Laurocerasus

An evergreen shrub of the Rosaceæ whose leaves and kernels contain cyanogenic glycosides (notably prunasin/amygdalin) which liberate hydrocyanic (prussic) acid under enzymic action. The pharmacology is therefore that of cyanide: sudden respiratory–circulatory failure, muscular convulsion, glottic spasm, coma, and profound cyanosis; lesser doses yield faintness, slow irregular pulse, sighing or gasping breathing, and spasmodic cough with laryngeal tightening [Hughes], [Clarke]. The homœopathic tincture is prepared from the fresh leaves (expressed juice at once fixed with alcohol), or from the pharmacopœial Aqua Laurocerasi; triturations have been made from the dried leaf and kernel [Allen], [Clarke]. Toxicology sets the keynote complexion—blue face, cold sweat, speechless dyspnœa, pulse small or imperceptible—reproduced clinically in cardiac and respiratory collapse states, spasmodic coughs with impending asphyxia, and “blue children” of cardiac disease [Hering], [Allen], [Boericke].

The pathogenesis rests chiefly on [Toxicology]—accidents with laurel-water—and [Clinical] confirmations collated by Hering, Allen and Clarke; fragmentary provings exist. Constant features: threatened asphyxia with gasping, sighing, slow or arrested respiration, cyanosis of face and lips, coldness, faintness, weak, irregular or imperceptible pulse, laryngeal spasm, spasmodic cough ending in exhaustion, aphonia, and collapse, often worse lying and at night, and better by fanning, fresh air, and being propped up [Hering], [Allen], [Clarke], [Boericke], [Boger]. Early [Clinical] verifications include whooping-cough with cyanotic spells, cardiac disease with blue face and gasping, asphyxia of the new-born, spasm of the glottis, and pulmonary œdema facsimiles [Hering], [Clarke], [Farrington].

The essence of Laurocerasus is asphyxial collapse with cyanosis and cardio-respiratory failure of a quiet, almost silent sort. The organism is choked off: respiration sighs, slows, or ceases, glottis locks, the voice fails, the face turns blue, the pulse is small, weak, intermittent, and a cold, clammy sweat breaks out. The patient cannot lie—on falling asleep the breathing stops—and begs for fanning and fresh air to the face, while the body desires warmth. This polarity—cool air to the face, warmth to the trunk—and the extreme sensory economy (handling, questions, cold drinks, the act of swallowing, a startle) that arrest breath reveal a remedy belonging to the Hydrocyanic stream [Hering], [Clarke], [Hughes]. The axis runs Vagus–Heart–Larynx. The vagal brake is over-pulled: slightest stimulus slows or stops action; hence the sinking at epigastrium, the pulse that disappears, the glottis that snaps shut. The venous cast—blue lips, blue fingers, mottled skin—shows blood unsatisfied with air; yet there is not the windy flatulent distress of Carbo-veg., nor the explosive convulsion of Hydrocy-ac.; the Laurocer. crisis is short of breath, short of voice, short of pulse, and short of noise.

Miasmatically, the picture is acute–syphilitic—threatening life by loss of function, not by fever. Pace is nocturnal, paroxysmal; the whooping-cough child becomes blue at the end of the fit; the infant at the nipple turns dusky; the puerperal woman fades with cold sweat; the cardiac sufferer cannot lie for fear the heart will stop. The modalities clinch: worse lying, worse on dropping asleep, worse cold drinks, worse exertion and emotion, worse in warm, close rooms; better being fanned, open window, propped sitting, warm coverings, quiet—and a little improvement when sweat breaks. Micro-comparisons steady prescribing: Antimonium tart. when chest is rattling and expectoration must be raised; Carbo-veg. when venous stagnation and flatulence demand fanning without the laryngeal lock; Hydrocy-ac. for instant respiratory paralysis and convulsions; Ammonium carb. when cyanosis marries intolerance of warm rooms; Opium when breath stops in heavy stupor with stertor rather than in light, watched sleep; Cuprum when spasms and cramps dominate the blue finish. In management, the physician reproduces the ameliorations: air, fanning, quiet, propping, warm wraps, and warm sips—and selects Laurocer. where voice fails, glottis shuts, small pulse trembles, and the very idea of lying down threatens the breath. Cure declares itself when sleep becomes safe, the blue gives way to pallor then warmth, the pulse is felt, and the child can nurse without choking.

