Lac defloratum

Prepared from skimmed cow’s milk (cream mechanically removed), then triturated to 3C and succussed through serial dilutions per pharmacopoeial method before potentisation [Hering], [Allen], [Clarke], [Boericke]. Historical notes record provings and extensive bedside confirmations in periodic “sick headache” with gastric atony, sea-/railway-sickness, and obstinate constipation with inert rectum in pale, chilly, anaemic, or chlorotic patients [Allen], [Nash], [Tyler], [Boericke]. Toxicological and dietary observations on milk intolerance—nausea, flatulence, sour stools, and urticaria—supply a physiological rationale for the milk and sweets aggravation so characteristic of the remedy’s picture [Clarke], [Hughes], [Boericke]. As an animal-derived product, its sphere often ties neuro-vegetative instability to digestive atony, with a strong motion intolerance footprint (ship, carriage, rail) and relief from tight pressure, absolute stillness, darkness, and sleep [Nash], [Tyler].

Early provings and clinical collections were assembled from American and British school practitioners in the late 19th century; Lac defloratum quickly gained a reputation for periodic migraine with gastric stasis, sea/railway-sickness, torpid rectum, and chilly pallor with cold sweat [Proving: Allen], [Proving/Clinical: Hering], [Clinical: Nash], [Clinical: Tyler], [Clarke], [Boericke], [Boger]. Short case series emphasised menstrual association of the headaches and the striking relief from sleep and firm pressure [Nash], [Tyler], [Clarke].

Lac defloratum inhabits the liminal space between stomach, head, and the vestibular apparatus. Its psychological shading is quiet, resigned oversensitivity rather than irritable tension: the patient withdraws into darkness and silence, craving stillness because the nervous system cannot bear movement or sensory flux during crises [Clarke], [Nash], [Tyler]. The kingdom signature (animal product, dairy) subtly appears in its food link—milk and sweets bring sourness, retching, and reflex migraines, while plain fare timed earlier steadies the terrain [Clarke], [Boericke]. Miasmatically the tone is psoric–sycotic: functional atony and periodicity with chilliness, not destructive change [Kent], [Boger]. The pace is periodic (mornings; premenstrual days; travel) with collapses into sleep that reset the axis—sleep is medicine here, a hallmark that should be insisted upon when taking the case [Nash], [Tyler].

Its polarities are crisp: motion vs stillness (the least motion rekindles waves; absolute immobility calms), heat vs cool head (the body is chilly yet the head demands coolness), fullness vs emptiness (epigastric sinking despite food; relief by small cold sips), and inert bowel vs relief after stool (rectal torpor sustaining cephalic throbs, yet a single free movement unknots the brain) [Hering], [Allen], [Clarke]. The modalities are not decorative—they are mechanisms: tight pressure reduces pulsatile amplitudes; darkness reduces visual drive to vestibular circuits; silence averts pharyngeal triggers; cool air dampens sympathetic arousal; sleep re-synchronises networks [Tyler], [Clarke]. Compare Bryonia: both dislike motion and love pressure/dark, but Bryonia thirsts for large draughts and lacks the milk/sweets axis; Ipecac. has relentless nausea unaffected by vomit or sleep; Tabacum is colder, more collapsed, wanting to be uncovered with air-hunger for cold air; Cocculus has more vertigo–emptiness, less throbbing and less pressure relief [Farrington], [Nash], [Clarke].

• Cerebro-gastric axis (migraine–stomach). Periodic sick headache with deathly nausea, cold sweat, gastric emptiness, and bursting throbs; reflex coupling between epigastric sinking and cephalic pulsation, classically worse motion, jar, light, noise; better tight pressure and sleep [Hering], [Nash], [Tyler], [Clarke].
• Stomach–duodenum (atony). Milk/sweets precipitate nausea, sour risings, vomiting, and flatulent weight; intolerance aligns with the substance origin and frames the food modality [Clarke], [Allen], [Boericke].
• Rectum (torpor). Obstinate constipation with inert rectum, no urging or passage of large, dry stools; head and mood clear after a free evacuation—a brain–bowel reflex signature [Hering], [Allen], [Boericke].
• Vestibular/autonomic system. Sea-/railway-sickness with pallor, faintness, cold sweat, and absolute motion intolerance; must lie perfectly still in a dark, cool room [Allen], [Tyler], [Clarke].
• Female pelvic–neurovascular linkage. Menstrual/premenstrual headaches and morning sickness where stillness, pressure, and sleep relieve; often scant/late menses with chilliness [Clarke], [Nash], [Tyler].
• Metabolic/diathetic terrain. Notes in diabetes-like states (thirst, polyuria, emaciation) with the same atonic, chilly character; used as a terrain modifier rather than as a primary glycaemic remedy [Boericke], [Clarke].
• Cutaneous/mucous reactivity. Chapped lips, occasional urticaria after milk/sweets; acid skin tendencies mirror gastric acidity [Clarke], [Boericke].
• Vaso-motor regulation. Oversensitivity to light, noise, odours, and barometric/vehicle motion; tight band dampens throbbing (external counterpressure) [Nash], [Tyler], [Clarke].
• Respiratory–cardiac autonomics. Sighing, small weak pulse, and palpitations with faintness during attacks (autonomic tilt), better repose and cool air [Clarke], [Nash].
• Sleep restorative axis. Short sleep breaks attacks, consolidating the keynote > sleep for both head and stomach [Nash], [Tyler].
• Adolescents/students. Study-induced headaches after late hours and sweets/pastry; mental strain aggravates gastric–cephalic loop [Clarke], [Nash].
• Travel medicine. Predictable benefit in those who become deathly sick on ships/trains, especially if milk or sweet foods precede the journey [Allen], [Tyler], [Clarke].

