Itching moderate; soreness prominent; worse damp cold; better warmth and greasing.

Aetiology / Environment

• Dulcamara: cold damp worsens catarrh; thin mucus, not ropy; lacks “punched-out” ulcer signature. [Clarke], [Farrington]

• Rhus-t.: cold damp rheumatism, better motion; Kali-bi. better rest, more stringy catarrh. [Boger], [Kent]

Sinusitis / Root-of-nose pain

• Sticta: dry, stuffed nose with frontal pressure; fewer plugs; Kali-bi. has clinkers and elastic strings. [Clarke]

• Pulsatilla: bland, yellow-green catarrh, weepy, open air better; Kali-bi. thick, tenacious, foul, cold air worse. [Kent], [Clarke]

• Hydrastis: thick, tenacious discharge but lacks small-spot headaches and punched-out ulcers. [Farrington], [Clarke]

Diphtheria / Croup / Larynx

• Spongia: dry bark, better warm drinks; no stringy exudate; Kali-bi. has shredding membrane and ropy masses. [Boericke]

• Hepar: great chilliness, pus and suppuration; secretions not ropy like glue; sensitive to touch. [Hering], [Kent]

• Mercurius: salivation, foul breath, ulcer edges ragged; Kali-bi. has clean, round, yellow-based ulcers. [Clarke]

Bronchitis / Expectoration

• Antimonium tart.: coarse rales, great torpor, cyanosis; Kali-bi. less prostration, more tenacity and strings. [Boger], [Boericke]

• Bryonia: dry, painful cough, worse motion; sputa not ropy; Bry. wants absolute rest, dry state. [Kent]

• Phosphorus: burning chest, haemoptysis, thirst for cold; sputa not especially stringy; Kali-bi. prefers warmth. [Farrington]

Gastric

• Nux-v.: irritable dyspepsia, craves stimulants; heaviness after overeating; mucus not ropy; Nux likes warmth too but lacks mapping and strings. [Kent], [Clarke]

• Lycopodium: bloating, 4–8 p.m.; red sand in urine; craving sweets; Kali-bi. “stone after little,” mapped tongue, beer agg. [Clarke]

Ulcers / Skin

• Kali-c.: indurated edges, stitching pains; little punched-out character; cough/stitch 3 a.m. keynote differs. [Kent]

• Silicea: fistulae, offensive pus, slow healing; not clean-cut round ulcers; more suppurative. [Boericke]

• Arsenicum: burning, black base ulcers; prostration and restlessness; secretions not ropy. [Farrington]

Alternation / Localised “spot” pains

• Actaea spicata: small-joint rheumatism worse slight motion; lacks mucous ropiness. [Boger]

• Sanguinaria: right supraorbital periodic pain relieved by vomiting; nasal crusts but less stringy; thermal differentials (Sang. likes open air). [Clarke]

• Complementary: Hydrastis—both thick catarrh; Hydr. for relaxed mucosa without strings; Kali-bi. when ropy plugs dominate. [Farrington], [Clarke]

• Complementary: Cistus canadensis—in ozæna with septal ulceration; Cist. helps torpid bone–mucosa states; Kali-bi. gives ropy string keynote. [Clarke]

• Complementary: Silicea—chronic fistulae and sluggish ulcers after ropy catarrh has been reduced. [Boericke]

• Follows well: Hepar—in membranous laryngitis after the violent, sensitive stage subsides, leaving tenacious shreds. [Hering], [Farrington]

• Follows well: Mercurius—when salivary, foul, ragged ulcer phase passes to clean-cut, stringy stage. [Clarke]

• Precedes well: Antimonium tart.—elderly chronic bronchitis; Kali-bi. reduces viscosity; Ant-t. clears rales when weakness remains. [Boger], [Boericke]

• Precedes well: Pulsatilla—if discharge becomes bland, non-adherent and patient craves open air. [Kent]

• Related: Sticta, Sanguinaria (sinus); Spongia, Hepar (croup); Hydrastis (catarrh); Silicea (ulcers); Lyc., Nux (gastric). [Clarke], [Farrington]

• Antidotes: Hepar and Merc. to caustic effects locally (supportive); general—warmth, steam, oily dressings for chrome lesions. [Hughes], [Clarke]

• Inimicals: None fixed; avoid mechanical alternation with Merc./Hepar without fresh indications. [Kent]

Indications

• Sinusitis with root-of-nose boring pain, thick elastic plugs and post-nasal strings; pressure and heat give relief; cure tracks with restoration of free discharge. [Hering], [Clarke]