• Respiratory centre and vagus—arrested or sighing respiration, tendency to apnœa, glottic spasm; breathing stops on dropping into sleep (see Respiration/Sleep) [Hering], [Allen], [Clarke].
  • Heart and great vessels—small, weak, intermittent pulse, impending syncope; cardiac failure with lividity; precordial emptiness and sinking (see Heart/Generalities) [Hughes], [Clarke], [Boericke].
  • Larynx and trachea—spasmodic, choking cough, voice failing to a whisper; cough paroxysm ends in cyanosis and prostration (see Throat/Chest) [Hering], [Allen].
  • Peripheral circulation—cold, blue extremities, mottled skin, cold sweat; venous stasis (see Skin/Extremities) [Clarke], [Boger].
  • New-born/infant sphere—asphyxia neonatorum, spasm of glottis, “blue children” of cardiac lesions; whooping-cough with failing breath (see Respiration/Chest) [Hering], [Clarke], [Farrington].
  • Lungs—pulmonary œdema tendency; rattling, threatened suffocation with weak heart (see Chest/Respiration) [Hughes], [Boericke].
  • Brain—stupefaction from hypoxia; slow perception; fainting fits; convulsions in poisoning (see Mind/Head) [Allen], [Hering].
  • Digestive tract—sudden sinking at epigastrium; vomiting with asphyxial attacks; swallowing cold drinks aggravates (see Stomach/Abdomen) [Clarke], [Boger].
  • Uterine/parturient—cardiac–respiratory syncope in puerperal states; faintness with cold sweat (see Female/Generalities) [Clarke], [Farrington].
  • Reflex arcs—overshoot to slight stimulus (noise, handling) precipitating breath–heart failure (see Generalities/Modalities) [Hering], [Boger].

The mental state is dominated by asphyxial fear and stupor. There may be great anxiety with dread of suffocation, yet the sufferer quickly passes to indifference, dull comprehension and a far-away look—hypoxic stupefaction which tallies with the cyanotic complexion and small, failing pulse described under Heart and Generalities [Hering], [Clarke]. He cannot bear questions or handling; even a slight start or emotion checks respiration, echoing the modality (worse handling/emotion) already noted [Hering]. Children lift their hands to the throat or clutch the nurse, then sink back, lips blue. Some are placid, heavy, unconcerned amidst danger—a deceptive calm of low oxygen. There is a curious polarity: relief from fanning and fresh air to the face, while the body craves warmth; sitting up brings lucidity, lying down renews the fog (Mind ↔ Respiration/Modalities) [Clarke], [Boericke]. Memory is blurred after paroxysms; despair alternates with apathy. In puerperal faints the woman whispers she is sinking, asks to be fanned, and dares not be moved, the least stir arresting breath—a pattern repeated across this remedy’s crises [Hering], [Clarke].

Terribly characteristic: on falling asleep the breathing stops; the child starts, gasps, clutches; the adult awakes with a fright and blue lips—this tallies with the worse lying, worse after midnight modalities [Hering], [Allen], [Clarke]. Insomnia from fear of suffocation; sleep is only in short, watched snatches; the window must be open; fanning continues. Somnolence with stupor occurs in advanced collapse (Sleep ↔ Mind/Respiration).

Of suffocation, drowning, narrow places; dreams cease as the crises lessen and respiration is steady through sleep—often a therapeutic sign (Dreams ↔ Sleep/Respiration) [Clarke].

Laurocerasus is a cyanotic–collapse remedy: threatened asphyxia, sighing or arrested breathing, blue face and lips, cold, clammy sweat, small, weak, intermittent pulse, and sudden sinking—worse lying, worse at night, worse from cold drinks, exertion, handling, and emotion; better being fanned, fresh air to the face, sitting propped, warm wraps, quiet and rest [Hering], [Allen], [Clarke], [Boericke]. The picture lies between Hydrocyanic acid (more lightning-like convulsion and respiratory paralysis) and Carbo vegetabilis (collapse with flatulence and desperate desire to be fanned); Laurocer. is distinguished by glottic spasm, aphonia, asphyxial cough, and the infantile/puerperal indications with reflex arrest from slightest stimulus [Farrington], [Hughes], [Boger]. In chest failure with pulmonary œdema, Antimonium tart. shares rattling but wants expectoration and has more bronchial flooding; Laurocer. may be drier, more glottic and worse from cold drinks. In whooping-cough with blue finish, compare Cuprum (cramps, spasms, thumbs in palm), Ipecac. (nausea, mucus), Sambucus (night suffocation with dry spasm)—Laurocer. adds weak pulse, aphonia, and need for fanning [Hering], [Farrington]. Direction of cure moves from night arrest to safe sleep, from blue to pallid to warm, from imperceptible pulse to steady beat, with child or adult tolerating lying last.