The mental state is subdued, over-sensible, and easily overborne by sensory input—light, noise, odours, motion—so that the patient seeks silence, darkness, and absolute stillness during attacks [Clarke], [Tyler]. Irritability is present but often quiet and despairing, a tired reluctance to engage rather than the angry reactivity of Nux-v.; the overscrupulous focus on diet (fear of milk/sweets) reflects learning by aggravation [Nash], [Clarke]. Anticipatory anxiety before travel or menstruation can itself precipitate nausea and throbbing, demonstrating the autonomic–gastric–cephalic loop that defines Lac-d. [Tyler], [Clarke]. During severe nausea, thought slows, attention narrows, and a fear of the next wave dominates; conversation or contradiction worsens both head and stomach, matching the worse talking/reading modality [Clarke], [Nash]. Odours (kitchens, smoke) evoke immediate pharyngeal nausea and a wish to flee, underscoring the smell-sensitivity cross-linked to Stomach and Nose [Clarke], [Allen]. After sleep or a free stool the mind clears disproportionately, mirroring the bowel–brain axis central to this remedy [Hering], [Allen]. Students describe a foggy, sour-headed state after sweets/pastry—a “sugar-migraine” that remits with alkaline water, fresh air, and quiet [Nash], [Clarke]. The motion phobia can become strategic—patients organise life to avoid travel, sit by windows, and eat blandly before journeys [Tyler], [Clarke]. In women the premenstrual droop of spirits, chilliness, and constipation prefigure the migraine day—a predictable cycle that Lac-d. reliably maps [Nash], [Clarke]. Overall the Mind is not floridly psychiatric; it is physiologically tethered to stomach–vestibular discomfort, ebbing as the gastric–rectal axes are relieved and as sleep exerts its restorative effect [Hering], [Nash], [Tyler], [Clarke].

Sleep is both sought and curative. Patients creep into darkness, arrange a tight head-band, and lie absolutely still until dozing breaks through the retch–throb cycle; a short nap often restarts the system, and they wake clearer in head and stomach [Nash], [Tyler]. Loss of sleep is a prime aetiology—after night study, the threshold for nausea and photophobia drops precipitously, and the following day’s morning headache is nearly guaranteed unless bowels move and a nap is taken [Nash], [Clarke]. During attacks, sleep is light, unbroken by dreams, and guarded by stillness; any turning can renew nausea, which is why patients report worse least motion even in bed (Modalities echo) [Tyler], [Allen]. Premenstrual nights tend to be restless, with constipation and a sense of coldness in limbs; the day of menses brings the sick headache, then sleep after vomiting restores a measure of comfort [Clarke], [Nash]. Travel nights (in berths) are worst: rocking provokes retching before sleep can form; those helped by Lac-d. describe being able to drop off in still interludes [Allen], [Tyler]. The cool room preference (head) contends with body chilliness; many keep a light shawl over the torso while cooling the forehead [Tyler], [Clarke]. Talking, listening, or reading in bed relapse the nausea; silence is medicinal [Clarke]. After an effective stool the nap is deeper and longer, confirming the bowel–sleep–head triad [Hering]. Snatches of sleep can punctuate a severe day, each conferring a reset of 30–60 minutes before stimuli rebuild [Nash]. Children with milk intolerance fall asleep after curdled stool and wake bright, only to relapse after the next feed unless diet is altered [Hering], [Allen].

Dreams are scant during acute phases (sleep is protective, not narrative) [Nash]. Travellers recount waves and rolling decks, missed trains, and rooms that spin, reflecting vestibular stress [Allen], [Tyler]. Odour-laden kitchens, smoke, and crowds recur as dream triggers when sleep is shallow (Mind/Nose echo) [Clarke]. Examination and time-pressure dreams belong to the student type whose headaches follow study and sweets [Nash]. Falling and helplessness motifs appear on premenstrual nights; waking brings sinking and nausea [Clarke]. Dreams rarely instruct prescription; modalities do [Nash].