• Croup and diphtheritic states with grey, stringy exudate; shreds detach; warm steam + Kali-bi. often avert extension when chosen early by the ropy keynote. [Allen], [Farrington]

• Chronic bronchitis of the elderly: morning hawking of ropy sputa, relief after expelling; alternating days of “heavy stomach”; Kali-bi. first, Ant-t. later if rales persist. [Boger], [Boericke]

• Gastric catarrh: “stone in stomach” after little; ropy vomit; beer aggravates; mapped tongue—marked dyspeptic habit. [Allen], [Clarke], [Tyler]

• Ulcers and ozæna with punched-out, round edges; perforation of septum; consider Cistus or Silicea after Kali-bi. if ulcer repair lags though ropiness has ceased. [Clarke], [Boericke]

Posology

• In acute sinus and croup/diphtheritic states: 6C–30C every 1–3 hours, pausing once stringy discharge frees and respiration clears. [Allen], [Farrington]

• In chronic gastric catarrh and ropy bronchitis: 6X–30C twice daily over weeks, tapering as discharge normalises; watch for alternation with rheumatic pains. [Clarke], [Tyler]

• Higher potencies (200C and above) reserved for entrenched sinus/ozæna or ulcerative cases, often requiring longer follow-up. [Kent], [Clarke]

Repetition strategy

• Stop dosing when ropy discharge flows freely and pains lessen—“better out than in” is the clinical gauge. [Clarke], [Hering]

• If relapse alternates into chest or stomach, repeat in same potency; shift to Ant-t. when rales dominate or Silicea when ulcers remain sluggish. [Boger], [Boericke]

Adjuncts

• Warm compresses and pressure to root of nose or stomach during attacks.

• Steam inhalations to soften plugs and membranes.

• Avoid cold beer, sour foods, raw damp weather exposures.

• Moderate rest during gastric/stomach heaviness, light diet, warmth. [Clarke], [Boericke]

Case pearls

• Sinusitis with root-of-nose boring pain, plugs hawked out in long strings; Kali-bi. 30C t.i.d.; relief in three days, discharge free. [Clinical], [Clarke]

• Elderly man, chronic bronchitis, mornings clogged with ropy sputa; Kali-bi. 6X b.i.d.; cough eased, later Ant-t. completed clearance. [Clinical], [Boger]

• Dyspeptic patient, “stone in stomach” after beer, mapped tongue, vomiting of mucus; Kali-bi. 200C once weekly; gastric weight gone, diet tolerance improved. [Clinical], [Tyler]

• Ozæna with septal perforation and fetid crusts; Kali-bi. 30C nocte × 2; discharge softened, but Silicea later restored tissue healing. [Clinical], [Clarke]

Mind

• Indifference—dullness during catarrh; better when discharge flows—mood follows outlet. [Clarke]

• Fear—choking—on accumulated mucus—practical anxiety in croup/catarrh. [Hering]

• Irritability—touching affected part (nose/throat)—guarding the “spot.” [Hering]

• Aversion to conversation during gastric heaviness—“stone in stomach” phase. [Allen]

• Rest better than motion—mental quiet aligns with somatic localisation. [Boger]

• Children—peevish—do not want nose or mouth examined—behavioural keynote. [Clarke]

Head

• Pain—root of nose—boring—coin-sized—pressure amel. Sinus hallmark. [Hering], [Allen]

• Headache—frontal—morning—cold damp—agg.; warmth—amel. Seasonal axis. [Clarke]

• Headache—alternating sides—shifting in small spots—localisation signature. [Boger]

• Headache—worse stooping/motion; better tight bandaging. Modality classic. [Allen], [Hering]

• Headache—better after nasal discharge or expelling plugs—outlet law. [Clarke]

• Photophobia slight—light agg. congestive sinus, not ocular pathology. [Clarke]

Nose

• Coryza—thick, stringy, yellow-green—elastic plugs—drawn out in strings. Crown rubric. [Hering], [Allen]

• Post-nasal—clinkers; hawking—relieves head/chest. Mechanistic key. [Clarke]

• Ozæna—fetid; septal perforation—“punched-out” edges. Toxicologic echo. [Hughes], [Clarke]

• Nose—pain—root—pressure amel.; cold air agg. Modality. [Hering]

• Discharge—checked—chest/gastric—aggravates. Direction-of-disease. [Hering], [Kent]

• Epistaxis—after picking crusts—worsens ulcer. Management warning. [Clarke]

Throat / Larynx

• Diphtheritic membrane—stringy, grey—detaches in shreds—rawness. Hallmark exudate. [Allen], [Hering]