Little fever; rather chilliness with cold sweat, subnormal temperature in collapse; slight heat of face may follow a paroxysm as air returns [Allen], [Clarke]. Pulse is the guide—small, weak, unsteady.

Chill predominates; cold sweat with frightful oppression; heat scant and transient; sweat marks the turning of a crisis (Chill/Heat/Sweat ↔ Generalities) [Allen], [Boericke].

Vertigo on rising or after coughing; a sinking rush to the head with blackness before eyes; better sitting propped, worse lying back (Head ↔ Modalities) [Allen], [Clarke]. The face is pale at first, then livid or bluish; temples bathed in cold sweat (Head ↔ Fever/Perspiration). Heaviness of occiput; dull frontal pressure as air fails. Congestion is venous—dusky—rather than arterially throbbing; relief comes with deeper air or the breaking of sweat. Hair bristles with chill.

Stare wide or half-lidded; pupils dilated in collapse; conjunctivæ bluish or dusky [Allen], [Clarke]. Vision dims in spells; letters swim; eyes turn upward at the height of choking. Tears scant; photophobia slight. With improvement the gaze steadies as the fanning continues (Eyes ↔ Better for fanning).

Ears cold and bluish; noises in ears synchronous with the small, weak pulse [Clarke]. Sudden sounds precipitate start and breath-stoppage (Ears ↔ Mind/Respiration).

Nostrils widely dilated, winging with dyspnœa; nasal alæ blue; cold tip [Hering], [Clarke]. Air-hunger is visible at the nose; obstruction not primary.

Cyanosis—livid lips, blue nose, leaden hue about the mouth and eyelids; cold, clammy sweat beads on forehead and upper lip [Hering], [Allen], [Clarke]. Jaw slack in stupor; trismus only in severe convulsions (Toxicology). Facial expression is that of impending suffocation; the child turns the head to seek air, which tallies with better fanning/open window (Face ↔ Modalities).

Voice fails to a whisper; aphonia in cough-spells; tongue cold, sometimes protruded and bluish; mouth dry or filled with frothy saliva during choking [Hering], [Allen]. Speech itself exhausts breath and renews the cough (Mouth ↔ Throat/Respiration). Taste bitter after paroxysm; desire for warm sips.

Teeth clenched during convulsive twitchings in poisoning; otherwise no standing dental picture [Allen]. Grinding in children at the height of a choking spasm may occur.

Glottic spasm—as if the throat closed; cannot get air, especially after swallowing cold water (echoing Worse for cold drinks) [Clarke], [Boger]. Fauces dry or numb; tickle trivial compared with constriction. Tight collars intolerable; patient tears open clothing (Throat ↔ Generalities/Modalities).

Oppression as of a weight upon the chest; spasmodic cough ending in threatened suffocation; voice fails; cannot bear to lie down; head forward, elbows on knees, begs for air [Hering], [Clarke], [Boericke]. Rattling suggests œdema when the heart is weak; in other cases the chest is dry but the glottis locks, the face turns blue, and the patient is near apnœa (Chest ↔ Larynx/Respiration). The child in whooping-cough becomes livid, gasps and collapses at the close of a bout; Laurocer. will often break the “blue finish,” this tallying with the affinity for infants. Tight clothing at chest aggravates.

Pulse small, weak, intermittent or imperceptible; præcordial emptiness, sinking; impending syncope and cold sweat [Hughes], [Clarke], [Boericke]. Palpitation is less than failure; there may be irregular action that stops on slight motion or emotion (Heart ↔ Modalities). Cyanosis accompanies—especially in congenital heart disease or valvular failure with venous stasis. The patient feels as if the heart would cease if he lies down; sitting up steadies action. Pressure with the hand sometimes comforts (reflex).