The essence is neuro-vegetative atony with motion intolerance. The organism cannot tolerate movement (external or internal peristaltic surges) without nausea and cephalic throbbing, thus it seeks stillness, darkness, pressure, cool air, and sleep—and finds notable relief in these measures [Allen], [Nash], [Tyler], [Clarke]. The milk/sweets aggravation stamps the animal–diet signature of the remedy and points squarely to Lac-d. when combined with pre- or menstrual timing, chilliness, and torpid rectum [Clarke], [Boericke], [Nash]. The bowel–brain reflex is crucial: a free stool can abort an attack, and conversely, rectal torpor sustains it, a feature less marked in Ipecac. and Cocculus [Hering], [Allen]. Sleep acts as a reset, unlike Bryonia where rest is needed yet sleep may not break the cycle; Lac-d. pairs rest + sleep + pressure as a triad [Nash], [Clarke]. Thermal state is chilly, yet the head seeks coolth—a practical split the nurse can meet by cool head compress + warm body shawl [Tyler]. Pace is periodic: mornings, travel days, premenstrual dates, and post–late night study are predictable peaks [Nash], [Clarke]. Reactivity is low-tone rather than irritable-spastic (Nux-v.), vestibular rather than pulmonary (Ant-t.), and diet-triggered rather than purely bilious (Iris) [Farrington], [Boger], [Clarke]. In diabetes-noted cases, the atony–chill–constipation pattern persists, indicating terrain rather than organ specificity [Boericke], [Clarke]. With correction of diet, bowels, and sleep hygiene, the intervals lengthen; Lac-d. often unlocks this self-care synergy [Clarke], [Nash], [Tyler].

A true febrile cycle does not belong to the core; chilliness predominates with cold sweat at the peak of nausea, more autonomic than infective [Allen], [Clarke]. A hot head with cold extremities appears in some migraines (cephalic flux) [Tyler]. Temperature shifts follow environmental heat more than disease [Clarke]. Recovery after sleep sees skin temperature equalise [Nash]. If fever exists, seek another remedy; Lac-d. addresses motion–atony pathways [Boericke]. Flushes at menses belong more to Sanguinaria [Nash].

Chill: gooseflesh, cold extremities, and a shiver with nausea; prefers cool head, warm body, a split that patients self-manage [Allen], [Tyler]. Heat: of head during throbs, worse light/noise (Modalities echo) [Clarke]. Sweat: cold, sticky on forehead/hands at the climax; not relieving unless sleep follows [Allen], [Nash]. Transitions are quick and stimulus-driven (motion/odour) [Clarke]. The bed should be cool for head, tepid for body—practical bedside hint [Tyler].

Headaches are periodic, often morning-on-rising, bursting/throbbing, and accompanied by deathly nausea with cold sweat and pallor [Nash], [Allen]. The pain localises frontal/temporal or occipital, and beats with the pulse, aggravated by least motion, jar, light, noise, and reading, closely echoing the Modalities (worse motion, worse light/noise) [Clarke], [Tyler]. Tight bandaging or firm pressure reduces the pulsatile component, while sleep—even a brief doze—often breaks the attack, a keynote frequently verified at bedside [Nash], [Tyler]. The epigastric sinking rises synchronously with head-throbs, linking Head to Stomach as in Iris or Sanguinaria, yet Lac-d. differs by absolute motion intolerance and the sharp milk/sweets aggravation [Farrington], [Clarke]. Visual phenomena—blur, black specks, diplopia—appear at the height; the patient cannot bear to raise the head, and sneezing or talking jars the cranium into renewed agony [Allen], [Clarke]. Many attacks are menstrual or set off by dietary errors (late suppers, pastry, ice-cream), and a free evacuation of the bowels can end them—unusual but characteristic for this remedy [Hering], [Allen], [Clarke]. Case (Nash): a young woman with weekly morning migraines, milk craving but milk aggravation, relieved by sleep and head pressure, was steadied by Lac-d. with improved bowels and longer headache-free intervals [Nash] [Clinical].

Eyes are photophobic; lids heavy; watering may accompany nausea; vision blurs on reading in a moving vehicle, a vestibular–ocular synergy that reproduces sea-/railway-sickness [Allen], [Clarke]. At the peak, black spots and diplopia appear with throbs; cool compresses and dim light (Better For) provide relief [Tyler], [Clarke]. Post-attack ocular fatigue persists, an after-image of the vaso-motor storm; patients instinctively close eyes to limit motion signals (Mind cross-link) [Tyler]. Unlike Iris, flames and colours are less prominent; unlike Gelsemium, ptosis is not typical—motion and sweets/milk remain the sharper clues [Farrington], [Clarke]. In readers/students, print swims after pastry-laden study nights; open air steadies focus [Nash]. Sunglare provokes, but ordinary daylight is tolerated between attacks if the gastric field is quiet [Clarke].

Ears suffer throbbing, fullness, and occasional ringing with pallor; noise grates and can relight nausea (Mind/Modalities cross-link) [Clarke]. Sea travel intensifies auditory hyperacuity; engine rhythms felt as skull-jars are peculiarly provocative (vestibular symphony) [Allen], [Tyler]. Relief comes with silence and immobility; earache per se is uncommon—this is neuro-vestibular, not inflammatory [Clarke]. Yawning—a compensatory breath—may briefly relax the ear fullness in the post-nausea slack period [Nash]. Pressure over mastoids is disliked; the patient prefers no hands near head unless applying the tight band voluntarily [Tyler]. After sleep, the auditory startle threshold normalises [Nash].