• Sensation—string/plug in throat—must hawk—relieved by warm drinks. [Hering], [Farrington]

• Hoarseness—singers—strings on folds—damp weather agg. Voice rubric. [Clarke]

• Croup—night—steam amel.; cold damp agg. Emergency pattern. [Hering]

• Sore throat—localised spot; shifting sides—small-spot keynote. [Clarke], [Boger]

• Swallowing—warm liquids amel.; cold agg. Modal pivot. [Allen]

Chest / Respiration

• Expectoration—ropy—drawn in long strings—difficult—relief after. Master chest rubric. [Hering]

• Bronchitis—winter—damp—agg.; warm room—amel. Seasonal axis. [Clarke]

• Cough—paroxysmal to dislodge strings; leaning forward amel. Posture note. [Farrington]

• Asthma—with gastric load—“stone in stomach”—alternating symptoms. [Clarke]

• Pain—retrosternal—small spot—pressure/heat—amel. Localisation again. [Clarke]

• Croup—night; 2–5 a.m.—agg. Time pointer. [Hering], [Allen]

Stomach / Abdomen / Rectum

• Stomach—weight—“stone after little”—beer/cold drinks—agg.; hot drinks—amel. Signature. [Allen], [Clarke]

• Vomiting—ropy mucus—relieves heaviness. Outlet rule. [Allen]

• Tongue—mapped—denuded red patches with sharp borders. Visual keynote. [Hering]

• Diarrhoea—gelatinous, stringy mucus—“sago” stool. Characteristic stool. [Allen]

• Colic—small circumscribed spots—pressure/heat—amel. Localisation. [Clarke]

• Constipation ↔ diarrhoea—alternation with catarrh/rheumatism. Pattern. [Kent]

Skin / Ulcers

• Ulcers—round—punched-out—yellow base—sharp edges—chrome-holes. Core skin rubric. [Hughes], [Hering]

• Crusts—thick—adherent—beneath clean-cut ulcer. Morphology. [Clarke]

• Fissures—round-edged—corners of nose/mouth—damp cold—agg. Site cue. [Clarke]

• Healing—sluggish—better warmth/greasing; worse cold damp. Regimen note. [Hughes]

• Picking crusts—bleeding—deeper ulcer. Avoidance cue. [Clarke]

• Eruptions—honey-yellow, tenacious crusts. Visual confirmation. [Hering]

Extremities / Generalities / Sleep

• Rheumatism—wandering—small spots—shifting; cold damp—agg.; warmth—amel. Pattern. [Boger], [Kent]

• Alternation—gastric ↔ rheumatic; nasal ↔ chest; suppression—aggravation elsewhere. Directional law. [Hering], [Kent]

• Worse—cold, damp, fog, east winds; Better—warmth, hot drinks, pressure, rest. Master polarity. [Clarke], [Boericke]

• Morning—hawking/nausea; Night—croup/membrane. Time axis. [Allen], [Hering]

• Sleep—disturbed by plugs; dreams of choking; better after expectoration. Bedside cue. [Hering]

• Fat, fair, flabby—catarrhal habit—winter relapses. Constitutional hint. [Boericke]

Hahnemann — Chronic Diseases (1835): early notes on Kali salts and chronic mucosal states; general philosophy used.
Hering — The Guiding Symptoms of Our Materia Medica (1879–1891): keynotes—stringy mucus, croup/diphtheria shreds, small-spot localisation, alternation, punched-out ulcers.
Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): proving and toxicology—sinus/root-of-nose pains, gastric ropy vomit, gelatinous stools, modalities.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): clinical confirmations—ozæna, septal perforation, sinusitis, mapped tongue, beer aggravation, relationships.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): concise keynotes—ropy secretions, punched-out ulcers, croup, winter catarrh, constitutional type.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): toxicology of chrome salts; industrial “chrome-holes” informing ulcer morphology.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): modalities—worse cold damp; small-spot pains; alternation; repertorial pivots.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): miasmatic framing; localisation; alternation of complaints; comparisons with Kali-c., Merc., Hepar.
Farrington, E. A. — Clinical Materia Medica (1890): laryngeal/bronchial sphere—croup and ropy expectoration; micro-comparisons (Spong., Hepar., Ant-t.).
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): condensed keynotes—stringy secretions, mapping, alternation, modalities.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): differentiations in catarrhal chest and gastric states; sequencing hints.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): sinusitis/croup therapeutics; dosing and supportive measures (steam, warmth).
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): vivid portrait—“glue and gimlet” essence; constitutional remarks.
Lippe, A. von — Keynotes and Characteristics (late 19th c.): pointed keynotes employed for bedside selection.