Cardinal: sighing, gasping, retarded respiration, or sudden arrest—breathing stops on dropping asleep; must be fanned; open window indispensable [Hering], [Allen], [Clarke]. Swallowing cold water precipitates choking; exertion, speaking, crying bring on asphyxial spells (Respiration ↔ Modalities). In infants, the nipple in the mouth may trigger a blue spell; in whooping-cough, the close of the paroxysm is the dangerous moment. A peculiar silent pause—no effort—then a deep catching breath—marks Laurocer.

Sudden sinking at epigastrium (vagal), premonitory of faint; nausea during spells; eructations give slight relief (Stomach ↔ Generalities) [Clarke]. Aversion to cold food and drink; warm things are better. Vomiting may follow a cough paroxysm, after which breathing is freer for a time.

Anxious griping across the epigastrium with dyspnœa; abdomen drawn in during inspiratory efforts. Flatus retained during spells; after crisis, soft stool or eructation gives momentary ease (Abdomen ↔ Respiration).

Stool suppressed during attacks; flaccid sphincter in profound collapse; involuntary stool only in toxic convulsions [Allen]. After relief, a loose stool may follow with sweat and prostration.

Urine scanty during crises; later increased and pale as circulation recovers [Clarke]. In children, transient incontinence may attend a whooping-fit at its height (spasm). No burning.

Aversion to cold things; cold drinks aggravate by provoking laryngeal closure; warm sips soothe (Food ↔ Throat/Stomach) [Clarke], [Boger]. Appetite absent in crises; afterward desire for warm broth.

Sexual sphere not central; a fainting swoop may follow coitus in the weak-hearted, with blue lips and gasping—a Laurocer. indication when small pulse, cold sweat and need to be fanned co-exist (Male ↔ Heart/Generalities) [Clarke].

In puerperal states: sudden syncope with cold sweat, blue lips, sighing or arrested respiration; must be fanned, cannot lie; least handling increases faintness (Female ↔ Generalities/Modalities) [Clarke], [Farrington]. Menses may cease during prolonged asphyxial illness.

Coldness between scapulæ; dorsal aching from propping posture; drawing pains from sternum through to back at each abortive inspiration (Back ↔ Chest) [Clarke]. Loin weakness after paroxysm from exhaustion.

Cold, blue hands and feet; nails livid; fingers tremble; the child throws the arms up during choking (Extremities ↔ Respiration) [Hering], [Clarke]. Cramps in calves in the chilly stage; legs powerless rising from faint. Slight exertion renews the sinking.

Cyanosed, mottled; cold, clammy sweat on face and chest; skin insensible in deep collapse [Allen], [Clarke]. Urtication not typical; the cutaneous story is venous stasis.

Aetiology / Collapse–asphyxia

• Hydrocyanic acid: fulminant convulsion, instant cardiac–respiratory paralysis; fewer cough/aphonia signs; more glottic and infantile; both cyanotic [Allen], [Clarke].
• Carbo-veg.: collapse, wants to be fanned, belching, flatulence; less glottic spasm; more worse lying with aphonia and cold drinks aggravation [Clarke], [Boericke].
• Camphora: icy collapse with spasms but not the cough–glottic picture; anchored in the chest and larynx [Allen].

Chest failure / œdema / rattling

• Antimonium tart.: loud rattling, drowsy, wants to be carried; cyanotic; drier, weaker pulse, glottic closure; worse cold drinks [Hering], [Farrington].
• Ammonium carb.: cyanosis, cannot breathe in warm rooms; lividity, nosebleed; needs fanning yet warmth to body; glottic spasm prominent [Clarke].
• : spasmodic cough with nausea, much mucus, clean tongue; cyanosis less profound; Laurocer. aphonic, faint, small pulse [Farrington].

Whooping-cough—blue finish

• Cuprum: violent spasms, convulsions, thumbs in palm, cramps; weaker pulse, more silent pause, aphonia [Hering].
• Sambucus: night suffocation of children with dry spasm; less cyanosis; more collapse and need of fanning [Boericke].
• Drosera: incessant paroxysms, retching; not the asphyxial syncope of Laurocer. [Clarke].