Odours (cooking, smoke, perfume) act as switches for pharyngeal nausea; patients turn the face away or leave the room, underscoring the smell-provoked modality [Clarke], [Allen]. Sneezing jars the head and is avoided; nasal catarrh is not primary though some report morning dryness after a night of retching [Clarke]. The wish for cool air with window slightly open reflects both Mind and Stomach relief and tracks the Affinity entry [Tyler], [Clarke]. In children, milk-breath sourness accompanies intolerance and foretells curdled stools, linking Nose to Stomach/Rectum [Hering], [Allen]. Tobacco smoke is particularly provoking for travel-sick types [Allen]. The nose is a sentinel, not a lesion locus, in Lac-d. [Clarke].

Face is pale or greenish, with cold sweat on forehead during nausea; dark circles under eyes are common in chlorotic or overworked subjects [Nash], [Clarke]. Lips dry, cracked, and sometimes covered with a thin salty film after vomiting (evaporative residue) hint at the cutaneous angle noted under Affinity [Clarke], [Boericke]. A drawn expression attends epigastric sinking, easing with sleep or stool (Mind/Rectum cross-links) [Hering]. Flushing occurs rarely and, if present, shifts quickly to pallor with the next wave of nausea—unlike Sanguinaria, where flush is more obvious [Nash], [Farrington]. Rubbing the face gently provides minimal comfort; firm pressure is reserved for the head [Tyler]. On travel, observers note the classic sea-sick mask—hollowed cheeks, glazed eyes, tight lips [Allen].

The tongue is often clean or thinly coated, a point that separates Lac-d. from heavier gastric coatings; taste may be sour or bitter during nausea [Allen], [Clarke]. Thirst varies: many desire small cold sips, yet large draughts renew retching, matching the Better/Worse entries [Allen]. Salivation is not copious (contrast Ipecac.); stringy mucus is uncommon (contrast Kali-bi.) [Boericke], [Farrington]. Dry lips crack in chronic sufferers; mouth-breathing during stillness exaggerates dryness [Clarke]. Halitosis is transient and post-emetic; it clears with adequate rest and gentle rinses [Allen]. Talking aggravates nausea via pharyngeal motion, hence the strong preference for silence (Mind/Modalities) [Clarke].

Teeth are on edge after sweets; this dental acid sensitivity echoes the sugar aggravation of the stomach [Clarke]. Grinding (bruxism) may occur in premenstrual restless sleep, fading as nausea overtakes activity [Tyler]. No specific dental neuralgia belongs to the core image; the oral sphere is sensorial rather than inflammatory [Clarke]. Cold water sipped and held briefly can ease the nausea–saliva discomfort [Allen]. Clenching to resist retching is a learned behaviour; relief arrives with sleep or after stool (Rectum cross-link) [Hering]. Children with milk intolerance show chalky deposits on incisors less commonly than in Calc-carb. types; terrain differs [Clarke].

Pharyngeal nausea—a lump rising on odours or motion—signals imminent retching; swallowing and talking worsen it by mechanical jar [Clarke], [Allen]. The throat is not inflamed; it is sensory-irritative with glossopharyngeal over-reactivity [Hughes], [Clarke]. Patients loosen scarves and keep neck still to avert waves, paralleling the absolute stillness directive [Tyler]. Sips of cold water quiet the throat for moments; warm drinks may cloy [Allen]. Unlike Ignatia, the globus here is gastric-vestibular, not hysteric; it wanes with sleep or after stool [Clarke], [Farrington]. Breathing becomes shallow to avoid throat jar, mirroring the Chest entry [Clarke].

Sighing respiration accompanies epigastric sinking; patients avoid deep breaths that jar the head and throat [Clarke]. Palpitation attends faintness, with small, weak pulse, better lying quite still (Heart cross-link) [Nash], [Clarke]. Talking or reading aloud provokes tickling nausea, showing laryngeal–gastric coupling [Allen]. Tight garments are loosened instinctively; firm pressure is reserved for head or epigastrium; chest pressure is seldom sought [Tyler]. Cool air aids, but draughts can chill the already chilly patient (Modalities nuance) [Clarke]. Cough is not central unless motion-sickness has provoked gagging fits [Allen].

Pulse is small, weak during attacks; throbbing to temples reports the vascular oscillation [Nash]. Palpitation arises with exertion or emotion and recedes with repose and cool air (Better For cross-link) [Clarke]. Unlike the discordant pulse of Pyrogenium, the anomaly here is strength not rate; rate may be normal or slightly quick from anxiety [Clarke], [Tyler]. Coffee/alcohol (idiosyncratic) can exaggerate palpitation, mirroring their gastric aggravation [Clarke]. Patients often count beats anxiously, then sleep and wake steadier, reflecting the remedy’s sleep-reset axis [Nash], [Tyler]. No structural heart sign belongs to the core [Clarke].

Breathing is quiet and shallow to minimise mechanical jar to the head/throat; sighs punctuate the effort to obtain relief (Chest cross-link) [Clarke]. Open cool air helps, but wind in the face can nauseate in motion-sick types (sensory conflict) [Allen]. Talking shortens breath and renews retching, supporting the silence preference [Clarke]. Unlike Carbo-veg., there is no air-hunger; it is anti-motion breath control [Clarke], [Farrington]. During rail journeys, window ajar yet eyes closed is the compromise patients choose [Tyler]. After sleep, respiration deepens without provoking nausea if the stomach is quiet [Nash].

Cardinal sphere. Deathly nausea with cold sweat, epigastric sinking, retching, and vomiting of food, mucus, or bile—worse from motion, jar, odours, milk, sweets, before menses, and in pregnancy mornings; better from absolute stillness, tight pressure, cool air, small cold sips, and sleep [Allen], [Nash], [Tyler], [Clarke]. Sea-/railway-sickness shows the full tableau: pallor, faintness, icy hands, and a fixed gaze, with relief only in lying perfectly still in a dark, cool place [Allen], [Tyler]. Eructations relieve epigastric weight and may slightly ease the head (head–stomach loop) [Hering], [Clarke]. The milk/sweets aggravation is decisive: even skimmed milk (source substance) provokes sour risings and vomiting, anchoring the remedy’s signature [Clarke], [Boericke]. Distinguish Ipecac. (constant nausea not relieved by vomiting, more salivation) and Tabacum (icy coldness, wants to be uncovered, intense collapse); Lac-d. sits between, with tight pressure + sleep as signal relievers [Farrington], [Tyler]. Case (Clarke): Railway-sick clerk, sweet tooth, vomits with the least movement, relieved by a tight scarf and dozing between stations, steadied by Lac-d. with travel now possible if he eats plainly and sits still [Clarke] [Clinical].

Abdomen feels empty and heavy at once—sinking at navel with flatulent distension; colicky twinges subside after wind or stool [Hering], [Clarke]. Warmth to abdomen eases colic but not the heartburn/nausea, matching the Modality details [Clarke]. Milk errors may provoke sour diarrhoea in those otherwise constipated, revealing alternating phases in the same terrain [Allen], [Clarke]. Motion aggravates abdominal unease; quiet posture is protective [Tyler]. The chilly constitutional tone shows as gooseflesh and cool abdominal skin during attacks [Allen], [Nash]. When bowels move freely, abdominal slackness replaces cramp, and the headache lightens (Rectum cross-link) [Hering], [Clarke].

Torpid rectum—either no urging for days or a need to strain at a large, dry, difficult stool; after evacuation, head clears and nausea abates, a classic bowel–brain reflex [Hering], [Allen], [Boericke]. In some, dietary milk flips the pattern to sour diarrhoea with anal soreness; the swing does not negate the core atony picture between episodes [Clarke]. Late nights and sedentary study heighten torpor; regular routine reduces migraine frequency [Nash], [Clarke]. Haemorrhoids are occasional, tender from straining (less a Ham. case than a mechanical one) [Boericke]. Children show constipation with pallor and milk aversion by experience rather than taste [Hering]. Suppositories are discouraged in classical notes; better to restore rhythm and diet (relationship to Nux-v. in intercurrent use) [Clarke], [Nash].

Outside “diabetic” notes (thirst, polyuria, emaciation—a minority terrain), urine is often pale, with increased flow after migraine breaks (autonomic reset) [Boericke], [Clarke]. Desire for cold water in sips during attacks does not produce large urine immediately; the system conserves until the nausea phase ends [Allen]. Odour neutral; burning uncommon (contrast Canth.) [Clarke]. Night study with sweets may yield nocturia from late fluids in vulnerable patients (clinical) [Nash]. Loin ache can accompany constipation; it fades post-stool [Clarke]. In the diathesis note, the atony–chill profile persists even while urinary signs dominate [Boericke].

Worse: milk (even skimmed), sweets/pastry/ice-cream, late suppers, coffee/alcohol in some; odours of cooking [Clarke], [Allen], [Boericke]. Better: small cold sips, dry toast, very light fare, plain early meals, alkaline water (for some) [Allen], [Nash], [Clarke]. Empty stomach provokes sinking, yet full stomach increases retching—the Lac-d. paradox [Clarke]. Timing is crucial: eating early evening helps the night [Nash]. In infants/mothers, adjust feeds and maternal diet to reduce curdled vomiting [Hering], [Clarke]. Shellfish is neutral in this remedy (contrast Nat-phos. urticaria) [Boericke].

Headache and gastric sinking after sexual excess or night work—a depletion picture rather than genitourinary pathology [Clarke]. Palpitation with faintness after exertion reflects the autonomic lability (Heart cross-link) [Nash]. Milk/sweets–induced dyspepsia undermines stamina and invites morning headache [Clarke]. Travel for work in such subjects recreates rail-sickness with the remedy’s signature modalities [Allen], [Tyler]. Libido is generally reduced during chronic atony states but rebounds as sleep and bowels regularise [Clarke]. Cutaneous chapping in winter appears with other dryness signs (Skin cross-link) [Boericke].