Cardiac failure / small pulse

• Digitalis: slow, intermittent pulse, fear to move lest heart stop; less glottic spasm; cyanosis with arrested breathing [Clarke], [Boger].
• Cactus: iron band constriction, venous stasis; pains prominent; more aphonia, asphyxial spells [Farrington].
• Naja: cardiac pains with throat moral depression; less collapse; more blue, small pulse [Clarke].

Sleep–respiration arrest

• Opium: stertorous, congested stupor; insensibility, contracted pupils; wakeful fear, stopping breath on falling asleep with small pulse [Allen], [Clarke].
• Lachesis: worse after sleep, left-sided, talkative; silent, blue, wants fanning (polarity) [Kent].

• Complementary: Digitalis—both small, failing pulse; Digitalis for persistent myocardial weakness after Laurocer. has lifted the asphyxial spells [Clarke], [Boger].
• Complementary: Antimonium tart.—when pulmonary œdema/rattling follows Laurocer.’s glottic spells; sequence often needed in threatened suffocation [Hering], [Farrington].
• Complementary: Carbo-veg.—shared collapse and need of air; Carbo-veg. in flatulent, venous stagnation states beyond Laurocer.’s reach [Clarke].
• Follows well: Ipecac.—after mucus/nausea phase, if blue finish with small pulse remains [Farrington].
• Follows well: Aconite—when panic subsides to cyanotic failure with sighing respiration [Clarke].
• Precedes well: Hydrocy-ac.—if convulsive apnœa persists despite relief of glottic spasm; escalate to more fulminant picture [Allen].
• Related: Am-c., Cupr., Samb., Drosera, Opium, Camph., Naja, Cactus—see differentials.
• Antidotes (states): Fresh air, fanning, warm wraps; medicinally Camph. in chill-collapse; Carbo-veg. when venous stasis predominates [Clarke], [Allen].
• Inimicals: None recorded; avoid alternation without new totality [Kent].

• Whooping-cough with “blue finish”—paroxysm ends in aphonia, blue face, small pulse, must be fanned; Laurocer. 6C–30C in short intervals, lengthen as spells lessen [Hering], [Farrington], [Clarke].
• Asphyxia neonatorum / spasm of glottis in infants—dusky baby, gasps, breathing stops on dropping asleep; propped position, fresh air + Laurocer.; follow with Ant-t. if rattling ensues [Hering], [Boericke].
• Cardiac failure facies—cannot lie, blue lips, cold sweat, pulse imperceptible; Laurocer. with Digitalis support as indicated; maintain quiet, warm wraps, fanning [Clarke], [Boger].
• Dysphagia for cold water—cold drinks bring on choking with blue lips in laryngeal-nervous subjects; a small keynote that often decides [Clarke], [Boger].

Mind
• Anxiety—fear of suffocation; begs for air; yet sinks into stupor—choose when cyanosis and small pulse co-exist. [Hering], [Clarke].
• Ailments from fright/startle—breath checked; reflex apnœa. [Hering].
• Aversion to being questioned/handled—handling worsens breath. [Hering].
• Indifference/torpor during danger—hypoxic stupor; deceptive calm. [Allen], [Clarke].
• Better—quiet, fresh air, being fanned—indispensable prescribing cue. [Clarke], [Boericke].
• Despair alternating apathy in paroxysms—course of crises. [Clarke].

Head / Face
• Face—cyanosis, lips blue; cold sweat on forehead—collapse picture. [Allen], [Clarke].
• Vertigo—on rising; blackness before eyes; better sitting up. [Allen].
• Head—venous congestion; dusky; not throbbing—venous cast guides away from Acon. [Clarke].
• Jaw slack; aphonia during spells—glottic–laryngeal tie-in. [Hering].
• Nose/alar—winging, alæ blue—air hunger sign. [Hering], [Clarke].
• Ears cold/blue; noise startles → breath arrest—avoid stimulus. [Clarke], [Hering].

Throat / Larynx / Respiration
• Glottis—spasm; cannot breathe; especially after cold drinks. Keynote. [Clarke], [Boger].
• Aphonia during cough paroxysms; voice fails to whisper. [Hering], [Allen].
• Respiration arrests on falling asleep; must be roused/fanned. Signature. [Hering], [Allen].
• Dyspnœa—worse lying, worse warm room; better open window. [Clarke], [Boericke].
• Sighing, gasping, retarded respirations—vagal brake pattern. [Clarke].
• Whooping-cough—blue finish, small pulse. [Hering], [Farrington].