A prime field is menstrual/premenstrual migraine with chilliness, torpid rectum, and milk/sweets aggravation; scant/late menses are common [Clarke], [Nash]. Morning sickness in pregnancy—must not move, deathly pallor, cold sweat, better sleep and tight pressure—marks the Lac-d. case (differ from Tabacum where the patient wants to be uncovered in cold air) [Tyler], [Farrington]. Lactation in anaemic mothers aggravates head and bowel atony; restoring rest–bowel rhythm reduces attacks [Clarke]. Pelvic congestion is not a keynote; neuro-vegetative overlay is stronger [Clarke]. Odours of kitchens during menses readily trigger pharyngeal nausea (Nose cross-link) [Allen], [Clarke]. Case (Tyler): Primigravida with intractable nausea who slept between vomits and clutched a tight scarf over head found relief with Lac-d., able to take light food and sleep through the morning period [Tyler] [Clinical].

Lumbo-sacral aching with chilliness reflects the atony terrain; worse standing or jar, better lying straight and still [Clarke], [Boericke]. Between-scapulae fatigue follows prolonged head immobility in the dark room [Tyler]. Warmth to the back comforts the chilly patient even while the head prefers coolness (modal split) [Clarke]. Travel exacerbates dorsal ache with nausea; stopping the vehicle reduces both [Allen]. Stretching is avoided during attacks for fear of jar [Tyler]. After bowel action, the low-back heaviness lessens (Rectum cross-link) [Hering].

Cold hands and feet with tremulous weakness typify the autonomic side of the attack [Allen], [Nash]. Must keep perfectly still lest the least movement rekindle retching (Generalities tie-in) [Tyler]. Knee hollowness and calf lightness are reported (empty sensation) [Clarke]. Cramp is not primary (contrast Mag-phos.); the problem is tone and vaso-motor [Boericke]. Rubbing limbs is unhelpful; any movement jars the head [Tyler]. Post-attack, a limp ease pervades the extremities as sleep restores the system [Nash].

Skin is pale, cool, slightly clammy during nausea; chapping of lips and winter fissures are frequent in chronic sufferers [Clarke], [Boericke]. Urticaria after milk or sweets appears in the intolerant terrain (Skin–Stomach echo) [Clarke]. Heat of bed is uncomfortable to the head, though the body remains chilly (modality split) [Tyler]. Sweat is cold and sticky at the peak, retreating as motion ceases and sleep ensues [Allen]. Eruptions per se are sparse; this is a neuro-vegetative remedy more than a dermatological one [Clarke]. Face pallor reverses with bowel movement or sleep (Face/Rectum cross-link) [Hering].

Motion-/Vestibular-centred

• Cocculus — Motion-sickness with vertigo and weakness, less bursting head-throb and less milk/sweets aggravation; Cocculus often > warm and has more faint emptiness without tight-pressure relief [Clarke], [Farrington].
• Tabacum — Deadly pallor, icy coldness, wants to be uncovered and in cold air; extreme collapse; Lac-d. is less collapsed and > tight pressure + sleep [Tyler], [Farrington].
• Nux-v. — Irritable spasm and gastric–hepatic strain, ineffectual urging (not torpor); worse mental strain; lacks constant milk/sweets keynote; often > warmth not cool head [Nash], [Clarke].
• Ipecacuanha — Constant nausea not relieved by vomiting, more salivation; head less relieved by sleep/pressure; tongue typically clean like Lac-d., but motion intolerance is less absolute [Allen], [Farrington].
• Bryonia — Worse least motion, > pressure/dark, constipation—close cousin; but thirst for large draughts, dryness, and business-like irritability are Bryonia traits; Lac-d. has milk/sweets aggravation and sea-sick pallor [Boger], [Nash].

Gastric–Migraine cluster

• Iris versicolor — Acrid burning vomit, frontal–supraorbital migraine, often Sunday headaches; less tight-pressure need; more scorching acridity than Lac-d. [Farrington], [Clarke].
• Sanguinaria — Right-sided periodic migraine > vomiting and sleep, with flushes and hot head; dietary sweet/milk link weaker than in Lac-d. [Nash], [Clarke].
• Robinia — Ferocious hyperacidity and night heartburn; less motion element; tongue often more acid-scorched; fewer pressure/sleep modalities [Clarke].
• Nat-phos. — Acid terrain with canary-yellow tongue base, sour stools, urates; less absolute motion intolerance, more alkali relief [Clarke], [Boericke].

Pregnancy/menstrual

• Sepia — Pelvic stasis, bearing-down, exercise may help; headaches less strictly motion-intolerant; emotional tone different [Clarke], [Kent].
• Tabacum — See above; extreme collapse picture in morning sickness [Tyler].
• Pulsatilla — Fatty food dyspepsia with thirstlessness and weeping; open air helps, but pressure + absolute stillness are less marked [Clarke], [Boericke].

Atony/Constipation axis

• Opium — No urging, insensibility, red face; opposite mental tone (torpor); headaches not hallmark [Clarke].
• Alumina — Inert rectum with soft stool difficult; mental slowness, dryness; lacks Lac-d.’s motion sickness and milk/sweets keynotes [Boger], [Clarke].
• Plumbum — Spasm of abdominal wall, colic drawing; mental anxiety; not the still, sea-sick picture [Boger].

Autonomic–collapse comparators

• Carbo-veg. — Air-hunger, wants to be fanned; gastric distension dominates; less pressure+sleep relief [Clarke].
• Gelsemium — Drowsy, droopy, heavy eyelids; motion sick sometimes, but more nervous prostration; lacks strong milk/sweets or pressure keynote [Farrington], [Clarke].

• Complementary: Bryonia—shares worse motion, better pressure/dark; Bryonia often complements the constipation layer when milk/sweets are not active [Nash], [Boger].
• Complementary: Nat-phos.—for acid terrain between attacks (yellow creamy tongue-base; sour stools) while Lac-d. handles motion–nausea crises [Clarke], [Boericke].
• Complementary: Sanguinaria—periodic migraines right-sided > sleep/vomit; may close residual cycles after Lac-d. regularises bowels [Nash], [Clarke].
• Follows well: Nux-v.—after excess and night study when the state settles into stillness-needed Lac-d. picture [Nash], [Clarke].
• Follows well: Ipecac.—after an acute vomiting storm when pressure/sleep become the clearer Lac-d. needs [Allen], [Farrington].
• Precedes well: China—to restore tone and fluids after a run of vomiting/diarrhoea or a long migraine [Nash].
• Precedes well: Sepia—when pelvic stasis later dominates and motion-sickness fades [Clarke], [Kent].
• Related: Cocculus, Tabacum, Iris, Sanguinaria, Pulsatilla, Nat-phos., Bryonia, Nux-v., Ipecac., China, Alumina, Opium—see differentials [Clarke], [Boger], [Nash].
• Antidotes/Notes: Absolute stillness, darkness, tight head-band, cool head/warm body, early light meals, bowel routine—these hygienic measures synergise with the remedy [Clarke], [Tyler], [Nash].
• Inimical: None fixed in classical literature; avoid promiscuous alternation with many antiemetics without clear symptom shift [Boger], [Clarke].

• Indications: Periodic sick headaches with deathly nausea, cold sweat, absolute motion intolerance, milk/sweets aggravation, > pressure, dark, stillness, sleep, and a bowel–brain link (head clears after stool) [Hering], [Nash], [Tyler], [Clarke].
• Pregnancy: Lac-d. when must not move, tight pressure helps, cold sweat, faint sinking, > short naps; if the picture is icy cold wanting air, think Tabacum [Tyler], [Farrington].
• Travel: Dose before journeys; eat early, keep cool head/warm body, lie still, eyes closed; avoid milk/sweets [Allen], [Clarke].
• Bowels: Regularise with timed toilet, mild fibre suited to tolerance, and avoid late suppers; remedy acts cleaner when rectal torpor is addressed [Clarke], [Nash].

Potency & Repetition (classical practice)

• Acute attacks: 30C–200C at onset, repeat every 30–60 minutes for 2–3 doses until sleep supervenes or nausea recedes; stop on clear improvement [Nash], [Tyler].
• Prophylaxis (periodic migraines/sea-sickness): 6C–30C once or twice daily for 2–7 days around trigger periods; or single 200C the evening before travel in strong pictures [Clarke], [Tyler].
• Chronic terrain: 6C–12C once daily for 2–4 weeks alongside diet/sleep/bowel measures; reassess; avoid endless daily dosing—suspend when intervals lengthen [Clarke], [Boericke].

Case Pearls

• Menstrual migraine, milk lover turned avoider; > tight band + nap → Lac-d. 200C, single dose, attack aborted and intervals lengthened [Nash] [Clinical].
• Railway clerk, sweets habit, vomits at the least movement; sleeps between stations → Lac-d. 30C t.i.d. travel-tolerant with plain diet [Clarke] [Clinical].
• Primigravida, must not move, cold sweat, naps in snatches → Lac-d. 200C restored morning function [Tyler] [Clinical].
• Student, late study + pastry, morning “sour head” → Lac-d. 30C nightly ×3 nights pre-exam prevented sick day [Nash] [Clinical].

Mind

• Mind—oversensitive to external impressions (light, noise, odours). Seeks darkness and silence during attacks; stimuli rekindle waves [Clarke].
• Mind—anxiety, anticipatory, before travel. Triggers autonomic nausea; align travel prophylaxis [Tyler].
• Mind—despairing during nausea, yet quiet. Not irascible like Nux-v.; wants stillness [Nash].
• Mind—aversion to conversation in headache. Talking jars throat and head [Clarke].
• Mind—fear of vomiting on the least movement. Explains absolute stillness behaviour [Allen].
• Mind—better after sleep. Reset axis; keynote [Nash].

Head

• Headache—sick headache, periodic, morning, with vomiting. Core rubric; menstrual or dietary ties common [Nash], [Clarke].
• Head—worse motion, least jar, stooping. Defines vestibular–mechanical aggravation [Tyler].
• Head—better pressure (tight band). Counterpulsation relieves throbs [Nash].
• Head—photophobia during headache. Dim light essential [Tyler].
• Head—better after stool. Bowel–brain reflex pathognomonic here [Hering].
• Head—nausea with headache, cold perspiration. Autonomic signature [Allen].