Chest / Heart
• Cannot lie down—suffocation on recumbency. [Hering], [Clarke].
• Pulse intermittent, imperceptible, weak; impending syncope. [Clarke], [Boericke].
• Oppression—weight on chest; better being fanned/pressure. [Clarke], [Boger].
• Cardiac failure with cyanosis—pallor → lividity; cold sweat. [Clarke].
• Tight clothing aggravates chest—remove constriction. [Boericke].
• Exertion/speaking arrests breath; jarring renews oppression. [Hering], [Clarke].

Sleep
• Breathing stops on dropping asleep—must be watched. Cardinal. [Hering], [Allen].
• Cannot sleep lying; must be propped. [Clarke].
• Night aggravation (after midnight); long spells. [Clarke].
• Dreams of suffocation/drowning; wakes gasping. [Clarke].
• Somnolence with stupor in collapse—danger sign. [Allen].
• Better—window open; fanning continued through sleep. [Boericke].

Generalities / Modalities
• Worse—lying, after midnight, handling, emotion, cold drinks, warm close rooms, exertion. Modality cluster. [Hering], [Clarke], [Boger].
• Better—being fanned, fresh air, sitting propped, warm wraps, quiet. Prescribing cluster. [Clarke], [Boericke].
• Cold, clammy sweat with faintness—collapse stamp. [Allen], [Clarke].
• Sinking at epigastrium—vagal sign in faints. [Clarke].
• Cyanosis of extremities; nails blue—venous stasis rubric. [Clarke].
• Reflex apnœa from swallowing cold water—small deciding keynote. [Boger].

Infant / Puerperal
• Asphyxia neonatorum; gasps; must be fanned; blue. [Hering], [Clarke].
• Spasm of glottis—nipple in mouth triggers choking. [Hering].
• Puerperal syncope—blue lips, cold sweat; propped posture. [Clarke], [Farrington].
• Whooping-cough of infants—blue finish, aphonia. [Hering].
• Cannot bear warm, close nursery—open window essential. [Boericke].
• Better—warm body, cool face air—polarity guiding. [Clarke].

Allen, T. F. — Encyclopædia of Pure Materia Medica (1874–1879): toxicology/clinical—cyanosis, arrested respiration on sleep, aphonia, small pulse.
Hering, C. — The Guiding Symptoms of Our Materia Medica (1879–1891): confirmations—whooping-cough blue finish, glottic spasm, infant/puerperal collapse; modalities.
Clarke, J. H. — A Dictionary of Practical Materia Medica (1900): full portrait—laurel-water pharmacology, fanning/open-air amelioration, cold drinks aggravation, heart–lung failure.
Hughes, R. — A Manual of Pharmacodynamics (late 19th c.): cyanogenic chemistry of Laurocerasus; respiratory–cardiac toxicology; clinical analogies.
Boericke, W. — Pocket Manual of Homœopathic Materia Medica (1901): keynotes—collapse, cyanosis, whooping-cough spells, better air/fanning, worse lying.
Boger, C. M. — Synoptic Key of the Materia Medica (1915): generalities—reflex arrest, cold drinks aggravate, quiet/pressure/fanning ameliorations; comparisons.
Farrington, E. A. — Clinical Materia Medica (1890): respiratory–cardiac remedies—Hydrocy-ac., Ant-t., Carbo-veg.; infant and puerperal indications.
Kent, J. T. — Lectures on Homœopathic Materia Medica (1905): philosophical differentials—Opium vs. Laurocer. (sleep–breath arrest), Am-c., Carbo-veg. collapse.
Nash, E. B. — Leaders in Homœopathic Therapeutics (1899): collapse therapeutics; remedy sequencing around asphyxial states.
Dewey, W. A. — Practical Homœopathic Therapeutics (early 20th c.): whooping-cough and suffocative catarrhs; bedside regimen (air, posture).
Lippe, A. von — Keynotes and Characteristics with Comparisons (late 19th c.): selecting signs—blue face, imperceptible pulse, better fanning.
Tyler, M. L. — Homœopathic Drug Pictures (20th c.): clinical vignettes—blue babies, glottic spasm, the “cool face, warm body” polarity.