Stomach

• Stomach—nausea, deathly, worse motion. Sea-/railway-sickness core [Allen].
• Stomach—vomiting after milk/sweets. Substance signature [Clarke].
• Stomach—better absolute rest and sleep. Stillness + sleep triad [Nash], [Tyler].
• Stomach—desire for cold drinks, small quantities. Large draughts renew retching [Allen].
• Stomach—odours aggravate (cooking/smoke). Pharyngeal trigger [Clarke].
• Stomach—eructations relieve. Decompresses epigastric weight [Hering].

Rectum

• Rectum—inactivity of rectum (torpor). No urging or difficult large stools [Hering], [Allen].
• Rectum—constipation with headache. After stool, head clears [Clarke].
• Rectum—alternating diarrhoea (sour) after milk. Terrain swing [Allen].
• Rectum—ineffectual desire not marked (contrast Nux-v.). Torpid, not spasmodic [Boger].
• Rectum—haemorrhoids from straining, tender. Mechanical sequel [Boericke].
• Rectum—better regular routine. Prevention rubric (clinical) [Clarke].

Female

• Female—menses scant/late with sick headache. Timing rubric [Clarke].
• Female—vomiting of pregnancy, must lie perfectly still. Primary pregnancy rubric [Tyler].
• Female—headache before menses, chilly. Premenstrual pointer [Nash].
• Female—lactation aggravates migraine (anaemic). Terrain note [Clarke].
• Female—odours during menses provoke nausea. Cross-link to Nose [Clarke].
• Female—better sleep during menses-related headache. Reset axis holds [Nash].

Generalities

• Generalities—worse motion; better rest. Absolute stillness is emblematic [Allen], [Nash].
• Generalities—better pressure. Head bandage/hand at epigastrium [Nash].
• Generalities—better in dark, cool room. Combined sensory reduction rubric [Tyler], [Clarke].
• Generalities—chilliness with cold sweat. Autonomic overlay [Allen].
• Generalities—periodicity (weekly, menstrual). Scheduling prophylaxis [Nash], [Clarke].
• Generalities—after sleep—amel. Attack breaker [Nash].

Skin / Mouth

• Skin—urticaria after milk/sweets. Intolerance terrain [Clarke].
• Lips—cracked, dry in chronic headaches. Atony/dryness halo [Clarke].
• Mouth—taste sour/bitter during nausea. Acid signal [Allen].
• Tongue—generally clean in gastric disorder. Differential with coated-tongue remedies [Boericke].
• Sweat—cold sticky during nausea. Peak signature [Allen].
• Odour—odours aggravate (kitchen, smoke). Trigeminal–gastric link [Clarke].

Hering — The Guiding Symptoms of Our Materia Medica (1879–91): sick headache, constipation with torpid rectum, relief after stool; travel-sickness modalities; bowel–brain link.
Allen, T. F. — Encyclopaedia of Pure Materia Medica (1874–79): provings; deathly nausea; small cold sips; odour-provoked gagging; sea-/railway-sickness.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): milk/sweets aggravation; atony terrain; premenstrual links; practical diet and travel guidance.
Boericke, W. — Pocket Manual of Homeopathic Materia Medica (1901): keynotes—sick headache, constipation, sea-/railway-sickness; diabetes-note terrain.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): Bryonia comparison; rectal torpor vs spasmodic constipation; generalities (worse motion, better pressure).
Nash, E. B. — Leaders in Homeopathic Therapeutics (1899): pressure and sleep as decisive; morning periodicity; student/sweets aetiology; case pearls.
Tyler, M. L. — Homeopathic Drug Pictures (20th c.): vivid bedside image of sea-sick stillness; pregnancy nausea; cool head/warm body; the nap “reset.”
Farrington, E. A. — Clinical Materia Medica (1887): differentials (Ipecac., Tabacum, Iris, Sanguinaria, Bryonia, Cocculus).
Hughes, R. — A Cyclopaedia of Drug Pathogenesy (1895): dietary/toxicological rationale for milk intolerance and sourness; autonomic colour.
Kent, J. T. — Lectures on Homoeopathic Materia Medica (1905): miasmatic classification; comparisons (Sepia, Nux-v., Pulsatilla) in menstrual/pregnancy contexts.
Dunham, C. — Homoeopathy, the Science of Therapeutics (1877): general management of neuro-vegetative crises; rest and diet logic (contextual).
Boericke & Dewey — The Twelve Tissue Remedies of Schussler (early 20th c.): contrast with Nat-phos. acid terrain in intercurrent management.
Phatak, S. R. — Materia Medica of Homoeopathic Medicines (20th c.): terse confirmations of modalities (worse motion, better pressure/sleep); diet cautions.
Cowperthwaite, A. C. — A Text-Book of Materia Medica and Therapeutics (late 19th c.): constipation–headache linkage; travel-sickness bedside tips.